Turner, Basdekis-Jozsa and Briken 2013 Flashcards
What was the aim of Turner, Basdekis-Jozsa and Briken 2013?
To investigate the use of testosterone lowering medication (TLM) in sex offender treatment in German forensic-psychiatric institutions in 2011.
How any participants were there?
69 were asked.
50 replied.
32 agreed to take part.
Where were the questionnaires sent to?
forensic-psychiatric institutions in Germany.
Who was to complete the questionnaires?
medical/psychological head of the institution.
mean age was 51.1
23 males, 9 females
31 were medical doctors and one was a clinical psychologist.
What was the questionnaire like?
had 85 items and 2 sections.
1 section: age and gender of offenders, their offences and the juridical decision.
2 section: overview of treatment (evaluate, effectes and side effects)
How many ppts were reported on?
3963
all were males and most had been convicted for sex abuse/rape/child sex abuse.
266 received some type of drug- 96 of these were TLMs. 78.1% of offenders gave consent before treatment.
What TLMs were used and how many of the 96 patients had what?
GnRH (Gonadotropin-releasing hormone)- 65
CPA (cyproterone acetate) - 31
What were the results of Turner, Basdekis-Jozsa and Briken 2013?
- 60% on CPA and 75.4% on GnRH agonist had a reduction in the frequency of sexual thoughts.
- 52% on CPA and 66.7% on GnRH agonist had a reduction in the intensity of sexual thoughts.
- 40% on CPA and 43.9% on GnRH agonist had a reduction in the frequency of masturbation.
Were there side effects and what were they?
yes
Side effects included: -weight gain (48% fro CPA and 19.3% for GnRH)
-depression (8% for CPA)
-kidney/liver dysfunction (4% for CPA)
-bone mineral density loss (14% for GnRH)
What were the conclusions of Turner, Basdekis-Jozsa and Briken 2013?
16% of all sex offenders in German forensic-psychiatric institutions are being treated with TLM. TLMs seemed to decrease sexual desire and interest – so were effective but often also created side effects. Further research is needed – double-blind clinical trials and placebo controlled research is still not available due to ethical issues. Benefits and risks of the treatment must be carefully considered before treatment starts.
Strengths of Turner, Basdekis-Jozsa and Briken 2013
+reliability - found 15% of all patients being treated in intitutions were sex offenders. Hahn agrees (17%)
+application - sex offenders have distinct features dissimilar to other offenders. thus investigating use and effectiveness of treatments is useful.
+application - informed consent and briefing should occur. highlighted that TLMs are often used with psychotheraputic treatments
+application - prescription should be performed carefully
+representative for German-forensic psychiatric institutions.
Weaknesses of Turner, Basdekis-Jozsa and Briken 2013
- limited generalisabilty- no female offenders
- dosage not specifically assessed.
- data based on reports from clinicians and were not strictly controlled.
- data is vulnerable to effects caused by different assessment dates.
- lacks validity - duration and other diseases may influence occurrence and severity of side effects.
- not effective for every patient - needs further research.
- restricted generalisabilty - as 4 institutions didn’t participate
