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Florence Thibaut - One of the best experts on this subject based on the ideXlab platform.
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GUIDELINES The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the biological treatment of Paraphilias
2015Co-Authors: Florence Thibaut, La Barra, Harvey Gordon, Paul CosynsAbstract:Objectives. The primary aim of these guidelines was to evaluate the role of pharmacological agents in the treatment and management of Paraphilia, with a focus on the treatment of adults males. Because such treatments are not delivered in isolation, the role of specifi c psychosocial and psychotherapeutic interventions was also briefl y covered. These guidelines are intended for use in clinical practice by clinicians who diagnose and treat patients with Paraphilia. The aim of these guidelines is to improve the quality of care and to aid physicians in clinical decisions. Methods. The aim of these guidelines was to bring together different views on the appropriate treatment of Paraphilias from experts representing different con-tinents. To achieve this aim, an extensive literature search was conducted using the English language literature indexed on MEDLINE/PubMed (1990 – 2009 for SSRIs) (1969 – 2009 for antiandrogen treatments), supplemented by other sources, including published reviews. Results. Each treatment recommendation was evaluated and discussed with respect to the strength of evidence for its effi cacy, safety, tolerability and feasibility. Conclusions. An algorithm was proposed with six levels of treatment for different categories of Paraphilias
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Pharmacologic treatment of Paraphilias.
The Psychiatric clinics of North America, 2014Co-Authors: Alessandra Almeida Assumpção, John M. W. Bradford, Frederico Duarte Garcia, Heloise Delavenne Garcia, Florence ThibautAbstract:The treatment of Paraphilias remains a challenge in the mental health field. Combined pharmacologic and psychotherapeutic treatment is associated with better efficacy. The gold standard treatment of severe Paraphilias in adult males is antiandrogen treatment with cognitive behavioral therapy. Selective serotonin reuptake inhibitors have been used in mild types of Paraphilia and in cases of sexual compulsions and juvenile Paraphilias. Antiandrogen treatments seem to be effective in severe paraphilic subjects committing sexual offenses. In particular, gonadotropin-releasing hormone analogs have shown high efficacy working in a similar way to physical castration but being reversible at any time. Treatment recommendations, side effects, and contraindications are discussed.
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Pharmacologic Treatment of Sex Offenders With Paraphilic Disorder
Current Psychiatry Reports, 2013Co-Authors: Frederico Duarte Garcia, Alessandra Almeida Assumpção, Heloise Garcia Delavenne, Florence ThibautAbstract:Sexual offending is both a social and a public health issue. Evidence demonstrates that a combination of pharmacological and psychotherapeutic approaches may reduce or even eliminate deviant sexual behavior in sex offenders with paraphilic disorders. In this article, we will review pharmacological treatment options for sex offenders with Paraphilias. Both serotonin selective reuptake inhibitors (SSRIs) and antiandrogen treatments have been used with reported success in decreasing recidivism. SSRIs have been used in mild types of Paraphilias and juvenile Paraphilias. Antiandrogen treatments seem to be effective in severe sex offenders with paraphilic disorders in order to reduce victimization. Combined pharmacological and psychotherapeutic treatment is associated with better efficacy. Imaging studies may improve the knowledge of paraphilic disorders and the mechanisms of action of current treatments. In spite of existing evidence, there is a need for independent, large-scale and good quality studies assessing the long-term efficacy and tolerance of treatments.
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Pharmacologic Treatment of Sex Offenders With Paraphilic Disorder
Current Psychiatry Reports, 2013Co-Authors: Frederico Duarte Garcia, Alessandra Almeida Assumpção, Heloise Garcia Delavenne, Florence ThibautAbstract:Sexual offending is both a social and a public health issue. Evidence demonstrates that a combination of pharmacological and psychotherapeutic approaches may reduce or even eliminate deviant sexual behavior in sex offenders with paraphilic disorders. In this article, we will review pharmacological treatment options for sex offenders with Paraphilias. Both serotonin selective reuptake inhibitors (SSRIs) and antiandrogen treatments have been used with reported success in decreasing recidivism. SSRIs have been used in mild types of Paraphilias and juvenile Paraphilias. Antiandrogen treatments seem to be effective in severe sex offenders with paraphilic disorders in order to reduce victimization. Combined pharmacological and psychotherapeutic treatment is associated with better efficacy. Imaging studies may improve the knowledge of paraphilic disorders and the mechanisms of action of current treatments. In spite of existing evidence, there is a need for independent, large-scale and good quality studies assessing the long-term efficacy and tolerance of treatments.
