Paraphilias
Chapter 5:Mental, Behavioral and Neurodevelopmental disorders
ICD-10 F65 is a billable code used to indicate a diagnosis of paraphilias.
Paraphilias are characterized by intense sexual arousal to atypical objects, situations, or individuals, which may include non-consenting partners or non-human objects. These behaviors can lead to significant distress or impairment in social, occupational, or other important areas of functioning. The DSM-5 classifies paraphilias into two categories: paraphilic disorders, which cause distress or impairment, and paraphilias that do not. Common types include fetishistic disorder, voyeuristic disorder, exhibitionistic disorder, and pedophilic disorder. The onset of paraphilic behaviors often occurs in adolescence or early adulthood, and while some individuals may manage their paraphilic interests without causing harm, others may engage in illegal or harmful activities. Treatment often involves psychotherapy, behavioral interventions, and, in some cases, pharmacotherapy to manage impulses. Understanding the nuances of paraphilias is crucial for accurate diagnosis and coding, as they intersect with personality disorders, impulse control issues, and maladaptive behaviors.
Detailed patient history, including onset and impact of paraphilic behaviors, treatment plans, and progress notes.
Patients presenting with distress related to paraphilic interests, legal issues stemming from behaviors, or co-occurring mental health disorders.
Consideration of the legal implications of certain paraphilic behaviors and the need for sensitivity in documentation.
Comprehensive psychological assessments, including standardized testing and behavioral observations.
Therapeutic interventions for individuals struggling with paraphilic disorders and their impact on relationships.
Focus on behavioral modification techniques and the ethical implications of treatment.
Used for therapy sessions addressing paraphilic disorders.
Session notes detailing patient progress and treatment focus.
Psychiatrists and psychologists should document the therapeutic approach and patient engagement.
The main types of paraphilias include fetishistic disorder, voyeuristic disorder, exhibitionistic disorder, and pedophilic disorder. Each type has specific diagnostic criteria and implications for treatment.