The revision of the Paraphilic Disorders group and the Factitious Disorders group was carried out after confirming the principles of revision to ICD-11: (1) retention of function as a public health tool useful for various investigations and reports, (2) recognition of the possible benefits of receiving mental health service even if it does not mean mental disorder, and (3) exclusion of only social deviations and conflicts without personal dysfunction. Among the sexual categories, those recognized as mental disorders were included under the group name of "Paraphilic Disorders", and the other sexual categories were moved to the new group "Conditions Related to Sexual Health". The common characteristics of the Paraphilic Disorders group were as follows. (a) It has a persistent and intense patterns of atypical sexual arousal. (b) The pattern involves a person who is incapable of or refuses to consent. (c) The pattern causes marked distress to oneself. However, it is due to the excitement pattern itself, not secondary to fear of criticism by others. (d) The pattern poses a serious risk of injury or death to oneself or the other persons, even with the consent of the latter. In defining each category, in addition to these common characteristics, the behaviors that characterize each were specified. For factitious disorders, a unique group name "Factitious Disorders" was established. Its characteristics are that, among some groups complaining of physical symptoms, neither the manifestation of symptoms nor their motives are intentional, and that the main purpose of the complaint was to acquire the sick role rather than obtaining external benefits such as money or exemption from obligations. As a subgroup, three subcategories of "Factitious Disorder Imposed on Self", "Factitious Disorder Imposed on Another", and "Factitious Disorder, Unspecified" were included by incorporating DSM-5.
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