Zoophilia as an Early Sign of Psychosis

IntroductionZoophilia is a disorder of sexual preference that is characterised by sexual fantasies or behaviours that include animals [1]. Although sexual contact between a man and an animal has been described since biblical times, zoophilia as a mental disorder is first classified in the third edition of the Diagnostic and statistic manual for mental research (DSM-III) [2]. In the last edition of DSM5 5 is classified under the category "Other specified paraphilic disorder". This category is applied for clinical pictures where dominant symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning, but do not meet the full criteria for any of the disorders in the paraphilic disorders diagnostic class. With the above mentioned, it is important to meet the time criteria of at least six months of recurrent and intense sexual arousal involving animals. Therefore, paraphilia is a necessary but not a sufficient condition for having a paraphilic disorder, and a paraphilia by itself does not necessarily require clinical intervention until it causes distress or impairment to the individual or risk of harm to others [3]. According to the other most acknowledged diagnostic guidelines, zoophilia is classified into "other disorders of sexual preference" [4]. In the recent literature there are several articles where authors tried to classify zoophilia to help its easier diagnosis and treatment. For the sake of easier diagnosis, Aggrawal and associates, in 2011, have offered a classification of zoophilia in ten categories, which among the others include sexual fantasies about animals, occasional sexual relations with animals and exclusive sexual relations with animals [5].When talking about the etiology and patophisiology of paraphilia, all the information leading to now suggest an influence of psychosocial and neurobiological factors for the formation of deviant sexual behaviour. Psychological factors which are though to be most important are family violence, dysfunctional family relations, and sexual abuse in childhood. When talking about the neurobiological side, endocrine function in pedophilia research has shown an elevated response of luteinisic hormone (LH) to stimulation of the luteinisic releasing hormone (LRH) or gonadotropin releasing hormone (GRH) [6], which could also be present in zoophilia, but has not been decisively confirmed when taken in consideration a relatively rare incidence of this paraphilia. Furthermore, Casanova and associates have come to a closer approach to the patoanatomic basis of zoophilia, by a representation of two psychiatric patients with zoophilia, where in both of the patients' post mortem had found atrophy of hippocampal pyramidal cells. The first case was a man that suffered from hebephrenic schizophrenia, and the second case was a man that suffered from a bipolar affective disorder and chronic alcoholism. In both cases alongside zoophilia, records show incidence of other paraphilia [7].Some of the recent research suggest a higher incidence of zoophilia in men, persons with mental retardation, poor social skills and lower levels of education, as well as a higher incidence of zoophilia in people from rural areas, especially among those who work with animals [8]. However, there have been contrary findings, like an internet research on a sample of 82 men and 11 women, which resulted in more common frequency of zoophilia with people of higher education levels and average functioning in society [9]. According to a research by Abel and associates, conducted on 561 men treated for paraphilia, it has been found that certain respondents with zoophilia had comorbidly manifested other paraphilia, while at the same time other psychiatric disorders have not been researched apart from disorders od sexual preference and their representation [10].Zoophilia and other psychiatric disordersSome of the research has tried to answer the question of how much zoophilia is present in psychiatric patients. …