Table 1.

Comparison of DSM-5 Substance Use Disorder and Hypersexual Disorder

DSM-5 Substance Use Disorder (APA, 2013) Criteria	Hypersexual Disorder (Kafka, 2010) Criteria
A. Problematic substance use over at least 12 months	A. Problematic sexual behavior over at least six months. Need 4 of 5 criteria.
Impaired control and motivation
1. Substance is taken in larger amounts or over a longer period than was intended
2. Persistent desire or unsuccessful efforts to cut down or control substance use	1. Repetitive but unsuccessful efforts to control or reduce sexual fantasies/urges/behaviors
3. Significant time is spent in activities necessary to obtain substance, use the substance, or recover from its effects	2. Excessive time is expended by sexual fantasies/urges or planning for sexual behavior
4. Craving, or a strong desire or urge to use the substance
Social impairment
5. Failure to fulfill major role obligations at work, school, or home due to substance use	Accounted for by clinical impairment in functioning
6. Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by use
7. Important social, occupational, or recreational activities are stopped/reduced due to substance use
Risky use
8. Recurrent substance use in situations considered physically hazardous	3. Repetitively engaging in sexual behavior while disregarding the risk for physical/emotional harm to self or others
9. Continued use despite persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by substance
Dependence
10. Tolerance, as defined by either of the following: Markedly increased amounts of substance to achieve intoxication or desired effect Markedly diminished effect with continued use of the same amount of substance	No equivalent
11. Withdrawal - Substance is taken to relieve or avoid withdrawal symptoms
	Dysphoric mood state/life stressors
No equivalent	4. Repetitively engaging in these sexual fantasies/urges/behaviors in response to dysphoric mood states
	5. Repetitively engaging in sexual fantasies/urges/behaviors in response to stressful life events
Diagnostic Criteria:
Severity: mild (2–3 criteria), moderate (4–5 criteria), and severe (6 or more criteria)	B. Clinically significant personal distress or impairment in social, occupational or other important areas of functioning associated with the frequency and intensity of these sexual fantasies/urges/behaviors
Substances: alcohol, cannabis, phencyclidine, other hallucinogen, inhalants, opioid, sedative, hypnotic, or anxiolytic, stimulant: specify amphetamine or cocaine, tobacco	C. Sexual fantasies/urges/behavior are not due to direct physiological effects of substance or to maniaD. Person is 18 years of age
	Specify if: masturbation, pornography, sexual behavior with consenting adults, cybersex, telephone sex, strip clubs, other