Which factors influence the appropriateness of testosterone-lowering medications for sex offenders? A survey among clinicians from German forensic-psychiatric institutions

Abstract

Objectives. 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 (; 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.

Key words::

• sex offender
• cyproterone acetate
• gonadotropin-releasing hormone agonist
• depo-Provera
• sex offender treatment

Acknowledgements

We thank the participating clinicians for their participation in this study.

Statement of Interest

Peer Briken is consultant for Dr Pfleger GmbH Bamberg, Germany. The authors have no other conflict of interest with any commercial or other associations in connection with the submitted article.

The study was funded by the University Medical Center Hamburg-Eppendorf. There was no external funding; most importantly, there was no funding by a pharmaceutical company.

Notes

¹Bayer HealthCare Pharmaceuticals, 13353 Berlin, Germany.

²Dr. Pfleger GmBH, 96045 Bamberg, Germany.

³Pharmacia & Upjohn Company – Division of Pfizer, Inc, NY, NY 10017.

⁴Abbott Laboratories, Abbott Park, Illinois, 60064.