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Here are some friends with simlar question as we.And I have this question for many days,anyone help us?
Kitty said: Yes.Underlying psychoses? - YouQA-I try seach this on internet but no results found.Maybe this is a stupid question.
Mike said: oh,no,you are wrong.I have found as below for this question(Underlying psychoses? - YouQA),it will help you,my kids.

Okay, let's say you get off on ppl drowning or being smothered or suffocated. So much so that you fantasize about doing it to ppl you know. Does that indicate a psychotic tendency like in serial killers?
No. If you find it sexually arousing you may have a fetish, but that's not unusual either. Most people, whether they pay attention to their thought or not, experience random thoughts that can be upsetting if they engage them; however, most people let their thoughts pass with little attention (kind of like working with a radio on in the background). The only time thoughts like these become a concern is if you start have the compulsion to actually follow through. If you think that these thoughts are becoming urges and you believe you can't control them, then you should see a psychologist ASAP. But, generally speaking, if these fantasizes are just passing thoughts, realize that is normal and let the thoughts pass by and move on to whatever you are doing.

Other Answers:
Umm.it would seem to me that that person needs to get some help now. In the classes I have taken, and my experience working with metally ill people, that sounds like classic physhotic tendencys to me.

when one thinks of those things,what is really under neath it is a feeling of power or control.which means things are not OK especially since all of those things lead to death.and yes serial killers think or dream of those same things.i would say that person does have a very low sense of self or even a grandiose feeling of self.the key to being human is balance and there is no balance in that kind of thinking,that person should seek help before something that starts as a fantasy ends in tragedy.

nope it simply means you're a paraphiliac, as long as you don't hurt anyone it shouldn't be a problem

I would say such a person represses a lot of anger. It has to be let out in one way or another, and it's better to be released through harmless fantasy. If the person has to resist hard, on the other hand, the wish to go out and make the fantasy true, than he has problem that needs to be addressed soon, in therapy. If it always stays on the fantasy level and doesn't increase in intensity, than you are doing "role playing" which allows you to get rid of negative feelings. A better way might be to pummel your pillow or something, as you imagine those events. Then you are more likely to let go of the bad feelings completely.

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