Which factors influence the appropriateness of testosterone-lowering medications for sex offenders? A survey among clinicians from German forensic-psychiatric institutions.
OBJECTIVE
Although testosterone-lowering medications (TLM) are a frequently used addition to psychotherapy in sex offender treatment, discord still seems to exist amongst clinicians as to in which cases administering TLM is justified. The depo-Provera scale (DPS), which was published by Maletzky and Field (Aggress Violent Behav 2003;8:391), assesses the appropriateness of TLM administration in sex offender treatment.


METHODS
The DPS was sent to all forensic psychiatric institutions in Germany. The clinical directors of these institutions were asked to rate the importance of each item of the DPS on a six-point Likert scale.


RESULTS
Twenty-nine clinicians participated. The most important reason selected for the prescription of TLM for sex offender treatment was a "history of sexual offender treatment failure". The least important item was "deviant sexual interest, by plethysmograph or Abel Screen" (neither plethysmograph nor Abel Screen is used in Germany).


CONCLUSIONS
Clinicians' attitudes towards the DPS correspond to the suggestions made in the current WSFBF-guidelines for the pharmacological treatment of sex offenders (Thibaut et al. 2010 ; World J Biol Psychiatry 11:604-655). Use of the DPS could therefore contribute to a more structured approach towards helping clinicians come to a decision about whether or not to treat a sex offender with TLM.
Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf , Hamburg , Germany.
Daniel
D
Turner
Raphaela
R
Basdekis-Jozsa
Arne
A
Dekker
Peer
P
Briken
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004358:Drug Therapy / Q000592:standards*; D005260:Female; D005555:Forensic Psychiatry / Q000592:standards*; D005858:Germany; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000592:standards; D012742:Sex Offenses / Q000517:prevention & control*; D013739:Testosterone; D055815:Young Adult
D013739:Testosterone
cyproterone acetate; depo-Provera; gonadotropin-releasing hormone agonist; sex offender; sex offender treatment