![]() ![]() The significant changes in DSM-5 include the change in nomenclature from “paraphilia” to “paraphilic disorder.” DSM-5 also introduced specifier terms such as “in remission,” and clarification between behavior and paraphilias. DSM-IV-TR moved transvestism from a disorder of gender identity to a paraphilia called transvestic fetishism. DSM-IV maintained the diagnostic classification of paraphilias. The paraphilias were classified as psychosexual disorders, which included gender identity disorder, psychosexual dysfunctions, and ego-dystonic homosexuality. The term paraphilias was introduced in DSM-III. DSM-II defined sexual deviations in a broad category as “personality disorders and certain other nonpsychotic mental disorders.” DSM-II sexual deviations included sexual orientation disturbance (homosexuality), fetishism, pedophilia, transvestism, exhibitionism, voyeurism, sadism, masochism, and “other sexual deviation.” Psychiatrists can serve a pivotal role in reducing sexual offender recidivism by treating individuals with paraphilic disorders.ĭSM originally characterized sexual deviations with psychopathic personality disorders based on the belief that sexual deviations were criminal acts, and thereby those individuals who engaged in sexual deviations were unlawful or psychopathic. In the past few decades, research on sexual offenders has shown that those with paraphilic disorders are at high risk for committing future sexual offenses. ![]() As a result, there are few psychiatrists who work with individuals who have paraphilic disorders. Paraphilic disorders are rarely part of the curriculum for psychiatry residents or fellows.
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