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World J Biol Psychiatry. 2016;17(1):2-38. doi: 10.3109/15622975.2015.1085598. Epub 2015 Nov 23.

The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the treatment of adolescent sexual offenders with paraphilic disorders.

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a University Hospital Cochin, Faculty of Medicine Paris Descartes, INSERM U 894 CPN , Paris , France .
b University of Ottawa, Institute of Mental Health Research, Division of Forensic Psychiatry, Queen's University, Clinical Director, Forensic Treatment Unit, Brockville Mental Health Centre, Royal Ottawa Health Care Group , Brockville , Ontario , Canada .
c Institute for Sex Research and Forensic Psychiatry, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf , Hamburg , Germany .
d East Psychiatry and Mental Health Department , University of Chile , Clinica Las Condes , Chile .
e Clinic for Child and Adolescent Psychiatry, University of Medicine of Rostock , Rostock , Germany , and.
f University Forensic Centre (University Hospital of Antwerp) , Belgium.


The primary aim of these guidelines was to evaluate the role of pharmacological agents in the treatment of adolescents with paraphilic disorders who are also sexual offenders or at-risk of sexual offending. Psychotherapeutic and psychosocial treatments were also reviewed. Adolescents with paraphilic disorders specifically present a different therapeutic challenge as compared to adults. In part, the challenge relates to adolescents being in various stages of puberty and development, which may limit the use of certain pharmacological agents due to their potential side effects. In addition, most of the published treatment programmes have used cognitive behavioural interventions, family therapies and psychoeducational interventions. Psychological treatment is predicated in adolescents on the notion that sexually deviant behaviour can be controlled by the offender, and that more adaptive behaviours can be learned. The main purposes of these guidelines are to improve the quality of care and to aid physicians in their clinical decisions. These guidelines brought together different expert views and involved an extensive literature research. Each treatment recommendation was evaluated and discussed with respect to the strength of evidence for efficacy, safety, tolerability and feasibility. An algorithm is proposed for the treatment of paraphilic disorders in adolescent sexual offenders or those who are at risk.


Juvenile sexual offender; SSRI; antiandrogens; paraphilic disorder; psychological treatment

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