Die antiandrogene Behandlung von Sexualstraftätern vor dem Hintergrund der aktuellen Wirksamkeitsforschung und der kriminologischen Realität

Übersicht

Zusammenfassung

Die antiandrogene Behandlung von Sexualstraftätern erfährt derzeit eine Renaissance. Zentral wirksame Antihormone stehen nunmehr vermehrt zur Verfügung. Wenngleich die libidosenkende Wirkung bekannt ist und die Mittel offenbar auch in der Lage sind, die Dranghaftigkeit sowie Heftigkeit devianter Fantasien und Impulse zu verringern, fehlt bislang der Nachweis einer spezifischen rückfallsenkenden Wirkung bei Sexualstraftätern. Dies liegt v. a. am Fehlen von Studien, in denen äquivalente Kontrollgruppen untersucht wurden. Die Tatsache, dass die Rückfallbasisraten konstant sinken, erschwert neben grundsätzlichen methodischen Grenzen der forensischen Forschung die spezifische Nachweisbarkeit von möglicherweise sinnvollen Interventionen. Der bislang fehlende Wirkungsnachweis, z. T. schwerwiegende Nebenwirkungen und eine schwierige Indikationsstellung sollten den Einsatz derartiger Medikamente in der forensischen Sexologie und Psychiatrie weiterhin auf den besonders schwer zu behandelnden Einzelfall beschränken.

Schlüsselwörter

Sexualstraftäter Antiandrogentherapie Indikation Effektivität Rückfall 

Antiandrogen treatment of sexual offenders: empirical evidence and criminological facts

Abstract

Antiandrogen treatments for sexual offenders are reported to be powerful additional strategies to psychological interventions. Several reviews concluded that these pharmacological treatment regimes reduce sexual offender recidivism risk. On close inspection all studies reporting an effectiveness of antiandrogen treatment on sexual offender risk reduction lack equivalent control groups. The results are confounded by the fact that in almost every case either the control group had a higher a priori risk or findings were derived from non-forensic patients. However, low relapse base rates, the absence of random assignment studies and a recently reported further dramatic decline in sexual reconviction rates makes it difficult to produce empirical evidence for any treatment. As reduction of sexual deviant urges and fantasies by antiandrogenic medication has been consistently reported it might nevertheless help to additionally treat a small group of sexual offenders suffering from non-controllable deviant urges.

Keywords

Sexual offender Antihormonal treatment Indication Effectiveness Relapse 

Notes

Interessenkonflikt

Der Autor erhielt für das Symposium „Psychotherapie und LHRH-Agonisten“ ein Referentenhonorar und eine Übernahme der Reisekosten von der Fa. Dr. Pfleger.

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  1. 1.VollzugsdirektionBegutachtungs- und Evaluationsstelle für Gewalt- und Sexualstraftäter (BEST)WienÖsterreich
  2. 2.Sektion Forensische PsychotherapieUniversitätsklinik für Psychosomatische Medizin und Psychotherapie UlmUlmDeutschland

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