It seems difficult to me to distinguish OCD from so-called sexual addiction; perhaps the main difference would be that the individual is bothered by his behavior in one case (OCD) and not the other (addiction); yet this single minor subjective difference would seem to be a small feature upon which to base an entire diagnostic entity. Indeed, there appear to exist many cases of OCD without insight, that is, OCD in which the patient is not much bothered by his or her symptoms. OCD is not, traditional teaching notwithstanding, uniformly characterized by presence of insight (better phrasing than the old ego-dystonic term, in my view).
One reputable website defines sexual addiction as “a progressive intimacy disorder characterized by compulsive sexual thoughts and acts.” DSM’s definition, under paraphilias, as sexual disorders NOS includes the following ideas: “compulsive searching for multiple partners, compulsive fixation on an unattainable partner, compulsive masturbation, compulsive love relationships and compulsive sexuality in a relationship.” This kind of definition seems quite hard to distinguish from OCD with sexual content.
I’ve always struggled with how to talk about “process addictions” and other compulsive behaviors. More specifiically, how to distinguish them from AOD addiction.
A psychiatrist wrestles with sexual addiction and wonders if obsessive compulsive disorder (OCD) is the best way to conceptualize sexual addiction: