Clinical characteristics and psychiatric comorbidity in males with exhibitionism
Background: This study was constructed to detail the demographic and phenomenological features of males with exhibitionism. Method: Male subjects with DSM-IV exhibitionism were administered a semistructured interview to elicit demographic data and information on the phenomenology, age at onset, and associated features of the disorder. Subjects also underwent structured clinical interviews to assess both Axis I and Axis II comorbidities. Data were collected from September 2003 to March 2005. Results: Twenty-five males with exhibitionism (mean ± SD age = 35.0 ± 13.1 years [range, 14-68 years]) were studied. The majority of subjects were single (60% [N = 15]) and heterosexual (80% [N = 20]). The mean ± SD age at onset for exhibitionism was 23.4 ± 13.1 years. All subjects reported urges to expose themselves with little control over these urges. Exposing oneself while driving was the most common expression of the disorder. Twenty-three (92%) suffered from a current comorbid Axis I disorder (major depressive disorder, compulsive sexual behavior, and substance use disorders were most common), and 40% (N = 10) suffered from a personality disorder. Suicidal thoughts were common (52% [N = 13]), and many (36% [N = 9]) had been arrested for exhibitionism. Conclusion: Exhibitionism appears to be associated with high rates of psychiatric comorbidity and impairment. Research is needed to optimize patient care for men with this disorder.