Antiandrogene Behandlung von Menschen mit Intelligenzminderung in der ambulanten Nachsorge

Androgen deprivation therapy for people with intellectual disability in outpatient aftercare

Zusammenfassung

Die antiandrogene Behandlung von Menschen mit paraphilen Störungen, die Sexualstraftaten begangen haben, gilt inzwischen als Standard zur Reduktion ihres Rückfallrisikos. Oftmals ist die medikamentöse Behandlung eine Voraussetzung, dass eine sichere Entlassung aus dem 63iger Maßregelvollzug in ein stabiles Nachsorgesetting möglich ist. Menschen mit Intelligenzminderung weisen sowohl ein erhöhtes Risiko auf, Sexualstraftaten zu begehen, als auch ein erhöhtes einschlägiges Rückfallrisiko. Daher stellt auch für Menschen mit Intelligenzminderung (IM) eine möglicherweise langfristige antiandrogene Behandlung eine wichtige Option zur Reduktion von paraphilen Phantasien dar und reduziert eine entsprechende paraphile Ansprechbarkeit sicher und nachhaltig. Der vorliegende Beitrag schildert bei 8 Menschen mit Intelligenzminderung, die eine Sexualstraftat begangen haben, die Sicherstellung einer indizierten antiandrogenen Behandlung im ambulanten Setting im Rahmen eines Gesamtbehandlungsplans mit dem Schwerpunkt des Monitorings von unerwünschten Anwendungswirkungen.

Abstract

Today androgen deprivation therapy of individuals who are diagnosed with paraphilic disorders and who have also sexually offended in the past is considered as standard procedure in order to reduce the risk of reoffending. In many cases medicinal treatment is a precondition that enables a safe release from forensic psychiatry into an established aftercare setting. Individuals who are diagnosed with an intellectual disability have a higher risk to sexually offend in the first place and also have a higher risk to sexually reoffend. Therefore, for individuals diagnosed with an intellectual disability (possibly long-term prescribed) hormonal treatment is also an important option in order to securely and permanently reduce paraphilic phantasies and to reduce paraphilic interests and drive. This article presents eight cases of an indicated antiandrogenic treatment in an outpatient setting. Androgen deprivation therapy is part of a holistic treatment plan that focuses on monitoring undesirable side effects.

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Correspondence to Dr. med. Tatjana Voß.

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T. Voß, R. Reichel und D. Calvano geben an, dass kein Interessenkonflikt besteht.

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Voß, T., Reichel, R. & Calvano, D. Antiandrogene Behandlung von Menschen mit Intelligenzminderung in der ambulanten Nachsorge. Forens Psychiatr Psychol Kriminol (2020). https://doi.org/10.1007/s11757-020-00635-8

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Schlüsselwörter

  • Verhaltensauffälligkeiten
  • Ambulante medikamentöse Behandlung
  • Sexualstraftäter
  • Management von Nebenwirkungen
  • Rückfälligkeit

Keywords

  • Challenging behaviour
  • Sexual delinquency
  • Management of side effects
  • Forensic outpatient aftercare
  • Risk of recidivism