Psychoanalytic Analysis

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Now that the diagnostic criteria, supplemental features, comorbidities, and differentials have been identified and described, there will be a review of supportive evidence. There were a lot of concerns with regards to frotteuristic disorder being in the DSM-5 such as the social stigmas and legal liability associated with the diagnosis. So, the DSM-5 adapted by providing absolute “what if” solutions to avoid over diagnosis. As frotteurism is not a victimless action, distress can be an outcome, therefore there should be a clinician to assess and treat the individual. Further a psychologist will not report if one is experiencing frotteuristic urges, (unless other identifiable victims are being harmed) which maintains the rapport between client …show more content…
X described feelings of sadness and disinterest in work within the last three months. He experienced fatigue, body aches, headaches, and feelings of hopelessness, further investigation led to the exposure of his remorse of frotteuristic behaviors. His daily routine involved boarding crowded train cars and brushing up against random women and has lasted 4-5 years. The behavior got so extreme that he would spend his days off riding trains from 10 am to 1 am and the urges began to interfere with his work. Furthermore, his interest in sexual intercourse has been reduced substantially compared to his arousal from frotteurism. Although he was showing signs of depression, his sexual behavior was not affected. Mr. X was diagnosed with major depressive disorder (MDD) and frotteurism using the DSM-IV-TR and treated with medications, orgasmic reconditioning, and advice to stay busy, which reduced these behaviors by approximately 80 percent. (Kalra, 2013). All cases thus far indicate comorbidities with depressive symptoms, seemingly frotteurism is causal to depression due to the guilt associated with these …show more content…
In a case study, Cannas et al. (2006) report on a 51-year old male PD patient, who began to show signs of PD at the age of 44. Two years later, the patient began to show a mild motor disability and was diagnosed with PD. He was then put on Peroglide, a dopamine agonist ergot derivative, which is commonly used to treat PD. At the time, he was not taking any other form of medication. After the introduction of this new medication, his wife reported an increase in libido, but there was no public activity. Three years later, the patient was accused of forcing his sexual intentions by locking himself in a room with a woman and repeatedly touching her. His mood status at the time showed signs of anxiety, irritability, depression, insomnia, and anguish, so he returned to the neurologist who dropped his dose down and prescribed an atypical neuroleptic, Quetiapine. The patient later report experiencing extreme jealousy and an increase in his sexual drive. Therefore, the neurologist reduced the dose further, which resulted in the ability to control jealousy and sexual drive (Cannas et. al 2006). Although the etiology and pathogenesis of frotteuristic disorder and similar paraphilia’s remains unknown, this report indicates that individual’s with advanced PD or using dopaminergic drugs will demonstrate an increase in sexual behaviors.

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