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Pharmacological treatment of Paraphilias.
The Israel journal of psychiatry and related sciences, 2012Co-Authors: Florence ThibautAbstract:BACKGROUND The psychiatrist's main role is to provide care to the paraphilic patient and to reduce personal distress. However, in cases of Paraphilia associated with sexual offences, reducing paraphilic behavior is critical in an approach to preventing sexual violence and reducing victimization. This review will focus on this specific population. METHOD We discuss the recently published recommendations for the treatment of Paraphilias of the World Federation of Societies of Biological Psychiatry which were based on a review of the available literature about pharmacological treatment of Paraphilias (1970-2010). RESULTS AND CONCLUSION Antiandrogens, and mostly GnRH analogues, significantly reduce the intensity and frequency of deviant sexual arousal and behavior, although informed consent is necessary in all cases. GnRH analogue treatment constitutes the most promising treatment for sex offenders at high risk of sexual violence, such as pedophiles or serial rapists. SSRIs remain an interesting option in adolescents, in patients with depressive or OCD disorders, or in mild Paraphilias such as exhibitionism. Pharmacological interventions should be part of a more comprehensive treatment plan including psychotherapy and, in most cases, behavior therapy.
Martin P. Kafka - One of the best experts on this subject based on the ideXlab platform.
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Hypersexual desire in males: are males with Paraphilias different from males with Paraphilia-related disorders?
Sexual abuse : a journal of research and treatment, 2003Co-Authors: Martin P. Kafka, John HennenAbstract:The assessment of current sexual behavior (fantasies, urges, and activities) and sexual preoccupation (measured in min/day) associated with both conventional (i.e., adult relationship-associated) or unconventional (Paraphilia and Paraphilia-related) sexual behavior were ascertained from a sample of 120 consecutively evaluated males with Paraphilias (PA; n = 88, including sex offender Paraphiliacs; n = 60) and Paraphilia-related disorders (PRD; n = 32). In addition, an assessment of hypersexual desire, defined as the highest sustained period (at least 6 months minimum duration) of persistently enacted sexual behavior (total sexual outlet/week [TSO] after age 15) was assessed. In almost all measures, the PA and PRD groups were not statistically significantly different. The average PA or PRD reported a mean hypersexual TSO of 11.7 +/- 7.3, a mean age of 21.6 +/- 7.1 years at onset of peak hypersexual behavior, and a mean duration of 6.2 +/- 7.6 years of hypersexual TSO. When the sample was stratified into three subgroups on the basis of the lifetime number of PAs + PRDs as a proxy measure of the severity of sexual impulsivity, the "high" group, with at least 5 lifetime PAs and PRDs, consisted of all paraphilic males, predominantly sex offenders, who self-reported the highest hypersexual desire (14.3 +/- 7.9), the highest current TSO/week (9.9 +/- 8.1), the most current sexual preoccupation (2-4 hr/day), and the highest likelihood of incarceration secondary to paraphilic sex-offending behavior. Although hypersexual desire, a quantitative measure of enacted sexual behaviours, may be a meaningful construct for clinically derived samples, the incidence and prevalence of hypersexual desire in community samples of males with Paraphilias and Paraphilia-related disorders is unknown.
