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Abstract：
BACKGROUND: The addition of compulsive sexual behavior disorder (CSBD) into the ICD-11 chapter on mental, behavioral, or neurodevelopmental disorders has greatly stimulated research and controversy around compulsive sexual behavior, or what has been termed \"hypersexual disorder,\" \"sexual addiction,\" \"porn addiction,\" \"sexual compulsivity,\" and \"out-of-control sexual behavior.\"
OBJECTIVE: To identify where concerns exist from the perspective of sexual medicine and what can be done to resolve them.
METHODS: A scientific review committee convened by the International Society for Sexual Medicine reviewed pertinent literature and discussed clinical research and experience related to CSBD diagnoses and misdiagnoses, pathologizing nonheteronormative sexual behavior, basic research on potential underlying causes of CSBD, its relationship to paraphilic disorder, and its potential sexual health consequences. The panel used a modified Delphi method to reach consensus on these issues.
RESULTS: CSBD was differentiated from other sexual activity on the basis of the ICD-11 diagnostic criteria, and issues regarding sexual medicine and sexual health were identified. Concerns were raised about self-labeling processes, attitudes hostile to sexual pleasure, pathologizing of nonheteronormative sexual behavior and high sexual desire, mixing of normative attitudes with clinical distress, and the belief that masturbation and pornography use represent \"unhealthy\" sexual behavior. A guide to CSBD case formulation and care/treatment recommendations was proposed.
CONCLUSIONS: Clinical sexologic and sexual medicine expertise for the diagnosis and treatment of CSBD in the psychiatric-psychotherapeutic context is imperative to differentiate and understand the determinants and impact of CSBD and related \"out-of-control sexual behaviors\" on mental and sexual well-being, to detect forensically relevant and nonrelevant forms, and to refine best practices in care and treatment. Evidence-based, sexual medicine-informed therapies should be offered to achieve a positive and respectful approach to sexuality and the possibility of having pleasurable and safe sexual experiences.
OBJECTIVE: To identify where concerns exist from the perspective of sexual medicine and what can be done to resolve them.
METHODS: A scientific review committee convened by the International Society for Sexual Medicine reviewed pertinent literature and discussed clinical research and experience related to CSBD diagnoses and misdiagnoses, pathologizing nonheteronormative sexual behavior, basic research on potential underlying causes of CSBD, its relationship to paraphilic disorder, and its potential sexual health consequences. The panel used a modified Delphi method to reach consensus on these issues.
RESULTS: CSBD was differentiated from other sexual activity on the basis of the ICD-11 diagnostic criteria, and issues regarding sexual medicine and sexual health were identified. Concerns were raised about self-labeling processes, attitudes hostile to sexual pleasure, pathologizing of nonheteronormative sexual behavior and high sexual desire, mixing of normative attitudes with clinical distress, and the belief that masturbation and pornography use represent \"unhealthy\" sexual behavior. A guide to CSBD case formulation and care/treatment recommendations was proposed.
CONCLUSIONS: Clinical sexologic and sexual medicine expertise for the diagnosis and treatment of CSBD in the psychiatric-psychotherapeutic context is imperative to differentiate and understand the determinants and impact of CSBD and related \"out-of-control sexual behaviors\" on mental and sexual well-being, to detect forensically relevant and nonrelevant forms, and to refine best practices in care and treatment. Evidence-based, sexual medicine-informed therapies should be offered to achieve a positive and respectful approach to sexuality and the possibility of having pleasurable and safe sexual experiences.
摘要：
背景：将强迫性行为障碍（CSBD）添加到ICD-11关于精神，行为，或神经发育障碍极大地激发了围绕强迫性行为的研究和争议，或者所谓的“性欲障碍”，“\”性成瘾，\"\"色情成瘾,性强迫症,“和”失控的性行为。\"
目的：从性医学的角度确定存在的问题以及可以采取哪些措施来解决这些问题。
方法：由国际性医学学会召集的科学审查委员会审查了相关文献，并讨论了与CSBD诊断和误诊相关的临床研究和经验。病理性的非异型规范性行为，关于CSBD潜在根本原因的基础研究，它与亲热障碍的关系，及其潜在的性健康后果。小组使用改进的德尔菲方法就这些问题达成共识。
结果：根据ICD-11诊断标准，CSBD与其他性活动区分开来，并确定了有关性医学和性健康的问题。人们对自我标记过程提出了担忧，敌视性快感的态度，非异性恋性行为和高性欲的病理，规范态度与临床痛苦的混合，以及认为手淫和色情使用代表“不健康”的性行为。提出了CSBD病例制定和护理/治疗建议指南。
结论：在精神-心理治疗背景下诊断和治疗CSBD的临床性学和性医学专业知识对于区分和理解CSBD和相关的“失控性行为”对精神和性健康的决定因素和影响是必要的，检测法医相关和不相关的形式，并完善护理和治疗的最佳实践。循证,应提供性医学知情疗法，以实现积极和尊重的性行为方法，并有可能拥有愉快和安全的性经历。
目的：从性医学的角度确定存在的问题以及可以采取哪些措施来解决这些问题。
方法：由国际性医学学会召集的科学审查委员会审查了相关文献，并讨论了与CSBD诊断和误诊相关的临床研究和经验。病理性的非异型规范性行为，关于CSBD潜在根本原因的基础研究，它与亲热障碍的关系，及其潜在的性健康后果。小组使用改进的德尔菲方法就这些问题达成共识。
结果：根据ICD-11诊断标准，CSBD与其他性活动区分开来，并确定了有关性医学和性健康的问题。人们对自我标记过程提出了担忧，敌视性快感的态度，非异性恋性行为和高性欲的病理，规范态度与临床痛苦的混合，以及认为手淫和色情使用代表“不健康”的性行为。提出了CSBD病例制定和护理/治疗建议指南。
结论：在精神-心理治疗背景下诊断和治疗CSBD的临床性学和性医学专业知识对于区分和理解CSBD和相关的“失控性行为”对精神和性健康的决定因素和影响是必要的，检测法医相关和不相关的形式，并完善护理和治疗的最佳实践。循证,应提供性医学知情疗法，以实现积极和尊重的性行为方法，并有可能拥有愉快和安全的性经历。
