Repeated and intense sexual fantasies and urges for at least 6 months and sexual behavior related to 4 or more of the following 5 criteria: (1) Excessive time consumption of sexual fantasies and urges and planning to engage in sexual behavior. (2) Repeatedly engages in sexual fantasies, urges, and behaviors caused by irritable emotional states (e.g., anxiety, depression, worry, and irritability). (3) Repeatedly engaging in sexual fantasies, urges, and behaviors caused by stressful life events. (4) Repeated but unsuccessful attempts to control or significantly reduce these sexual fantasies, urges, and behaviors. (5) Repeatedly engaging in sexual behavior regardless of the physical or emotional harm to oneself or others. Associated with the frequency and intensity of these sexual fantasies, urges, and behaviors are clinically significant individual distress and impairment in social, occupational, or other important areas of functioning. These sexual fantasies, sexual urges and behaviors are not due to direct physiological effects or mania caused by exogenous substances. The age is 18 years or older.