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the Paraphilia related disorders a proposal for a unified classification of nonparaphilic hypersexuality disorders
Sexual Addiction and Compulsivity: The Journal of Treatment and Prevention, 2001Co-Authors: Martin P. KafkaAbstract:This article introduces a description of a group of nonparaphilic hypersexual behavior disorders, the Paraphilia-related disorders (PRDs). The rationale for the definition and characterization of these behaviors is described and empirical literature supporting the concept of PRDs is reviewed. The common Paraphilia-related disorders include compulsive masturbation, protracted promiscuity, pornography dependence, cybersex dependence, telephone sex dependence, severe sexual desire incompatibility and Paraphiliarelated disorder not otherwise specified. The comorbid associations and clinical characteristics supporting the evidence that PRDs are indeed related to paraphilic disorders are described. The case is made that the classification of nonparaphilic hypersexual disorders as "Paraphilia-related disorders" avoids the confusing use of characterizations such as "addiction" or "compulsivity" when applied to a broad range of sexual appetitive behavior disorders.
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psychostimulant augmentation during treatment with selective serotonin reuptake inhibitors in men with Paraphilias and Paraphilia related disorders a case series
The Journal of Clinical Psychiatry, 2000Co-Authors: Martin P. Kafka, John HennenAbstract:Background: We describe an open trial of psychostimulants (primarily methylphenidate sustained release [SR]) added to selective serotonin reuptake inhibitors (SSRIs; primarily fluoxetine) during the course of pharmacologic treatment of men with Paraphilias and Paraphilia-related disorders (PRDs). Method: Twenty-six men with Paraphilias (N = 14) or PRDs (N = 12) were assessed for lifetime mood disorders and attention-deficit/hyperactivity disorder (ADHD) as defined by DSM-IV. All men were assessed at baseline for total sexual outlet and average time per day associated with Paraphilia/PRD sexual behaviors. The indications for the addition of a psychostimulant to a stable dose of SSRI included the retrospective diagnosis of ADHD with persistent adult symptoms despite pharmacotherapy with an SSRI (N = 17); residual Paraphilia/PRD fantasies, urges, and activities despite SSRI pharmacotherapy (N = 16); the persistence or presence of residual depressive symptoms despite SSRI pharmacotherapy (N = 6); relapse or loss of SSRI efficacy during the treatment of sexual impulsivity disorders (N = 4); and treatment of SSRI-induced side effects (N = 4). Results: SSRI pharmacotherapy (mean ± SD duration = 8.8 ± 11.1 months) had statistically significant effects in diminishing Paraphilia/PRD-related total sexual outlet (p <.001) and average time/day spent in Paraphilia/PRD sexual behavior (p <.001). Addition of methylphenidate SR (mean dose = 40 mg/day; mean ± SD duration = 9.6 ± 8.2 months) was associated with additional statistically significant effects on Paraphilia/PRD-related total sexual outlet (p =.003) and average time per day (p =.04) in addition to improvement of putative residual ADHD and depressive symptoms. Conclusion: Methylphenidate SR can be cautiously and effectively combined with SSRI antidepressants to ameliorate Paraphilias and Paraphilia-related disorders for the indications listed above.
