Compulsive sexual behavior disorder and paraphilic disorders in a large Brazilian community sample: an online investigation.
6 affiliations
- 1Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
- 2Programa Transdisciplinar de Identidade de Gênero, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil.
- 3Departamento de Psiquiatria, Laboratório de Psiquiatria Digital, Universidade Federal do Parana, Curitiba, Brazil.
- 4Institute of Sexology and Sexual Medicine, Charite - Universitatsmedizin Berlin, Berlin, Germany.
- 5Department of Psychology, Universite de Montreal, Montreal, QC, Canada.
- 6Centre de Recherche Interdisciplinaire sur les Problèmes Conjugaux et les Agressions Sexuelles (CRIPCAS), Quebec City, QC, Canada.
Abstract
Background
The International Classification of Diseases 11th Revision (ICD-11) includes Compulsive Sexual Behavior Disorder (CSBD) among impulse control disorders, aiming to standardize diagnostic criteria and improve the understanding of problematic sexual behaviors across cultures. However, few large-scale studies have investigated CSBD and its association with Paraphilic Disorders (PD) in Latin American populations.Objective
To investigate the occurrence of high-risk CSBD in a large Brazilian community sample, examine its association with paraphilic interests and disorders, and evaluate associated sociodemographic and clinical factors.Methods
This cross-sectional online study included 5,227 Brazilian adults recruited through convenience sampling between September 2022 and April 2023. Participants completed sociodemographic questionnaires, a Brazilian Portuguese version of the CSBD-19, and a translated inventory assessing paraphilic interests and disorders based on DSM-5-TR criteria. Descriptive statistics, chi-squared tests, linear discriminant analysis, and multivariate backward stepwise logistic regression were performed.Results
The prevalence of high-risk CSBD (CSBD-19 > 50) was 5.4% (n = 282). The mean CSBD-19 score was 30.4 (SD = 9.7), increasing to 56.4 (SD = 6.1) among individuals classified as high risk. Male sex was strongly associated with high-risk CSBD (OR = 3.32, 95%CI: 2.45-4.50, p < 0.001). Significant associations were also identified for sexual sadism disorder (OR = 2.69, 95%CI: 1.79-4.07), paraphilic disorder involving specific body characteristics (OR = 2.46, 95%CI: 1.49-4.04), zoophilic interest (OR = 2.39, 95%CI: 1.70-3.37), partialism disorder (OR = 2.00, 95%CI: 1.17-3.42), and paraphilia-related distress (OR = 1.94, 95%CI: 1.44-2.61). Linear discriminant analysis demonstrated that the Negative Consequences domain showed the strongest discriminative contribution for high-risk CSBD classification (ω = 1.23).Conclusions
This study contributes to more inclusive research on compulsive sexual behavior disorder (CSBD) by investigating a large Brazilian sample, including individuals with diverse sexual orientations and gender identities. Using the ICD-11 framework, the estimated prevalence of high-risk CSBD was 5.4%, a rate comparable to those reported for other common mental health conditions. The study also supports the psychometric applicability of the Brazilian Portuguese version of the CSBD-19 for future epidemiological and cross-cultural research in Latin American populations. Further longitudinal and nationally representative studies are needed to clarify causal pathways, psychiatric comorbidities, minority stress influences, and the neurobiological and psychosocial mechanisms underlying the relationship between CSBD and paraphilic disorders.
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BibTeX
@article{canto2026compulsive,
title = {{Compulsive sexual behavior disorder and paraphilic disorders in a large Brazilian community sample: an online investigation.}},
author = {Gustavo Cambraia Do Canto and João Guilherme Almeida Jordani and Nino Cesar Marchi and Daniel Ingrisani Branco and Thiago Henrique Roza and Karine Schwarz and Klaus Michael Beier and Beáta Bőthe and Maria Inês Rodrigues Lobato},
journal = {Frontiers in psychiatry},
year = {2026},
month = oct,
doi = {10.3389/fpsyt.2026.1807692},
url = {https://europepmc.org/article/MED/42908752},
note = {CC BY},
}
RIS
TY - JOUR
TI - Compulsive sexual behavior disorder and paraphilic disorders in a large Brazilian community sample: an online investigation.
AU - Gustavo Cambraia Do Canto
AU - João Guilherme Almeida Jordani
AU - Nino Cesar Marchi
AU - Daniel Ingrisani Branco
AU - Thiago Henrique Roza
AU - Karine Schwarz
AU - Klaus Michael Beier
AU - Beáta Bőthe
AU - Maria Inês Rodrigues Lobato
PY - 2026
DA - 2026/10/07
JO - Frontiers in psychiatry
DO - 10.3389/fpsyt.2026.1807692
UR - https://europepmc.org/article/MED/42908752
AB - Background The International Classification of Diseases 11th Revision (ICD-11) includes Compulsive Sexual Behavior Disorder (CSBD) among impulse control disorders, aiming to standardize diagnostic criteria and improve the understanding of problematic sexual behaviors across cultures. However, few large-scale studies have investigated CSBD and its association with Paraphilic Disorders (PD) in Latin American populations.Objective To investigate the occurrence of high-risk CSBD in a large Brazilian community sample, examine its association with paraphilic interests and disorders, and evaluate associated sociodemographic and clinical factors.Methods This cross-sectional online study included 5,227 Brazilian adults recruited through convenience sampling between September 2022 and April 2023. Participants completed sociodemographic questionnaires, a Brazilian Portuguese version of the CSBD-19, and a translated inventory assessing paraphilic interests and disorders based on DSM-5-TR criteria. Descriptive statistics, chi-squared tests, linear discriminant analysis, and multivariate backward stepwise logistic regression were performed.Results The prevalence of high-risk CSBD (CSBD-19 > 50) was 5.4% (n = 282). The mean CSBD-19 score was 30.4 (SD = 9.7), increasing to 56.4 (SD = 6.1) among individuals classified as high risk. Male sex was strongly associated with high-risk CSBD (OR = 3.32, 95%CI: 2.45-4.50, p < 0.001). Significant associations were also identified for sexual sadism disorder (OR = 2.69, 95%CI: 1.79-4.07), paraphilic disorder involving specific body characteristics (OR = 2.46, 95%CI: 1.49-4.04), zoophilic interest (OR = 2.39, 95%CI: 1.70-3.37), partialism disorder (OR = 2.00, 95%CI: 1.17-3.42), and paraphilia-related distress (OR = 1.94, 95%CI: 1.44-2.61). Linear discriminant analysis demonstrated that the Negative Consequences domain showed the strongest discriminative contribution for high-risk CSBD classification (ω = 1.23).Conclusions This study contributes to more inclusive research on compulsive sexual behavior disorder (CSBD) by investigating a large Brazilian sample, including individuals with diverse sexual orientations and gender identities. Using the ICD-11 framework, the estimated prevalence of high-risk CSBD was 5.4%, a rate comparable to those reported for other common mental health conditions. The study also supports the psychometric applicability of the Brazilian Portuguese version of the CSBD-19 for future epidemiological and cross-cultural research in Latin American populations. Further longitudinal and nationally representative studies are needed to clarify causal pathways, psychiatric comorbidities, minority stress influences, and the neurobiological and psychosocial mechanisms underlying the relationship between CSBD and paraphilic disorders.
SN - 1664-0640
ER -