Reality is much more complex than both Victorian diagnoses and popular belief. Even today, there is much argument as to what constitutes pathological sexual behavior, namely, where to draw the line between personal preferences and habits and an illness that truly affects the individual’s well-being. There is also an issue of comorbidity; namely, research has shown a clear tendency for hindering sexual compulsive behaviors to coexist with bipolar disorder, anxiety, depression and substance abuse, among a variety of other problems and pathologies. This makes sexual compulsions even harder to pin down."

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