The Assessment and Management of Childhood Masturbation: An Analysis of 90 Cases

Abstract

Aim The child's self-stimulating pleasure behavior is defined as childhood masturbation (CM). Diagnosis of CM is mainly based on behavior and analysis of video recordings. This study aims to investigate etiological factors, movement patterns, and treatment options.

Medical records and video recordings of CM in our clinic between 2015 and 2020 were retrospectively reviewed.

Results Ninety patients aged 8 months to 9 years were included in our study. The male-to-female ratio was 23/67. The mean age at onset of masturbation (mean ± standard deviation) was 21.42 ± 18.44 (6–107) months. Note that 27.7% (32) of the patients were taking antiepileptic drugs before admission.

Eight of the 90 patients had abnormal electroencephalograms. The time of onset of CM was related to cessation of breast milk in 24.4%, separation from the mother in 43.3%, new siblings in 16.6%, initiation of toilet training in 7.7%, and parental divorce in 6.6%. Behavioral therapy was sufficient in 71.1%. Hydroxyzine hydrochloride in 19 (21.1%) and risperidone in 9 (10%) were given in the remaining cases. Overall, 23/28 of the cases receiving medication improved during follow-up.

Conclusion Physicians may have difficulty identifying repetitive movements in CM. Misdiagnosis or delayed diagnosis may lead to unnecessary use of antiepileptic drugs, delayed initiation of treatment, and prolonged treatment duration. Video recordings are important in the differential diagnosis of CM. CM may have psychosocial causes and can often be effectively treated with behavioral therapy. Pharmacological treatment (hydroxyzine hydrochloride and risperidone) may be considered in cases that do not respond to behavioral treatment.

Keywords

masturbation - nonepileptic seizures - psychomotor disorders - behavioral therapy

Publication History

Received: 20 July 2023

Accepted: 11 October 2023

Accepted Manuscript online:
12 October 2023

Article published online:
05 January 2024

• References

• 1 Leibetseder A, Eisermann M, LaFrance Jr WC, Nobili L, von Oertzen TJ. How to distinguish seizures from non-epileptic manifestations. Epileptic Disord 2020; 22 (06) 716-738
• 2 Deda G, Çaksen H, Suskan E, Gümüs D. Masturbation mimicking seizure in an infant. Indian J Pediatr 2001; 68 (08) 779-781
• 3 Tashakori A, Safavi A, Neamatpour S. Lessons learned from the study of masturbation and its comorbidity with psychiatric disorders in children: the first analytic study. Electron Physician 2017; 9 (04) 4096-4100
• 4 Mallants C, Casteels K. Practical approach to childhood masturbation–a review. Eur J Pediatr 2008; 167 (10) 1111-1117
• 5 Nechay A, Ross LM, Stephenson JBP, O'Regan M. Gratification disorder (“infantile masturbation”): a review. Arch Dis Child 2004; 89 (03) 225-226
• 6 Yang ML, Fullwood E, Goldstein J, Mink JW. Masturbation in infancy and early childhood presenting as a movement disorder: 12 cases and a review of the literature. Pediatrics 2005; 116 (06) 1427-1432
• 7 Meizner I. Sonographic observation of in utero fetal “masturbation”. J Ultrasound Med 1987; 6 (02) 111
• 8 Lindblad F, Gustafsson PA, Larsson I, Lundin B. Preschoolers' sexual behavior at daycare centers: an epidemiological study. Child Abuse Negl 1995; 19 (05) 569-577
• 9 Unal F. The clinical outcome of childhood masturbation. Turk J Pediatr 2000; 42 (04) 304-307
• 10 Shamo H. Early childhood masturbation: a clinical study. Al-Magallat al-Tibbiyyat al-Urdunniyyat 2005; 39 (01) 23-27
• 11 DiMario Jr FJ. Paroxysmal nonepileptic events of childhood. Semin Pediatr Neurol 2006; 13 (04) 208-221
• 12 Unal F. Predisposing factors in childhood masturbation in Turkey. Eur J Pediatr 2000; 159 (05) 338-342
• 13 Omranifard V, Najafi M, Sharbafchi MR, Emami P, Maracy M. Risperidone as a treatment for childhood habitual behavior. J Res Pharm Pract 2013; 2 (01) 29-33
• 14 Izadi-Mazidi M, Riahi F. Pathological childhood masturbation in children who referred to a child and adolescent psychiatric clinic. . J Compr Pediatr 2020;11(03):
• 15 Wilkinson B, John RM. Understanding masturbation in the pediatric patient. J Pediatr Health Care 2018; 32 (06) 639-643
• 16 Hansen JK, Balslev T. Hand activities in infantile masturbation: a video analysis of 13 cases. Eur J Paediatr Neurol 2009; 13 (06) 508-510
• 17 DiMario Jr FJ. Non- Epileptic Childhood Paroxysmal Disorders. New York: Oxford; 2009: 248-249
• 18 Doust ZK, Shariat M, Zabandan N, Tabrizi A, Tehrani F. Diagnostic value of the urine mucus test in childhood masturbation among children below 12 years of age: a cross-sectional study from Iran. Iran J Med Sci 2016; 41 (04) 283-287
• 19 Nguyen M, Murphy T. Mirtazapine for excessive masturbation in an adolescent with autism. J Am Acad Child Adolesc Psychiatry 2001; 40 (08) 868-869