The current edition, the DSM-IV-TR, holds that distress is necessary in most cases. But for paraphilias involving non-consenting parties, just acting on the urge is enough to qualify as mentally ill.

and current DSM-IV-TR (published in 2000) extensively, and who believes strongly in the clinical necessity of being well-trained in psychopathology and psycho-diagnosis, let me add my two cents to ...