Frotteuristic Disorder (302.89

This is a lifelong disorder that has a high rate of recidivism, despite treatment. It is difficult to treat the patient well enough to modify and/or control their behavior. Family members need

to be involved in managing the behavior by limiting internet access and restricting all

substances. Regular therapy is necessary to contain the behavior and to recognize triggers for

the behavior. Some individuals may spontaneously remit. Comorbidities include substance

abuse and the various mood disorders. The patient may exhibit suicidal behavior upon being

arrested or incarcerated. Various drugs have been tried with some success, particularly SSRIs.

Antiandrogens may also be prescribed to decrease testosterone production.

FROTTEURISTIC DISORDER (302.89)

Frotteuristic disorder is defined as a “courtship disorder” in which the patient demonstrates

sexual arousal by touching or rubbing against a nonconsenting individual. There are fantasies

around touching people. They tend to touch people in public places, such as in crowds or on

mass transportation vehicles. The symptoms must last at least six months to qualify as having the disorder. Distress and/or impairment of function must be present to make the diagnosis.

Full remission is the non-action of urges for a minimum of five years.

To make the diagnosis, the touching of a nonconsenting person must have had to occur on at

least three occasions and must be distressful to the patient. If distress and impulses have

occurred and the patient hasn’t yet acted on it, they could be diagnosed with frotteurism;

individuals who deny their behaviors despite evidence can also be diagnosed with the disorder.

The symptoms start in late adolescence and may not initially involve sexual arousal. Other

sexual impulse disorders (hypersexuality, exhibitionism, and voyeurism) can be comorbid, as

can antisocial personality disorder, conduct disorder, substance abuse disorders, and mood

disorders.

This is a very common behavior, affecting up to 30 percent of adult males, who do not meet the

criteria for the actual frotteuristic disorder. Patients with paraphilias have a 10-15 percent

chance of also having frotteuristic disorder. It is almost exclusively seen in males and

perpetrated upon women. The prevalence of frotteuristic behavior is unknown because many