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Psychostimulant Augmentation During Treatment With Selective Serotonin Reuptake Inhibitors in Men With Paraphilias and Paraphilia-Related Disorders: A Case Series
The Journal of clinical psychiatry, 2000Co-Authors: Martin P. Kafka, John HennenAbstract:Background: We describe an open trial of psychostimulants (primarily methylphenidate sustained release [SR]) added to selective serotonin reuptake inhibitors (SSRIs; primarily fluoxetine) during the course of pharmacologic treatment of men with Paraphilias and Paraphilia-related disorders (PRDs). Method: Twenty-six men with Paraphilias (N = 14) or PRDs (N = 12) were assessed for lifetime mood disorders and attention-deficit/hyperactivity disorder (ADHD) as defined by DSM-IV. All men were assessed at baseline for total sexual outlet and average time per day associated with Paraphilia/PRD sexual behaviors. The indications for the addition of a psychostimulant to a stable dose of SSRI included the retrospective diagnosis of ADHD with persistent adult symptoms despite pharmacotherapy with an SSRI (N = 17); residual Paraphilia/PRD fantasies, urges, and activities despite SSRI pharmacotherapy (N = 16); the persistence or presence of residual depressive symptoms despite SSRI pharmacotherapy (N = 6); relapse or loss of SSRI efficacy during the treatment of sexual impulsivity disorders (N = 4); and treatment of SSRI-induced side effects (N = 4). Results: SSRI pharmacotherapy (mean ± SD duration = 8.8 ± 11.1 months) had statistically significant effects in diminishing Paraphilia/PRD-related total sexual outlet (p
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the Paraphilia related disorders an empirical investigation of nonparaphilic hypersexuality disorders in outpatient males
Journal of Sex & Marital Therapy, 1999Co-Authors: Martin P. Kafka, John HennenAbstract:The frequency distribution of nonparaphilic hypersexual behaviors was investigated in an outpatient sample of 206 consecutively evaluated males seeking help for sexual impulsivity disorders (SIDs), either Paraphilia-related disorders (PRD; n = 63) or Paraphilias (PA; n = 143). Paraphilia-related disorders associated with help-seeking behaviors included compulsive masturbation (sample prevalence, 69%), protracted heterosexual or homosexual promiscuity (51%), pornography dependence (50%), telephone-sex dependence (24%), and severe sexual desire incompatibility (12%). Eighty-six percent of the PA sample reported at least one lifetime PRD. The subgroup of males with both PAs and lifetime PRDs (n = 123) self-reported the greatest number of lifetime SIDs, the highest incidence of physical and sexual abuse, the fewest years of completed education, and the highest likelihood of current unemployment or disability. As well, the subgroup of males with PAs but no lifetime PRDs (n = 20) self-reported the fewest lifetime SIDs; this subgroup was not statistically different from the PRD group on these aforementioned variables. These data suggest that social disadvantage, as assessed in this sample, is associated with the cumulative incidence of SIDs but not necessarily with the diathesis to develop paraphilic disorders.
John Hennen - One of the best experts on this subject based on the ideXlab platform.
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Hypersexual desire in males: are males with Paraphilias different from males with Paraphilia-related disorders?
Sexual abuse : a journal of research and treatment, 2003Co-Authors: Martin P. Kafka, John HennenAbstract:The assessment of current sexual behavior (fantasies, urges, and activities) and sexual preoccupation (measured in min/day) associated with both conventional (i.e., adult relationship-associated) or unconventional (Paraphilia and Paraphilia-related) sexual behavior were ascertained from a sample of 120 consecutively evaluated males with Paraphilias (PA; n = 88, including sex offender Paraphiliacs; n = 60) and Paraphilia-related disorders (PRD; n = 32). In addition, an assessment of hypersexual desire, defined as the highest sustained period (at least 6 months minimum duration) of persistently enacted sexual behavior (total sexual outlet/week [TSO] after age 15) was assessed. In almost all measures, the PA and PRD groups were not statistically significantly different. The average PA or PRD reported a mean hypersexual TSO of 11.7 +/- 7.3, a mean age of 21.6 +/- 7.1 years at onset of peak hypersexual behavior, and a mean duration of 6.2 +/- 7.6 years of hypersexual TSO. When the sample was stratified into three subgroups on the basis of the lifetime number of PAs + PRDs as a proxy measure of the severity of sexual impulsivity, the "high" group, with at least 5 lifetime PAs and PRDs, consisted of all paraphilic males, predominantly sex offenders, who self-reported the highest hypersexual desire (14.3 +/- 7.9), the highest current TSO/week (9.9 +/- 8.1), the most current sexual preoccupation (2-4 hr/day), and the highest likelihood of incarceration secondary to paraphilic sex-offending behavior. Although hypersexual desire, a quantitative measure of enacted sexual behaviours, may be a meaningful construct for clinically derived samples, the incidence and prevalence of hypersexual desire in community samples of males with Paraphilias and Paraphilia-related disorders is unknown.
