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Wenn ja, wie lange? – Dauer antiandrogener Behandlung von Sexualstraftätern mit paraphilen Störungen

Klinische Erfahrungen aus Auslassversuchen in der forensischen Nachsorgepraxis

When yes, for how long? – Duration of antiandrogenic treatment of sexual offenders with paraphilic disorders

Clinical experiences from treatment-free trials in forensic aftercare practice

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Forensische Psychiatrie, Psychologie, Kriminologie Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Insgesamt wurden seit 2010 in der Forensisch-Therapeutischen Ambulanz (FTA) Berlin 15 jeweils individuell begründete, therapeutisch begleitete Auslassversuche einer antiandrogenen Behandlung (ADT) durchgeführt.

Material und Methoden

Dieser Beitrag beschreibt die Bedingungen, unter denen verantwortbar und rechtlich vertretbar das Absetzen einer ADT erfolgen kann.

Ergebnisse

Insgesamt ergaben sich bei den 15 untersuchten, langjährig psychotherapeutisch behandelten und stabil forensisch rehabilitierten Patienten im Verlauf bisher keine kriminalprognostisch oder klinisch relevanten Destabilisierungen, die einen Abbruch des Auslassversuchs mit Wiederansetzen der antiandrogenen Depotmedikation notwendig gemacht hätten.

Schlussfolgerungen

Die bisherigen, kurzen Erfahrungen aus der klinischen Nachsorgepraxis zeigen, dass es in einem stark strukturierten Nachsorge-Setting mit engmaschigem klinischem Monitoring durchaus möglich ist, auch eine langjährige antiandrogene Medikation auszusetzen. Dies ist nicht zuletzt deshalb wichtig, um bei eintretender Destabilisierung die Argumentation für eine entfristete Führungsaufsicht zu belegen. Über weitere Langzeitverlaufsuntersuchungen wird in späteren Publikationen berichtet werden.

Abstract

Background

Since 2010 a total of 15 individually justified, therapeutically accompanied treatment-free intervals from antiandrogenic treatment (ADT) have been carried out in the Forensic Therapeutic Outpatient (FTA) department in Berlin.

Material and methods

This article describes the conditions under which a responsible and legally justifiable cessation of ADT can be carried out.

Results

In all 15 of the investigated stable, forensically rehabilitated patients who had been on long-term psychotherapeutic treatment, no criminally prognostic or clinically relevant destabilization has so far occurred, which would have necessitated cessation of the treatment-free interval with resumption of the antiandrogenic depot medication.

Conclusion

The short-term experiences from the clinical aftercare practice have so far shown that in a strictly structered aftercare setting with continuous clinical monitoring, it is possible to withdraw even long-standing antiandrogenic medication. This is important not least to attest the argumentation for a removal of supervision of conduct in case destabilization does occur. Further long-term longitudinal investigations will be the subject of later publications.

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Authors and Affiliations

  1. Forensisch Therapeutische Ambulanz, Institut für Forensische Psychiatrie, Charite – Universitätsmedizin, Berlin, Deutschland

    Tatjana Voß, Karoline Klemke, Vera Schneider-Njepel & Hans Ludwig Kröber

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  1. Tatjana Voß
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  2. Karoline Klemke
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  4. Hans Ludwig Kröber
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Correspondence to Tatjana Voß.

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T. Voß, K. Klemke, V. Schneider-Njepel, H.-L. Kröber geben an, dass kein Interessenkonflikt vorliegt.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Voß, T., Klemke, K., Schneider-Njepel, V. et al. Wenn ja, wie lange? – Dauer antiandrogener Behandlung von Sexualstraftätern mit paraphilen Störungen. Forens Psychiatr Psychol Kriminol 10, 21–31 (2016). https://doi.org/10.1007/s11757-015-0346-z

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