Neurobiological Pathways Linking Compulsive Sexual Behavior Disorder and Psychiatric Comorbidities: A Narrative Review
Abstract
Compulsive sexual behavior disorder (CSBD) is a newly classified clinical condition characterized by persistent difficulty in controlling sexual impulses, repetitive sexual activity despite adverse consequences, and significant distress or impairment in various life areas. This narrative review explores the clinical and neurobiological overlaps between CSBD and selected mental disorders, including mood and anxiety disorders, attention-deficit/hyperactivity disorder, autism spectrum disorder, obsessive-compulsive disorder, and specific personality disorders. The review emphasizes shared mechanisms, such as dysregulation of the dopaminergic reward system, impairments in emotional regulation, and altered connectivity in brain regions responsible for impulse control and affect processing. Structural and functional neural changes associated with impulsivity, such as abnormalities in the prefrontal cortex, orbitofrontal cortex, and limbic system, are discussed as potential contributors to both CSBD and its comorbid conditions. These findings support a dimensional approach to diagnosis and treatment, highlighting the need for integrated clinical strategies that account for overlapping symptoms and underlying vulnerabilities.
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