(Pedophilia)

A pädophile disorder is characterized by recurrent, intense sexual fantasies causing, impulses or behaviors are included in the pre-pubescent or young adolescents (usually ? 13 years). It is only diagnosed when people ? 16 years and ? 5 years older than the child who is the target of fantasies or behaviors.

A pädophile disorder is characterized by recurrent, intense sexual fantasies causing, impulses or behaviors are included in the pre-pubescent or young adolescents (usually ? 13 years). It is only diagnosed when people ? 16 years and ? 5 years older than the child who is the target of fantasies or behaviors.

(Child abuse at a glance:. Sexual abuse) A pedophile disorder is characterized by recurrent, intense sexually arousing fantasies, urges or behaviors that are included in the pre-adolescent or young adolescents (typically ? 13 years). It is only diagnosed when people ? 16 years and ? 5 years older than the child who is the target of fantasies or behaviors. Pedophilia is a form of paraphilia that causes harm to others and is thus considered a para hydrophilic disorder. Sexual assaults against children make up a large portion of the displayed sexual offenses. Older adolescents (d. E. 17 or 18 years of age) who have ongoing sexual interest in or connection to a 12- or 13-year old may not meet the clinical criteria for a disorder. However, legal criteria may differ from psychiatric criteria. For example, the sexual activity between a 19-year-olds and a 16-year-olds may be a crime and no pedophile disorder, depending on the jurisdiction. The guidelines for the diagnosis of age apply to Western cultures and not for the many cultures where sexual activity, marriage and childbearing are accepted in much younger age than in the West. Most pedophiles are male. The attraction can be made to small boys, girls or both. However pedophiles prefer children of the opposite sex against children of the same sex in the ratio 2: 1. In most cases, the child knows the adult who may be a family member, a step-parent or authority figure (eg. As a teacher). View or touch seems to occur more frequently than genital contact. Pedophiles can be attracted only by children (exclusive) or by adults (not exclusively), some only feel attracted to children who are related to them (incest). Criminal pedophiles, many of which have a comorbidity with antisocial personality disorder, tend to force or threaten the child with physical suffering or harm to his pet, it should not keep the abuse secret. The course of pedophilia is chronic, and the perpetrators have or frequently develop a substance abuse or dependence and depression. A penetrating familial dysfunction, personally experienced, sexual abuse and marital conflict are widespread. The other co-morbid disorders include attention deficit disorder, depression, anxiety disorders and post-traumatic stress disorder. Diagnosis Clinical examination The extensive use of child pornography is a reliable sign of sexual attraction to children and perhaps the only indicator of the disease. However, the use of child pornography does not meet the criteria for a pedophile disorder, although this is generally illegal. If a patient denies the sexual attraction of children, but let the circumstances to something else close, certain diagnostic tools can help to confirm this attraction. Among the tools include penile plethysmography (men), vaginal plethysmography (women) and sighting of standardized erotic material; However, the possession of such material can also be used for diagnostic purposes, be illegal in certain jurisdictions. Clinical criteria for the diagnosis (based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [DSM-IV-TR]) Recurrent, intense sexually arousing fantasies, urges or behaviors with a prepubescent child or children (generally ? 13 years ) exist for ? 6 months. The person has acted to the shoots or is crushed by the urges and fantasies and impaired. The person is older than the child (but excluding an older teenager who is in an ongoing relationship with a 12- or 13-year-olds) is the goal of fantasies or behaviors ? 16 years and ? 5 years. The identification of a patient as a potential pedophile sometimes provides medical professionals an ethical problem. However, the medical staff is to protect the community of children responsibility. Professionals should know the notification requirements in their state. There is a reasonable suspicion of sexual or physical abuse of children, the law requires that this must be reported to the authorities. Reporting requirements vary depending on the state (see Child Welfare Information Gateway). Therapy psychotherapy treatment of comorbid disorders Drug treatment (. Eg anti-androgens, SSRI) Usually, a long-term individual or group psychotherapy is required; This can be especially useful if it is part of a multimodal treatment that includes social skills training, treatment of concurrent physical and mental disorders and drug therapy. The treatment is less effective if it was ordered by the court, although many convicted sex offenders have benefited from treatments such as group therapy plus anti-androgens. Some pedophiles who adhere to the treatment and monitoring may refrain pedophile acts and be reintegrated into society. These results are all the more likely if no other psychiatric disorders, particularly personality disorders present. Drug in the United States is the treatment of choice medroxyprogesterone acetate By blocking the pituitary production of luteinizing hormone (LH) and follicle stimulating hormone (FSH), medroxyprogesterone reduces the production of testosterone, reducing the libido. Typical doses are 200 mg medroxyprogesterone i.m. 2 to 3 times / week for 2 weeks followed by 4 weeks 200 mg of 1- to 2 times / week, and finally 200 mg every 2-4 weeks. The gonadotropin-releasing hormone (GnRH) agonist leuprolide, which is reducing the pituitary production of LH and FSH, thus reducing the production of testosterone also an option and requires less frequent (in injections for 1- to 6 month intervals). In Europe, cyproterone acetate is that blocks testosterone receptors used. The serum levels of testosterone should be controlled and the female normal range (<62 ng / dL) are in male patients. The treatment must be carried out over a long period mostly because deviant fantasies usually occur weeks to months after the end of treatment. Liver function tests should be performed and blood pressure, bone density and blood count monitored if necessary. The benefits of anti-androgens in female Pedophile is less well documented. In addition to anti-androgens also SSRIs can (z. B. high doses of fluoxetine 60-80 mg once daily or fluvoxamine 200-300 mg po once daily) may be helpful. Drugs are most effective when they are used as part of a multimodal treatment program.

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