Thibaut Florence, Bradford John M W, Briken Peer, De La Barra Flora, Häßler Frank, Cosyns Paul
a University Hospital Cochin, Faculty of Medicine Paris Descartes, INSERM U 894 CPN , Paris , France .
b University of Ottawa, Institute of Mental Health Research, Division of Forensic Psychiatry, Queen's University, Clinical Director, Forensic Treatment Unit, Brockville Mental Health Centre, Royal Ottawa Health Care Group , Brockville , Ontario , Canada .
World J Biol Psychiatry. 2016;17(1):2-38. doi: 10.3109/15622975.2015.1085598. Epub 2015 Nov 23.
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.
这些指南的主要目的是评估药物制剂在治疗患有性偏好障碍的青少年(这些青少年同时也是性犯罪者或有性犯罪风险)中的作用。同时也对心理治疗和社会心理治疗进行了综述。与成年人相比,患有性偏好障碍的青少年呈现出不同的治疗挑战。部分挑战在于青少年正处于青春期和发育的不同阶段,这可能会因某些药物制剂的潜在副作用而限制其使用。此外,大多数已发表的治疗方案采用了认知行为干预、家庭治疗和心理教育干预。青少年心理治疗基于这样一种观念,即性偏离行为可由犯罪者控制,且可以习得更具适应性的行为。这些指南的主要目的是提高护理质量,并帮助医生进行临床决策。这些指南汇集了不同的专家观点,并进行了广泛的文献研究。针对疗效、安全性、耐受性和可行性的证据强度,对每项治疗建议进行了评估和讨论。本文提出了一种针对青少年性犯罪者或有风险者的性偏好障碍治疗算法。