[Paraphilia, sexual preference disorders. Diagnosis, etiology, epidemiology, treatment and prevention].
Hostility towards relationships is one prominent characteristic symptom for disorders of sexual preference (ICD-10) and paraphilias (DSM-IV). Paraphilic symptoms sometimes progress to obsessive or addictive- like forms leading to a loss of self-control but can occur also as single incidents or as episodic events. Besides constitutional aspects, problems in the development of close relationships to primary caregivers (attachment) play an important role in the development of these disorders. Actual relationship- and self-confidence problems often trigger the severity of disturbance, especially in the episodic forms of paraphilia. For patients who are in conflict with the law, cognitive-behavioral therapeutic approaches with the aim to minimize self-deception regarding the effects of the paraphilic behavior have become more and more relevant. Regarding the medical treatment, anti-hormonal therapy plays an important role, but also treatment with serotonergic agents and naltrexone are used. Only little can be advised in terms of prevention; general psycho-hygiene (regarding the parent-child relationship) is recommended. Beside these general measures, institutions which offer special treatment for people in danger to become delinquents may be able to prevent serious harm for possible victims of abuse.
Berner
Wolfgang
W
Universitätsklinikum Hamburg-Eppendorf, Hamburg-Eppendorf, BRD. berner@uke.uni-hamburg.de
Briken
P
P
D015928:Cognitive Behavioral Therapy / Q000379:methods*; D006727:Hormone Antagonists / Q000627:therapeutic use*; D006801:Humans; D009271:Naltrexone / Q000627:therapeutic use*; D010262:Paraphilic Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D012731:Sex Counseling / Q000379:methods*
D006727:Hormone Antagonists; D009271:Naltrexone; D017367:Selective Serotonin Reuptake Inhibitors