Concurrence of compulsive buying and sexual addiction.

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Letter to the Editor
Concurrence of compulsive buying
and sexual addiction
C
compulsive engagement in a behavior despite negative con-
sequences, and diminished control over the problematic
behavior.1To our knowledge there is only one report of
comorbid sexual addiction in patients with compulsive
buying. McElroy et al. reported that two out of 20 patients
with compulsive buying had lifetime but not current diag-
nosis of paraphilia and sexual addition.2We describe here
a 30-year-old man who suffered concurrent symptoms of
compulsive buying and sexual addiction for many years
without any treatment.
A 30-year-old married man visited the outpatient service
of Tri-Service General Hospital, Taipei, for help. According
to the patient his parents divorced when he was 7 years old
and he had lived with his grandmother from the age of 7 to
15 years. During this period the patient had some conduct
problems such as truancy, fighting, and running away from
home. He was therefore sent to Japan by his grandmother
where his father worked as a chef. The patient’s father,
however, lost his job and was not able to pay for his son’s
schooling after the age of 17. Since that time the patient
had earned his living by working as a waiter. Since the age
of 19 he had spent all of his salary on purchasing clothing,
shoes, video games, pornography, and adult videos every
month. He spent a lot of time in shopping and would buy
things that he did not need. The patient admitted that he
felt nervous and anxious before each purchase and
euphoric and excited when the act was completed, but
these moods would be followed by negative feelings such
as sadness, regret, depression, and guilt. As a result, he
had taken on several jobs, owned many credit cards, or
borrowed money to pay his debts.
In the previous 3 years the patient had been deeply
involved in compulsive sexual activities in addition to his
compulsive buying. He spent an excessive amount of time
engaged in sexual behavior, which included visiting
massage parlors for paid sex, engaging in extramarital
affairs, and changing acquainted sexual partners, despite
the fact that the patient maintained a satisfied sexual rela-
tionship with his wife. He noted that sexual experiences
provided his only coping mechanism for his work respon-
sibilities and financial stress, but he always had feelings of
guilt and remorse after his sexual acts as well, and tried,
unsuccessfully, to stop this behavior many times. To this
end he visited the outpatient department for help. Unfor-
tunately the patient did not return for a follow-up visit after
his initial assessment.
OMPULSIVE BUYING AND sexual addiction share
common core clinical features such as repetitive or
No personality disorder was diagnosed although the
patient reported some conduct problems during his ado-
lescence. The patient did have some obsessive–compulsive
characters, however, such as perfectionism, perseverance,
and indecisiveness. He denied having any history of depres-
sion, hypomania/mania, anxiety disorders, or child/sexual
abuse. There was no history of alcohol or substance abuse
but the patient’s mother had a history of bipolar disorder
and his sister had a history of major depression. There was
no history of compulsive buying or sexual addition in his
family members.
Most patients with behavioral addictions seldom search
for medical service actively.1Likewise, the present patient
showed up at the clinic for help only once. The one visit by
the patient limits this report. First, his clinical history
should have been further confirmed by his family. Second,
we should have made an assessment on his personality.
Nevertheless, this unique case has provided evidence in
support of phenomenological links between compulsive
buying and sexual addiction. More studies are warranted to
better understand the similarities and differences of these
two behavioral addictions.
ACKNOWLEDGMENT
This report was partially funded by a research grant from
the Tri-Service General Hospital, Taipei, Taiwan (TSGH-
C96-59).
REFERENCES
1Black DW. A review of compulsive buying disorder. World
Psychiatry 2007; 6: 14–18.
2McElroy SL, Keck PE Jr, Pope HG Jr, Smith JM, Strakowski
SM. Compulsive buying: A report of 20 cases. J. Clin. Psychia-
try 1994; 55: 242–248.
Yi-Wei Yeh, MD1
I-Shin Shiah, MD, PhD1,2*
Ming-Chuan Hu, MD3
Hsin-An Chang, MD1
Chang-Chih Huang, MD1
1Department of Psychiatry, Tri-Service General Hospital,
2National Defense Medical Center, Taipei, and
3Armed Forces Kang-Shan Hospital, Kaohsiung, Taiwan
*Correspondence: I-Shin Shiah, MD, PhD, Department of Psychiatry,
Tri-Service General Hospital, No. 325, Section 2, Cheng-Gung Road,
Neihu District, Taipei, 114, Taiwan. Email: ishiah@ms45.hinet.net
Received 6 January 2008; revised 23 March 2008; accepted 25 March
2008.
Psychiatry and Clinical Neurosciences 2008; 62: 484doi:10.1111/j.1440-1819.2008.01832.x
484
© 2008 The Authors
Journal compilation © 2008 Japanese Society of Psychiatry and Neurology