背景:性冒犯的人数,从监狱或法医精神病学释放后,他们继续接受药物治疗以减少性欲,不知道。此外,在门诊环境中停止性欲抑制抗雄激素治疗的人数也未知。尽管这可能与累犯风险增加有关,但这一点至关重要。
目的:评估在德国的门诊诊所中,有性冒犯并从监狱或法医精神病医院释放的个人的处方模式以及对药物治疗的依从性。
方法:通过电子邮件将评估药物治疗方式的自我构建的在线调查发送到德国n=103的法医门诊诊所。33例(32.0%)完成问卷,报告约834例患者。
结果:使用不同药物治疗因性犯罪而被定罪的个体的患病率以及停用降睾酮药物(TLM)的患者人数。
结果:在所有机构中,22.4%(n=187)的个体接受药物治疗,40.1%的人接受促性腺激素释放激素激动剂,26.2%抗精神病药,24.6%选择性5-羟色胺再摄取抑制剂,6.4%醋酸环丙孕酮,和2.7%的促性腺激素释放激素激动剂和醋酸环丙孕酮的组合。从法医精神病医院释放的患者人数与接受TLM治疗的患者人数之间存在显着正相关。在1年内,8.6%(n=16)在监督期期间或结束时停止了TLM,他们中的大多数人反对治疗提供者的建议。
结论:巨大的地区差异表明,在德国犯有性犯罪的门诊患者的药物处方方面存在不确定性。在相当大比例的患者中,在治疗提供者建议的第一年内停止TLM可能与严重的再犯罪风险有关。
■本调查捕获了法医善后设施中的药物治疗的流行情况,并且是第一个记录中断次数的人。这是一项仅涵盖1个国家的横断面调查,但包括大量的个人。
结论:尽管监狱中接受治疗的人数有所增加,大部分药物治疗仍然由法医医院提供,然后转化为门诊设置。停止服用此类药物的人数对于法医提供者和法律决策者来说都是一个高度相关的话题。
The number of individuals who sexually offended, and who are continued to be treated with pharmacological agents to reduce sex drive after their release from prison or forensic psychiatry, are not known. Furthermore, figures on the number of those who stop their sexdrive supressing antiandrogen treatment in the outpatient setting are unknown as well. This is of central importance though as it might be associated with an increased risk of recidivism.
To assess prescription patterns as well as adherence to pharmacological treatment in outpatient clinics in Germany for individuals who have sexually offended and were released from prison or forensic psychiatric hospital.
A self-constructed online survey assessing the pharmacological treatment modalities was sent by e-mail to n = 103 forensic outpatient clinics in Germany. Thirty-three (32.0%) completed the questionnaire and reported about 834 patients.
Prevalence of the use of different pharmacological agents in the treatment of individuals convicted for sexual offenses as well as the number of patients who have discontinued testosterone-lowering medication (TLM).
Among all institutions, 22.4% (n = 187) of individuals received pharmacological treatment, with 40.1% receiving gonadotropin-releasing-hormone-agonists, 26.2% antipsychotics, 24.6% selective serotonin reuptake inhibitors, 6.4% cyproterone acetate, and 2.7% a combination of gonadotropin-releasing-hormone-agonists and cyproterone acetate. A significant positive correlation was found between the number of patients released from a forensic-psychiatric hospital and the number of patients treated with TLM. Within 1 year 8.6% (n = 16) stopped their TLM during or at the end of the supervision period, most of them against treatment providers advice.
Substantial regional differences indicate uncertainties regarding the prescription of pharmacological agents for outpatients who have committed sexual offences in Germany. The discontinuiation of TLM within the first year of treatment against treatment providers advise in a substantial proportion of patients could be associated with a serious risk for reoffending.
The present survey captures prevalences of the pharmacotherapy in forensic aftercare facilities for individuals who have offended sexually, and is the first to record the number of discontinuations. This is a cross-sectional survey covering only 1 country, but includes a large number of individuals.
Even though the number of treated individuals has increased in prisons, the majority of pharmacological treatment is still provided by forensic hospitals, which then translates into the outpatient setting. The number of those who stop taking such medication is a highly relevant topic for both forensic treatment providers and legal decision makers.