A 35-year-old man reports intense, recurrent sexual urges involving observing unsuspecting individuals in private activities for the past 6 months, causing significant distress. He has never acted on these urges. According to DSM-5, which is the CORRECT classification?
- A Voyeuristic disorder — because the urges cause distress ✓
- B Voyeuristic paraphilia only — not a disorder, because he has not acted on urges and has not harmed others
- C Exhibitionistic disorder
- D Sexual masochism disorder
Correct answer: A. Voyeuristic disorder — because the urges cause distress
Explanation
DSM-5 distinguishes paraphilia (atypical sexual arousal pattern — not inherently disordered) from paraphilic disorder (paraphilia causing clinically significant distress or functional impairment to the person, or paraphilia whose enactment would harm non-consenting others). Voyeurism becomes voyeuristic disorder when it causes marked distress to the individual (as in this case), functional impairment, or when the person has acted on urges with non-consenting persons. This patient's distress qualifies for the disorder diagnosis even without acting on the urge.
Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.
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Written and medically reviewed by the StethoPrep medical team.