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psychostimulant augmentation during treatment with selective serotonin reuptake inhibitors in men with Paraphilias and Paraphilia related disorders a case series
The Journal of Clinical Psychiatry, 2000Co-Authors: Martin P. Kafka, John HennenAbstract:Background: We describe an open trial of psychostimulants (primarily methylphenidate sustained release [SR]) added to selective serotonin reuptake inhibitors (SSRIs; primarily fluoxetine) during the course of pharmacologic treatment of men with Paraphilias and Paraphilia-related disorders (PRDs). Method: Twenty-six men with Paraphilias (N = 14) or PRDs (N = 12) were assessed for lifetime mood disorders and attention-deficit/hyperactivity disorder (ADHD) as defined by DSM-IV. All men were assessed at baseline for total sexual outlet and average time per day associated with Paraphilia/PRD sexual behaviors. The indications for the addition of a psychostimulant to a stable dose of SSRI included the retrospective diagnosis of ADHD with persistent adult symptoms despite pharmacotherapy with an SSRI (N = 17); residual Paraphilia/PRD fantasies, urges, and activities despite SSRI pharmacotherapy (N = 16); the persistence or presence of residual depressive symptoms despite SSRI pharmacotherapy (N = 6); relapse or loss of SSRI efficacy during the treatment of sexual impulsivity disorders (N = 4); and treatment of SSRI-induced side effects (N = 4). Results: SSRI pharmacotherapy (mean ± SD duration = 8.8 ± 11.1 months) had statistically significant effects in diminishing Paraphilia/PRD-related total sexual outlet (p <.001) and average time/day spent in Paraphilia/PRD sexual behavior (p <.001). Addition of methylphenidate SR (mean dose = 40 mg/day; mean ± SD duration = 9.6 ± 8.2 months) was associated with additional statistically significant effects on Paraphilia/PRD-related total sexual outlet (p =.003) and average time per day (p =.04) in addition to improvement of putative residual ADHD and depressive symptoms. Conclusion: Methylphenidate SR can be cautiously and effectively combined with SSRI antidepressants to ameliorate Paraphilias and Paraphilia-related disorders for the indications listed above.
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Psychostimulant Augmentation During Treatment With Selective Serotonin Reuptake Inhibitors in Men With Paraphilias and Paraphilia-Related Disorders: A Case Series
The Journal of clinical psychiatry, 2000Co-Authors: Martin P. Kafka, John HennenAbstract:Background: We describe an open trial of psychostimulants (primarily methylphenidate sustained release [SR]) added to selective serotonin reuptake inhibitors (SSRIs; primarily fluoxetine) during the course of pharmacologic treatment of men with Paraphilias and Paraphilia-related disorders (PRDs). Method: Twenty-six men with Paraphilias (N = 14) or PRDs (N = 12) were assessed for lifetime mood disorders and attention-deficit/hyperactivity disorder (ADHD) as defined by DSM-IV. All men were assessed at baseline for total sexual outlet and average time per day associated with Paraphilia/PRD sexual behaviors. The indications for the addition of a psychostimulant to a stable dose of SSRI included the retrospective diagnosis of ADHD with persistent adult symptoms despite pharmacotherapy with an SSRI (N = 17); residual Paraphilia/PRD fantasies, urges, and activities despite SSRI pharmacotherapy (N = 16); the persistence or presence of residual depressive symptoms despite SSRI pharmacotherapy (N = 6); relapse or loss of SSRI efficacy during the treatment of sexual impulsivity disorders (N = 4); and treatment of SSRI-induced side effects (N = 4). Results: SSRI pharmacotherapy (mean ± SD duration = 8.8 ± 11.1 months) had statistically significant effects in diminishing Paraphilia/PRD-related total sexual outlet (p
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the Paraphilia related disorders an empirical investigation of nonparaphilic hypersexuality disorders in outpatient males
