[Failure of a study in forensic psychiatric hospitals : Clinical trial to investigate the additive effect of triptorelin on the efficacy of psychotherapy].

Background: A testosterone-lowering medication is relatively commonly used as a form of treatment for sexual offenders with severe paraphilic disorders in German forensic psychiatric hospitals; however, a double-blind, controlled and randomized study, which investigates the efficacy of this medication, is still lacking.

Aim: This article describes the process from the planning to the rejection of a clinical trial over the period from 2009 to 2015.

Methods And Results: Despite the careful planning with an interdisciplinary team and giving special consideration to the complex legal situation, the Federal Institute for Drugs and Medical Devices (BfArM) rejected the proposed trial in a brief formal letter with reference to the German Drug Law (§ 40 para.

What Keeps Them Together? Insights into Sex Offender Couples Using Qualitative Content Analyses.

Research on sex offenders' relationships is scarce. The aim of this qualitative study was to investigate sex offenders' relationships as well as their female partners' adjustment strategies by means of interview analysis. Both partners profit from the relationship in terms of mutual support and acceptance.

Relationship factors in sex offender couples: a pilot study in an outpatient setting.

Research indicates that sex offenders' relationships are often unstable and superficial. Sex offenders are portrayed as showing little empathy toward their partners and being incapable of sharing intimacy. This study aimed to explore sex offenders' intimate relationships and identify potential stabilizing factors in an outpatient setting.

Genital abnormalities in early childhood in sexual homicide perpetrators.

INTRODUCTION.: The present study investigates the relevance of genital abnormalities (GA) like cryptorchidism, hypospadias, and phimosis usually diagnosed in early childhood for the development of psychosexual problems and deficits in a sample of N = 163 convicted sexual homicide perpetrators. AIMS.

Personality disorders in men with sexual and violent criminal offense histories.

Little is known about personality disorders (PDs) in offenders with histories of both sexual and (nonsexual) violent offenses. This study aimed to identify possible differences of PD profiles across three different offender groups with both sexual and violent (S+V), only sexual (S), and only violent (V) offenses. Nonviolent (N) offenders were used as a comparison group.

Pleasure seeking and the aspect of longing for an object in perversion. A neuropsychoanalytical perspective.

In modern psychiatric classifications the term paraphilia has replaced the term perversion by changing the scope of the definitions from avoided procreation to failures of relationship-aspects of sexuality. Contemporary psychoanalysts also seem less interested in pleasure seeking aspects, which were so important within original Freudian thought, and instead concentrate interpretation on hostility and the history of the representation of objects. This paper discusses the connection between distinct object representations in perversions and attachment theory and neurobiological representations.

The utility of risk assessment instruments for the prediction of recidivism in sexual homicide perpetrators.

To examine the predictive accuracy of four well established risk assessment instruments (PCL-R, HCR-20, SVR-20, and Static-99) in an important subgroup of sexual offenders, these instruments were assessed retrospectively based on information from forensic psychiatric court reports in a sample of 90 released male sexual homicide offenders (out of an original sample of 166) in Germany. Follow-up information about criminal reconvictions after release were obtained from the federal criminal records. Total scores as well as subscales and single items of these risk assessment instruments did not predict sexual recidivism, and only some of them had moderate predictive power regarding nonsexual violent recidivism.

Double-blind, controlled, clinical trial planned in germany to investigate the efficacy of psychotherapy combined with triptorelin in adult male patients with severe pedophilic disorders: presentation of the study protocol.

Background: The treatment of paraphilias, especially of pedophilia, centers upon cognitive-behavioral psychotherapy and pharmacologic interventions. Two open, uncontrolled clinical studies using the synthetic LHRH-agonist triptorelin suggested that, combined with psychotherapy, antiandrogen treatment reduced deviant sexual fantasies, urges, and behaviors in paraphilic patients. There is a need for further research using controlled, randomized trials to examine the effectiveness of sexual offender treatment including psychotherapeutic and pharmacologic interventions.

Sociodemographic and diagnostic characteristics of homicidal and nonhomicidal sexual offenders.

The aims of this study were to compare the prevalence of psychiatric disorders and "psychopathy" in homicidal and nonhomicidal sexual offenders and to investigate the specificity of previous studies on psychiatric morbidity of a sample of sexual murderers. Information from court reports of 166 homicidal and 56 nonhomicidal sex offenders was evaluated using standardized instruments (SCID-II, PCL-R) and classification systems (DSM-IV). Sexual murderers were diagnosed more often with a personality disorder (80.

Sexual murderers with adult or child victims: are they different?

