Prescription of testosterone-lowering medications for sex offender treatment in German forensic-psychiatric institutions
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Prescription of testosterone-lowering medications for sex offender treatment in German forensic-psychiatric institutions. / Turner, Daniel; Basdekis-Jozsa, Raphaela; Briken, Peer.
in: J SEX MED, Jahrgang 10, Nr. 2, 01.02.2013, S. 570-8.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Prescription of testosterone-lowering medications for sex offender treatment in German forensic-psychiatric institutions
AU - Turner, Daniel
AU - Basdekis-Jozsa, Raphaela
AU - Briken, Peer
N1 - © 2012 International Society for Sexual Medicine.
PY - 2013/2/1
Y1 - 2013/2/1
N2 - INTRODUCTION: Different clinical guidelines suggest using testosterone-lowering medications (TLM) in sex offender treatment in addition to psychotherapy. Within Germany, there are two officially approved agents. So far, no current data exist about the routine use of TLM in a clinical context.AIM: The present observational study evaluates the frequency of the prescription of TLM and other medications in sex offender treatment in German forensic-psychiatric institutions. Experts are asked about the observed effects and side effects of TLM.METHOD: The heads of all 69 German forensic-psychiatric hospitals and outpatient clinics were asked to fill out a questionnaire assessing offender characteristics and treatment methods in use.MAIN OUTCOME MEASURES: Main outcome measures were the number of patients being treated with TLM and other pharmacological agents for reducing sexual drive. Further effects and side effects of the agents were evaluated.RESULTS: Thirty-two participating institutions reported on 3,963 patients, 611 of them being sex offenders (15.4%). Most sex offenders had been convicted for child sexual abuse (39.8%) or a sexual assault/rape (37.6%). Almost all sex offenders were treated psychotherapeutically and 37% were receiving an additional pharmacological treatment. Of all the sex offenders, 15.7% were treated with TLM; 10.6% were treated with a gonadotropin-releasing hormone agonist; and 5.1% were treated with cyproterone acetate. Of these, 26.0-75.4% showed improvements in such outcomes as reduction of frequency and/or intensity of sexual thoughts. The remaining 21.3% of sex offenders who received a pharmacological agent were treated with selective serotonin reuptake inhibitors (11.5%) or antipsychotic medications (9.8%).CONCLUSIONS: TLM are a frequently used addition to psychotherapy in sex offenders. In light of the lack of controlled clinical trials and the many side effects, benefits and risks should always be thoroughly assessed.
AB - INTRODUCTION: Different clinical guidelines suggest using testosterone-lowering medications (TLM) in sex offender treatment in addition to psychotherapy. Within Germany, there are two officially approved agents. So far, no current data exist about the routine use of TLM in a clinical context.AIM: The present observational study evaluates the frequency of the prescription of TLM and other medications in sex offender treatment in German forensic-psychiatric institutions. Experts are asked about the observed effects and side effects of TLM.METHOD: The heads of all 69 German forensic-psychiatric hospitals and outpatient clinics were asked to fill out a questionnaire assessing offender characteristics and treatment methods in use.MAIN OUTCOME MEASURES: Main outcome measures were the number of patients being treated with TLM and other pharmacological agents for reducing sexual drive. Further effects and side effects of the agents were evaluated.RESULTS: Thirty-two participating institutions reported on 3,963 patients, 611 of them being sex offenders (15.4%). Most sex offenders had been convicted for child sexual abuse (39.8%) or a sexual assault/rape (37.6%). Almost all sex offenders were treated psychotherapeutically and 37% were receiving an additional pharmacological treatment. Of all the sex offenders, 15.7% were treated with TLM; 10.6% were treated with a gonadotropin-releasing hormone agonist; and 5.1% were treated with cyproterone acetate. Of these, 26.0-75.4% showed improvements in such outcomes as reduction of frequency and/or intensity of sexual thoughts. The remaining 21.3% of sex offenders who received a pharmacological agent were treated with selective serotonin reuptake inhibitors (11.5%) or antipsychotic medications (9.8%).CONCLUSIONS: TLM are a frequently used addition to psychotherapy in sex offenders. In light of the lack of controlled clinical trials and the many side effects, benefits and risks should always be thoroughly assessed.
KW - Adult
KW - Androgen Antagonists
KW - Antipsychotic Agents
KW - Child
KW - Child Abuse, Sexual
KW - Combined Modality Therapy
KW - Commitment of Mentally Ill
KW - Cyproterone Acetate
KW - Drive
KW - Drug Therapy, Combination
KW - Germany
KW - Gonadotropin-Releasing Hormone
KW - Humans
KW - Libido
KW - Male
KW - Middle Aged
KW - Paraphilias
KW - Physician's Practice Patterns
KW - Prescription Drugs
KW - Psychotherapy
KW - Questionnaires
KW - Rape
KW - Serotonin Uptake Inhibitors
KW - Sex Offenses
KW - Testosterone
KW - Treatment Outcome
KW - Triptorelin Pamoate
U2 - 10.1111/j.1743-6109.2012.02958.x
DO - 10.1111/j.1743-6109.2012.02958.x
M3 - SCORING: Journal article
C2 - 23088739
VL - 10
SP - 570
EP - 578
JO - J SEX MED
JF - J SEX MED
SN - 1743-6095
IS - 2
ER -