Journal of Sex & Marital Therapy, 1999Co-Authors: Martin P. Kafka, John HennenAbstract:The frequency distribution of nonparaphilic hypersexual behaviors was investigated in an outpatient sample of 206 consecutively evaluated males seeking help for sexual impulsivity disorders (SIDs), either Paraphilia-related disorders (PRD; n = 63) or Paraphilias (PA; n = 143). Paraphilia-related disorders associated with help-seeking behaviors included compulsive masturbation (sample prevalence, 69%), protracted heterosexual or homosexual promiscuity (51%), pornography dependence (50%), telephone-sex dependence (24%), and severe sexual desire incompatibility (12%). Eighty-six percent of the PA sample reported at least one lifetime PRD. The subgroup of males with both PAs and lifetime PRDs (n = 123) self-reported the greatest number of lifetime SIDs, the highest incidence of physical and sexual abuse, the fewest years of completed education, and the highest likelihood of current unemployment or disability. As well, the subgroup of males with PAs but no lifetime PRDs (n = 20) self-reported the fewest lifetime SIDs; this subgroup was not statistically different from the PRD group on these aforementioned variables. These data suggest that social disadvantage, as assessed in this sample, is associated with the cumulative incidence of SIDs but not necessarily with the diathesis to develop paraphilic disorders.
Frederico Duarte Garcia - One of the best experts on this subject based on the ideXlab platform.
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Pharmacologic treatment of Paraphilias.
The Psychiatric clinics of North America, 2014Co-Authors: Alessandra Almeida Assumpção, John M. W. Bradford, Frederico Duarte Garcia, Heloise Delavenne Garcia, Florence ThibautAbstract:The treatment of Paraphilias remains a challenge in the mental health field. Combined pharmacologic and psychotherapeutic treatment is associated with better efficacy. The gold standard treatment of severe Paraphilias in adult males is antiandrogen treatment with cognitive behavioral therapy. Selective serotonin reuptake inhibitors have been used in mild types of Paraphilia and in cases of sexual compulsions and juvenile Paraphilias. Antiandrogen treatments seem to be effective in severe paraphilic subjects committing sexual offenses. In particular, gonadotropin-releasing hormone analogs have shown high efficacy working in a similar way to physical castration but being reversible at any time. Treatment recommendations, side effects, and contraindications are discussed.
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Pharmacologic Treatment of Sex Offenders With Paraphilic Disorder
Current Psychiatry Reports, 2013Co-Authors: Frederico Duarte Garcia, Alessandra Almeida Assumpção, Heloise Garcia Delavenne, Florence ThibautAbstract:Sexual offending is both a social and a public health issue. Evidence demonstrates that a combination of pharmacological and psychotherapeutic approaches may reduce or even eliminate deviant sexual behavior in sex offenders with paraphilic disorders. In this article, we will review pharmacological treatment options for sex offenders with Paraphilias. Both serotonin selective reuptake inhibitors (SSRIs) and antiandrogen treatments have been used with reported success in decreasing recidivism. SSRIs have been used in mild types of Paraphilias and juvenile Paraphilias. Antiandrogen treatments seem to be effective in severe sex offenders with paraphilic disorders in order to reduce victimization. Combined pharmacological and psychotherapeutic treatment is associated with better efficacy. Imaging studies may improve the knowledge of paraphilic disorders and the mechanisms of action of current treatments. In spite of existing evidence, there is a need for independent, large-scale and good quality studies assessing the long-term efficacy and tolerance of treatments.
