Comorbidity of fetishism and pedophilia with obsessive compulsive disorder: A case report

Paraphilia are abnormal expressions of sexuality. The prevalence of paraphilia is significantly higher than the number of cases diagnosed in general clinical facilities. Patients with paraphilia usually have different paraphilic fantasies, either concurrently or at different times in their lives. In the classic psychoanalytic model, failure to resolve the oedipal crisis results either in improper identification with the opposite–sex parent or in an improper choice of object for libido cathexis. In the other hand, castration anxiety or problems in the separation-individuation phase can be explanatory factors in the creation of fetishism. In this case report an 18 years old man with fetishism and pedophilia who also suffers from obsessive compulsive disorder (OCD)–like his mother–has been introduced. He had sexual abuse in childhood and masturbation from puberty frequently. The comorbidity between OCD and fetishism has not been reported yet. This report suggests the relationship between paraphilia and OCD. Also this comorbidity can be a sign of identification with the opposite sex parent to resolve the oedipal crisis. Moreover, early experiences of abuse (for example sexual abuse) can predispose development of paraphilic acts.