Paraphilic Disorders

Parphilic Disorders
  • 文章类型: Journal Article
    当前指南旨在评估药物在强迫性行为障碍(CSBD)患者治疗中的作用。它们旨在由治疗CSBD患者的临床医生在临床实践中使用。
    使用PubMed和GoogleScholar索引的英语文学进行了广泛的文献检索,没有时间限制,补充其他来源,包括发表的评论。
    每个治疗建议都根据其疗效的证据强度进行评估,安全,耐受性,和可行性。心理教育和心理治疗是首选治疗方法,应始终进行。推荐的药物类型主要取决于CSBD的强度以及合并症和精神疾病。很少有随机对照试验。虽然没有药物具有CSBD的正式适应症,选择性5-羟色胺再摄取抑制剂和纳曲酮目前是治疗CSBD的最相关的药物治疗方法。在CSBD合并副嗜性疾病的病例中,可以指示荷尔蒙剂,人们应该参考以前发表的关于治疗成人嗜性疾病的指南。在与CSBD相关的化学性行为的情况下,还提出了具体建议。
    针对不同类别的CSBD患者,提出了一种具有不同治疗水平的算法。
    The current guidelines aim to evaluate the role of pharmacological agents in the treatment of patients with compulsive sexual behaviour disorder (CSBD). They are intended for use in clinical practice by clinicians who treat patients with CSBD.
    An extensive literature search was conducted using the English-language-literature indexed on PubMed and Google Scholar without time limit, supplemented by other sources, including published reviews.
    Each treatment recommendation was evaluated with respect to the strength of evidence for its efficacy, safety, tolerability, and feasibility. Psychoeducation and psychotherapy are first-choice treatments and should always be conducted. The type of medication recommended depended mainly on the intensity of CSBD and comorbid sexual and psychiatric disorders. There are few randomised controlled trials. Although no medications carry formal indications for CSBD, selective-serotonin-reuptake-inhibitors and naltrexone currently constitute the most relevant pharmacological treatments for the treatment of CSBD. In cases of CSBD with comorbid paraphilic disorders, hormonal agents may be indicated, and one should refer to previously published guidelines on the treatment of adults with paraphilic disorders. Specific recommendations are also proposed in case of chemsex behaviour associated with CSBD.
    An algorithm is proposed with different levels of treatment for different categories of patients with CSBD.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    Objectives: The primary aim of these guidelines is to evaluate the role of pharmacological agents in the treatment and management of patients with paraphilic disorders, with a focus on the treatment of adult males. Because such treatments are not delivered in isolation, the role of specific psychotherapeutic interventions is also briefly covered. These guidelines are intended for use in clinical practice by clinicians who diagnose and treat patients, including sexual offenders, with paraphilic disorders. The aim of these guidelines is to bring together different views on the appropriate treatment of paraphilic disorders from experts representing different countries in order to aid physicians in clinical decisions and to improve the quality of care.Methods: An extensive literature search was conducted using the English-language-literature indexed on MEDLINE/PubMed (1990-2018 for SSRIs) (1969-2018 for hormonal 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 efficacy, safety, tolerability, and feasibility. The type of medication used depends on the severity of the paraphilic disorder and the respective risk of behaviour endangering others. GnRH analogue treatment constitutes the most relevant treatment for patients with severe paraphilic disorders.Conclusions: An algorithm is proposed with different levels of treatment for different categories of paraphilic disorders accompanied by different risk levels.
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  • 文章类型: Journal Article
    这些指南的主要目的是评估药物在治疗患有性交障碍的青少年中的作用,这些青少年也是性犯罪者或有性犯罪风险。还回顾了心理治疗和社会心理治疗。与成年人相比,患有亲性疾病的青少年特别提出了不同的治疗挑战。在某种程度上,挑战涉及青少年处于青春期和发育的不同阶段,由于其潜在的副作用,这可能会限制某些药物的使用。此外,大多数已发布的治疗方案都使用了认知行为干预措施,家庭治疗和心理教育干预。在青少年中,心理治疗是基于这样一种观念,即性越轨行为可以由犯罪者控制,并且可以学习更多的适应性行为。这些指南的主要目的是提高护理质量并帮助医生做出临床决策。这些指南汇集了不同的专家观点,并涉及广泛的文献研究。每个治疗建议都根据疗效证据的强度进行了评估和讨论。安全,耐受性和可行性。提出了一种算法,用于治疗青少年性犯罪者或处于危险中的性交障碍。
    The primary aim of these guidelines was to evaluate the role of pharmacological agents in the treatment of adolescents with paraphilic disorders who are also sexual offenders or at-risk of sexual offending. Psychotherapeutic and psychosocial treatments were also reviewed. Adolescents with paraphilic disorders specifically present a different therapeutic challenge as compared to adults. In part, the challenge relates to adolescents being in various stages of puberty and development, which may limit the use of certain pharmacological agents due to their potential side effects. In addition, most of the published treatment programmes have used cognitive behavioural interventions, family therapies and psychoeducational interventions. Psychological treatment is predicated in adolescents on the notion that sexually deviant behaviour can be controlled by the offender, and that more adaptive behaviours can be learned. The main purposes of these guidelines are to improve the quality of care and to aid physicians in their clinical decisions. These guidelines brought together different expert views and involved an extensive literature research. Each treatment recommendation was evaluated and discussed with respect to the strength of evidence for efficacy, safety, tolerability and feasibility. An algorithm is proposed for the treatment of paraphilic disorders in adolescent sexual offenders or those who are at risk.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    OBJECTIVE: 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 specific psychosocial and psychotherapeutic interventions was also briefly 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 continents. 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 efficacy, safety, tolerability and feasibility.
    CONCLUSIONS: An algorithm was proposed with six levels of treatment for different categories of paraphilias.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    This article presents the findings of a study exploring current levels of consensus among practitioners in the United Kingdom (UK) and the Republic of Ireland (ROI) about good practice in relation to youth who are sexually abusive. A three-stage Delphi procedure was used to survey the views of 78 practitioners, experienced in this field, on a range of matters relating to preferred responses to this population. The exercise indicated high levels of agreement that youth who are sexually abusive should be seen as a group clinically distinct from adult sex offenders and that all of their developmental needs, and their problematic behavior, should be targeted in intervention. A strong level of consensus was found among respondents about the goals and content of ideal practice with this user group, although there was less consensus about the theoretical models that should underpin practice.
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  • 文章类型: Journal Article
    Paraphilic syndromes, of which there are at least 40, are known legally as perversions and on the street as kinky and bizarre sex. Paraphilia accounts for a very high proportion of sex-offending that is prosecuted as criminal. A new treatment which combines a hormonal antiandrogen with sexological counseling therapy is becoming widely adopted in America and Europe. The treatment is available also to noncriminal paraphiliacs whose syndrome is a source of interpersonal suffering and crisis.
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