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Pharmacologic Treatment of Sex Offenders With Paraphilic Disorder
Current Psychiatry Reports, 2013Co-Authors: Frederico Duarte Garcia, Alessandra Almeida Assumpção, Heloise Garcia Delavenne, Florence ThibautAbstract:Sexual offending is both a social and a public health issue. Evidence demonstrates that a combination of pharmacological and psychotherapeutic approaches may reduce or even eliminate deviant sexual behavior in sex offenders with paraphilic disorders. In this article, we will review pharmacological treatment options for sex offenders with Paraphilias. Both serotonin selective reuptake inhibitors (SSRIs) and antiandrogen treatments have been used with reported success in decreasing recidivism. SSRIs have been used in mild types of Paraphilias and juvenile Paraphilias. Antiandrogen treatments seem to be effective in severe sex offenders with paraphilic disorders in order to reduce victimization. Combined pharmacological and psychotherapeutic treatment is associated with better efficacy. Imaging studies may improve the knowledge of paraphilic disorders and the mechanisms of action of current treatments. In spite of existing evidence, there is a need for independent, large-scale and good quality studies assessing the long-term efficacy and tolerance of treatments.
Alessandra Almeida Assumpção - One of the best experts on this subject based on the ideXlab platform.
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Pharmacologic treatment of Paraphilias.
The Psychiatric clinics of North America, 2014Co-Authors: Alessandra Almeida Assumpção, John M. W. Bradford, Frederico Duarte Garcia, Heloise Delavenne Garcia, Florence ThibautAbstract:The treatment of Paraphilias remains a challenge in the mental health field. Combined pharmacologic and psychotherapeutic treatment is associated with better efficacy. The gold standard treatment of severe Paraphilias in adult males is antiandrogen treatment with cognitive behavioral therapy. Selective serotonin reuptake inhibitors have been used in mild types of Paraphilia and in cases of sexual compulsions and juvenile Paraphilias. Antiandrogen treatments seem to be effective in severe paraphilic subjects committing sexual offenses. In particular, gonadotropin-releasing hormone analogs have shown high efficacy working in a similar way to physical castration but being reversible at any time. Treatment recommendations, side effects, and contraindications are discussed.
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Pharmacologic Treatment of Sex Offenders With Paraphilic Disorder
Current Psychiatry Reports, 2013Co-Authors: Frederico Duarte Garcia, Alessandra Almeida Assumpção, Heloise Garcia Delavenne, Florence ThibautAbstract:Sexual offending is both a social and a public health issue. Evidence demonstrates that a combination of pharmacological and psychotherapeutic approaches may reduce or even eliminate deviant sexual behavior in sex offenders with paraphilic disorders. In this article, we will review pharmacological treatment options for sex offenders with Paraphilias. Both serotonin selective reuptake inhibitors (SSRIs) and antiandrogen treatments have been used with reported success in decreasing recidivism. SSRIs have been used in mild types of Paraphilias and juvenile Paraphilias. Antiandrogen treatments seem to be effective in severe sex offenders with paraphilic disorders in order to reduce victimization. Combined pharmacological and psychotherapeutic treatment is associated with better efficacy. Imaging studies may improve the knowledge of paraphilic disorders and the mechanisms of action of current treatments. In spite of existing evidence, there is a need for independent, large-scale and good quality studies assessing the long-term efficacy and tolerance of treatments.
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Pharmacologic Treatment of Sex Offenders With Paraphilic Disorder
Current Psychiatry Reports, 2013Co-Authors: Frederico Duarte Garcia, Alessandra Almeida Assumpção, Heloise Garcia Delavenne, Florence ThibautAbstract:Sexual offending is both a social and a public health issue. Evidence demonstrates that a combination of pharmacological and psychotherapeutic approaches may reduce or even eliminate deviant sexual behavior in sex offenders with paraphilic disorders. In this article, we will review pharmacological treatment options for sex offenders with Paraphilias. Both serotonin selective reuptake inhibitors (SSRIs) and antiandrogen treatments have been used with reported success in decreasing recidivism. SSRIs have been used in mild types of Paraphilias and juvenile Paraphilias. Antiandrogen treatments seem to be effective in severe sex offenders with paraphilic disorders in order to reduce victimization. Combined pharmacological and psychotherapeutic treatment is associated with better efficacy. Imaging studies may improve the knowledge of paraphilic disorders and the mechanisms of action of current treatments. In spite of existing evidence, there is a need for independent, large-scale and good quality studies assessing the long-term efficacy and tolerance of treatments.