- Scott F Martin, MD
Scott F Martin, MD
- Clinical Instructor
- Case Western Reserve University School of Medicine
- Stephen B Levine, MD
Stephen B Levine, MD
- Clinical Professor of Psychiatry
- Case Western Reserve University School of Medicine
Fetishistic disorder is characterized by a distressing and persistent pattern of sexual arousal involving the use of nonliving objects or specific, nongenital body parts. In clinical usage, the term “fetish” delineates an object, such as a partner’s foot, which is used by an individual to attain sexual arousal and orgasm. Persons with sexual fetishes may need to be touching, smelling, or looking at their unique object, or engaging in fantasy about it, to become or stay aroused, either alone or with a partner.
In the revision of the American Psychiatric Association’s Diagnosis and Statistical Manual (DSM) from the fourth to fifth edition, fetishism was renamed fetishistic disorder . The diagnosis was broadened to include partialism, in which patients attain sexual arousal through the use of specific, nongenital parts of the partner’s body. There has been relatively little research on fetishism/fetishistic disorder. In the absence of clinical trials, treatment is based largely on clinical experience and published case reports.
This topic addresses the epidemiology, pathogenesis, clinical characteristics, course, assessment, diagnosis, and treatment of fetishistic disorder. Evaluation and management of other sexual and gender identity disorders are discussed separately. (See "Evaluation of male sexual dysfunction" and "Treatment of male sexual dysfunction" and "Sexual dysfunction in women: Epidemiology, risk factors, and evaluation" and "Sexual dysfunction in women: Management".)
The incidence and prevalence of fetishistic disorder in the general population are not known. It is not clear whether the rarity of fetishistic disorder as a presenting complaint represents a low prevalence or a lack of reporting by people with the condition.
Fetishism is typically not investigated separately from other forms of paraphilia. Across numerous studies, voyeurism and fetishism are often described as the most common paraphilic interests among men . A community survey of 1040 people selected randomly and demographically representative of the general population in Quebec studied fetishism (not necessarily associated with distress or impairment, ie, not a fetishistic disorder) , finding:
Subscribers log in hereLiterature review current through: Nov 2017. | This topic last updated: Dec 13, 2016.References
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), American Psychiatric Association, Arlington 2013.
- Joyal CC, Carpentier J. The Prevalence of Paraphilic Interests and Behaviors in the General Population: A Provincial Survey. J Sex Res 2017; 54:161.
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- Raphling DL. Fetishism in a woman. J Am Psychoanal Assoc 1989; 37:465.
- Kaplan LJ. Female Perversion, Anchor, New York 1991. p.66.
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- Stoller RJ. Perversion, Random House, New York 1975. p.132.
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- Levine SB, Risen CB, Althof SE. Essay on the diagnosis and nature of paraphilia. J Sex Marital Ther 1990; 16:89.
- Kafka MP. The DSM diagnostic criteria for fetishism. Arch Sex Behav 2010; 39:357.
- Brown JR. Paraphilias. Sadomasochism, fetishism, transvestism and transsexuality. Br J Psychiatry 1983; 143:227.
- http://www.revisef65.org/ (Accessed on November 12, 2012).
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, American Psychiatric Association, Washington DC 2000.
- Paterson J. The Assertiveness Workbook : How to express your ideas and stand up for yourself at work and in relationships, Harbinger Press, Oakland, CA 2000.
- Clayton AH. Fetishism and clomipramine. Am J Psychiatry 1993; 150:673.
- Lorefice LS. Fluoxetine treatment of a fetish. J Clin Psychiatry 1991; 52:41.
- Shiah IS, Chao CY, Mao WC, Chuang YJ. Treatment of paraphilic sexual disorder: the use of topiramate in fetishism. Int Clin Psychopharmacol 2006; 21:241.
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- Risk factors
- Psychodynamic model
- Cognitive-behavioral model
- CLINICAL CHARACTERISTICS
- Subtypes and specifiers
- Differential diagnosis
- Revisions in DSM-5
- - Common components
- - Psychodynamic psychotherapy
- - Cognitive-behavioral therapy
- Behavioral repatterning
- Assertiveness training
- - Couples therapy
- - SSRI/SNRIs
- - Other
- SUMMARY AND RECOMMENDATIONS