Patterns of overt sexual interaction among acute psychiatric inpatients

An indepth study was carried out over 1 year on all instances of overt heterosexual interactions among acute psychiatric patients on mixed-sex intensive treatment units. Sixteen of the 1060 patients treated on the units were involved in nine instances of overt heterosexual interactions. Analysis of the interactions showed three distinct patterns, called Types 1, 2 and 3. In Type 1 interactions, overt sexual behavior approaches normality. In Type 2 interactions, overt sexual behavior is of a pronounced demonstrative quality but avoids genital involvement. In Type 3, overt sexual interaction is confined exclusively to sexual intercourse. Multiple determinants of the patients' involvements in overt heterosexual interaction are presented. The type of overt sexual interaction engaged in by inpatients depended more on each patient's history, including past sexual life, than on clinical diagnosis. As a rule, the patient's most relevant and central problems were expressed in a very distinct manner in the overt sexual interaction on the unit. Thus, a thorough investigation of every case of such interaction provides an opportunity to discern these problems rapidly and to elaborate on them therapeutically.