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Abstract
Objectives. The primary aim of these guidelines was to evaluate the role of pharmacological agents in the treatment and management of paraphilia, with a focus on the treatment of adults males. Because such treatments are not delivered in isolation, the role of specific psychosocial and psychotherapeutic interventions was also briefly covered. These guidelines are intended for use in clinical practice by clinicians who diagnose and treat patients with paraphilia. The aim of these guidelines is to improve the quality of care and to aid physicians in clinical decisions. Methods. The aim of these guidelines was to bring together different views on the appropriate treatment of paraphilias from experts representing different continents. To achieve this aim, an extensive literature search was conducted using the English language literature indexed on MEDLINE/PubMed (1990–2009 for SSRIs) (1969–2009 for antiandrogen treatments), supplemented by other sources, including published reviews. Results. Each treatment recommendation was evaluated and discussed with respect to the strength of evidence for its efficacy, safety, tolerability and feasibility. Conclusions. An algorithm was proposed with six levels of treatment for different categories of paraphilias.
Acknowledgements
The authors are very grateful to Dr E. Catrin (Versailles University Hospital, France) and to B. Thirion (Head of the Library, Rouen University Hospital, France), for their help in the bibliographical research concerning hormonal treatment.
Statement of interest
Dr Bradford (Speaker bureau: Janssen-Ortho and Pfizer; Research support: Janssen-Ortho; Consultancy/Advisory Board: Janssen-Ortho and Pfizer. Drs Cosyns and de la Barra: none. Dr Thibaut (Consultancy: Debiopharm and Lundbeck; Speaker (CME): Janssen; CME grant: Sanofi).