Neobvyklá forma sexuálnejdeviácie

Kolibáš E., Siska L.: Uncommon Form of Fetishism

Fetishism is a sexual deviation encountered rarely even by psychiatric sexu-ologists in their practice. The authors present an account on a rare type offetishism - salivary fetishism. In 1998 they examined a 22-year-old man wherewas diagnosed already during the previous year pedophilia. The reason forthe previous ambulatory examination and hospital admission was the fin-ding that the patient pursues schoolgirls and asks them to spit into his palm.The patient reported that saliva of young girls cause intensive sexual arou-sal. The contact with saliva and listening to the bubbling of the saliva causesintensive sexual arousal and orgasm with ejaculation. The mentioned behavi-our has persisted for four years. Restrictions by parents and previous neuro-leptic treatment failed. According to anamnestic data the patient prefers thecompany of children, two years ago he still identified himself with children,occasionally he perceives sexual arousal in the company of young girls. Henever attempted tactile contact and is not interested in sexual intercoursewith girls. Phalloplethysmographic examination did not reveal a response to„normal“ stimuli nor to pedophilic stimuli. The authors prefer the diagnosis fetishism with a pedophilic component, in the discussion they reflect also ona combination of two types of sexual deviation (with incomplete expressionof pedophilia). They consider this alternative less likely. They rule out transi-ent deviant sexual behaviour as a manifestation of psychosexual infantilism.In the case-history they found bad relations between the patient and hisparents, retarded mental and somatic development during childhood andadolescence. Examination revealed also symptoms of slight organic braindamage (with subnormal intellect and specific developmental disorders), per-sonality disorder with psychasthenic features and a neurotic symptomatolo-gy. Detection of associated psychic disorders and factors which couldparticipate in the development of the sexual deviation are of practical impor-tance also for planning treatment. The initial hormonal inhibitory treatmentis successful and creates conditions for comprehensive treatment where psy-chotherapy is the most important constituent.

Key words:
sexual deviation, salivary fetishism, pedophilia, combined sexualdeviation, differential diagnosis.