Treatment of Paraphilic Sexual Disorders

Which factors influence the appropriateness of testosterone-lowering medications for sex offenders? A survey among clinicians from German forensic-psychiatric institutions

“…This raises the question as to whether ethical principles are always being considered to an appropriate extent. Moreover, treatment compliance could probably be increased in those patients who are currently not being extensively informed about the treatment (Fedoroff 2011). The present study provides an insight into the factors that clinicians view as important for the process of deciding whether or not a sex offender should be treated with TLM.…”

“…Moreover, many sex offenders are not willing to be treated with TLM, and compliance regarding the taking of the medication once treatment has started would appear to be rather low (Fedoroff 1995;Langevin et al 1988). However, treatment compliance can be increased markedly if the offender is informed comprehensively about the possible risks and side effects of the medication and if he has the feeling that he can decide freely about taking the medication and can withdraw from treatment at any time (Fedoroff 2011). In this context, about 78% of sex offenders in forensic-psychiatric institutions in Germany are asked for their written informed consent prior to TLM treatment and 72% are explicitly informed about possible risks and side effects before TLM treatment is started (Turner et al 2013).…”

Prevalence and correlates of individuals with sexual interest in children: A systematic review

“…While some community studies have examined SIIC using both male and female populations (e.g., Wurtele et al, 2014) the majority of samples have been male (Fedoroff et al, 1999;Freel, 2003;Fromuth & Conn, 1997;Santilla et al, 2017) which may introduce bias in estimations of prevalence. However, across studies more men that women indicate SIIC.…”

Sex and genes, part 2: A biopsychosocial approach to assess and treat challenging sexual behavior in persons with intellectual disabilities including fragile X syndrome and 22q11.2 deletion syndrome

“…Pharmacologic treatment strategies for problematic sexual behaviors have been reviewed (Fedoroff, ; Thibaut et al, ). Most clinicians adopt the basic principle, that is, “If something is working, don't fix it.” The problem that arises for people with ID is that they often are unable to say when something is not working, especially if it involves psychological problems, and even more so if those problems concern sexuality.…”