NDLI: Pharmacology of sexually compulsive behavior.

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Sexually compulsive behavior: hypersexuality. Preface.

Developmental psychopathological perspectives on sexually compulsive behavior.

Classifying hypersexual disorders: compulsive, impulsive, and addictive models.

Sexual behavior that is 'out of control': a theoretical conceptual approach.

Epidemiology, prevalence, and natural history of compulsive sexual behavior.

Paraphilia from a dissociative perspective.

Basic science and neurobiological research: potential relevance to sexual compulsivity.

Sexual arousal patterns: normal and deviant.

Treatment of sexually compulsive adolescents.

Pharmacology of sexually compulsive behavior.

Sexual offender treatment: a positive approach.

Treatment of compulsive cybersex behavior.

Female sexual compulsivity: a new syndrome.

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Pharmacology of sexually compulsive behavior.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Codispoti, Victoria L.
Description	Author Affiliation: Codispoti VL ( lcodis2000@aol.com)
Abstract	In a meta-analysis on controlled outcomes evaluations of 22,000 sex offenders, Losel and Schmucker found 80 comparisons between treatment and control groups. The recidivism rate averaged 19% in treated groups, and 27% in controls. Most other reviews reported a lower rate of sexual recidivism in treated sexual offenders. Of 2039 citations in this study (including literature in five languages), 60 studies held independent comparisons. Problematic issues included the control groups; various hormonal, surgical, cognitive behavioral, and psychotherapeutic treatments; and sample sizes. In the 80 studies compared after the year 2000, 32% were reported after 2000, 45% originated in the United States, 45% were reported in journals, and 36% were unpublished. Treatment characteristics showed a significant lack of pharmacologic treatment (7.5%), whereas use cognitive and classical behavioral therapy was 64%. In 68% of the studies, no information was available on the integrity of the treatment implementation; 36% of the treatment settings were outpatient only, 31% were prison settings, and 12% were mixed settings (prison, hospital, and outpatient). Integrating research interpretations is complicated by the heterogeneity of sex offenders, with only 56% being adult men and 17.5% adolescents. Offense types reported included 74% child molestation, 48% incest, and 30% exhibitionism. Pedophilia was not singled out. Follow-up periods varied from 12 months to greater than 84 months. The definition of recidivism ran the gamut from arrest (24%), conviction (30%), charges (19%), and no indication (16%). Results were difficult to interpret because of the methodological problems with this type of study. Overall, a positive outcome was noted with sex offender treatment. Cognitive-behavioral and hormonal treatment were the most promising. Voluntary treatment led to a slightly better outcome than mandatory participation. When accounting for a low base rate of sexual recidivism, the reduction was 37%, which included psychological and medical modes of treatment. Which treatments will reduce recidivism rates in sex offenders is extremely difficult to conclude. Some treatment effects are determined from small studies; however, recidivism rates may be based on different criteria. Larger studies tend to be published more frequently than small studies, negative results may be less likely to be reported in published studies, and differences in mandatory versus voluntary treatment may occur. Clearly more high-quality outcome studies are needed to determine which treatments work best for which individuals. One size is unlikely to fit all. However, pharmacologic intervention, although not always the perfect choice, has improved and will continue to advance the treatment of paraphilic, nonparaphilic, and compulsive sexual behaviors.
File Format	HTM / HTML
ISSN	0193953X
Issue Number	4
Volume Number	31
e-ISSN	15583147
Journal	Psychiatric Clinics of North America
Language	English
Publisher	Elsevier
Publisher Date	2008-12-01
Publisher Place	United States
Access Restriction	Subscribed
Subject Keyword	Discipline Psychiatry Compulsive Behavior Drug Therapy Paraphilias Sexual Dysfunctions, Psychological Androgen Antagonists Therapeutic Use Diagnosis Psychology Cyproterone Acetate Gonadotropin-releasing Hormone Agonists Humans Leuprolide Medroxyprogesterone Acetate Object Attachment Pedophilia Serotonin Uptake Inhibitors Journal Article Review
Content Type	Text
Resource Type	Article
Subject	Psychiatry and Mental Health

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