Spermatomania--the English response to Lallemand's disease.
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This paper presents an unusual form of sexual (masturbatory) activity and brings this unusual cause of death to wider medical attention and understanding. All 19 cases of autoerotic asphyxial death that occurred between 1978 and 1989 in the province of Alberta, Canada were reviewed. The fatal victim of autoerotic asphyxia is typically a single male aged 15 to 29 years. Autoerotic sexual activity is typically performed in isolation; often there is evidence of repetitive practice. The accidental death usually results when the "safety" mechanism designed to alleviate neck compression fails. Often the first sign of the activity (usually a surprise to family and friends) is death itself. Physicians who are alert to the practice may suggest counselling when patients present with sexual concerns, unusual marks around the neck or evidence of abrasions to limbs suggesting bondage or other masochistic practices.
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Offered in this article are interpretations that emerged in a qualitative, interpretive study focused on the family intervention called a "commendation." The tradition of philosophical hermeneutics informs and shapes the analysis of the data. Research participants include a heterosexual couple and a nurse who engaged in therapeutic conversations focused on difficulties with Internet pornography. Data sources include videotapes of clinical sessions, documentation, and research interviews. Isolated segments of clinical videotape are shared with the couple to prompt their memory of commending practices that emerged in clinical sessions. Commendations are not experienced by this couple as gentle and warm but instead as extremely provocative, albeit constructive. This study illuminates the complex, contextual nature of commending practice and suggests that the noticing of strengths and resources contains much more than the spoken word.
The assessment of current sexual behavior (fantasies, urges, and activities) and sexual preoccupation (measured in min/day) associated with both conventional (i.e., adult relationship-associated) or unconventional (paraphilia and paraphilia-related) sexual behavior were ascertained from a sample of 120 consecutively evaluated males with paraphilias (PA; n = 88, including sex offender paraphiliacs; n = 60) and paraphilia-related disorders (PRD; n = 32). In addition, an assessment of hypersexual desire, defined as the highest sustained period (at least 6 months minimum duration) of persistently enacted sexual behavior (total sexual outlet/week [TSO] after age 15) was assessed. In almost all measures, the PA and PRD groups were not statistically significantly different. The average PA or PRD reported a mean hypersexual TSO of 11.7 +/- 7.3, a mean age of 21.6 +/- 7.1 years at onset of peak hypersexual behavior, and a mean duration of 6.2 +/- 7.6 years of hypersexual TSO. When the sample was stratified into three subgroups on the basis of the lifetime number of PAs + PRDs as a proxy measure of the severity of sexual impulsivity, the "high" group, with at least 5 lifetime PAs and PRDs, consisted of all paraphilic males, predominantly sex offenders, who self-reported the highest hypersexual desire (14.3 +/- 7.9), the highest current TSO/week (9.9 +/- 8.1), the most current sexual preoccupation (2-4 hr/day), and the highest likelihood of incarceration secondary to paraphilic sex-offending behavior. Although hypersexual desire, a quantitative measure of enacted sexual behaviours, may be a meaningful construct for clinically derived samples, the incidence and prevalence of hypersexual desire in community samples of males with paraphilias and paraphilia-related disorders is unknown.
BACKGROUND: Changes in sexual function are commonly associated with MS and occur in many forms. Hypersexual thoughts or behavior are rare, but can present on the background of persistent cognitive impairment or psychiatric conditions such as mania, whereas isolated hypersexuality is still rarer. CASE REPORT: We describe the clinical, neuropsychological, electrodiagnostic, neuroimaging and endocrine findings in a MS patient with episodes of greatly increased libido. Imaging and neuropsychologicol studies indicated frontal lobe dysfunction; hormone studies showed no significant changes. CONCLUSION: Episodic hypersexuality can be a recurrent transient manifestation of MS.
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