This study investigates characteristics differentiating sexually motivated murderers targeting child victims (CV; n = 35) from those with only adult victims (AV; n = 100). In the initial phase, psychiatric court reports were evaluated using standardized instruments (SCID-II, PCL-R, HCR-20, SVR-20, Static-99). In the second phase, data on duration of detention and reconviction rates were obtained from German federal criminal records.

[Activity of sanitary surveillances in Vilnius at the time of the Second Republic of Poland].

At the time of the Second Republic of Poland, in March 1922, the city of Vilnius together with the Vilnius Region was incorporated into Poland. Sanitary and health negligence was one of the main problems of the city. The genesis of that situation dates back to the 120-year national bondage, when the city was under the Russian rule.

[Epidemiological situation of infectious diseases in Lvov and Cracow during and after World War I (until the year 1922)].

In Lvov and Cracow at the times of World War I, the infectious diseases such as tuberculosis followed by typhus fever, typhoid fever, dysentery, as well as scarlet fever, diphtheria, measles, whooping cough, smallpox, cholera and venereal diseases (particularly syphilis) posed one of the most significant and dangerous problems for inhabitants. Their increased prevalence was the result of deteriorating sanitary and living conditions of the city population. The spread of epidemic infectious diseases was enhanced by marching troops, migration of civilians and war prisoners, return of large groups of displaced people and demobilized soldiers after regaining independence in November 1918.

[Antiandrogenic pharmacotherapy of sexual offenders and home leave steps in the forensic psychiatric hospital Berlin].

Objective: Evaluation of the relationship between antiandrogenic therapy of sexual offenders and home leave steps in a forensic psychiatric hospital.

Methods: Retrospective evaluation of all sexual offenders (n = 79) who were treated in the forensic psychiatric hospital Berlin between the 1.1.

[History of the control of acute infectious diseases in Poland after the World War I--until the year 1924 (including big cities)].

Acute infectious diseases of high intensity, i.e. typhus fever, typhoid fever, dysentery, followed by scarlet fever, measles, malaria, relapsing fever, whooping cough, diphtheria, smallpox and Asiatic cholera spreading after the World War I in Poland posed one of the most significant problems in the reviving country.

[Sanitary conditions, medical care and epidemiology situation of infectious diseases in Lvov in the period of Galicia autonomy (from the years 60ties/70ties of 19th century to the year 1914)].

Galicia autonomy received at the turn of the 60s and 70s of the XIX century contributed to the formation of organizational basis for activities in favour of improvement of health in the country, including the biggest city of Austrian partition--Lvov. In this city until the World War I outbreak intensive works concerning construction of sewage and water supply systems were performed, what beneficially affected the sanitary conditions in some districts. At the same time despite strenuous efforts, the attempts to provide cobbled permanent surfaces of the majority of roads were unsuccessful.

[Sanitary conditions, health care and epidemiological situation of infectious diseases in Cracow in the period of Galicia autonomy (since 60ties/70ties of 19th century until 1914)].

After Galicia had received autonomy at the turn of the 60s and 70s of the XIX century in Cracow the changes in order to repair long-running neglects were introduced. In order to fulfill this aim, cobbled pavement surfaces of the roads as well as sewage and water supply systems were constructed. District sanitary physicians (ten physicians in 1914 after in 1910-1912 neglected suburbs were attached to the city) were supposed to inspect health care of inhabitants.

[Criminal responsibility in sexual homicide perpetrators].

Objective: Evaluation of criteria for criminal responsibility, esp. in paraphilias and personality disorders.

Methods: We compared sexual murderers with diminished responsibility or not-guilty for reasons of insanity (n = 73) and those held fully responsible (n = 61) regarding psychiatric disorders, signs of severe paraphilias, level of personality structure (using Operationalized Psychodynamic Diagnostics) and offence related criteria.

[Comparison of sexual murderers in forensic psychiatric hospitals and in prison].

Empirical data are lacking that answer the question of how sexual murderers detained in forensic mental hospitals can be differentiated from those sentenced to prison. Psychiatric court reports and national criminal records on sexual murderers detained in a forensic mental hospital (n=45) were compared with those of prisoners (n=89) regarding diagnostic, criminologic, and prognostic characteristics and criminal recidivism rates after detention. Sexual murderers detained in forensic mental hospitals were characterized by higher psychiatric morbidity and slightly higher risk of future sexual and nonsexual violence.

Criminal recidivism in sexual homicide perpetrators.

Forensic psychiatric reports on 166 sexual homicide perpetrators in Germany were retrospectively analyzed for criminal risk factors. Follow-up information about release and reconvictions from federal criminal records was available for 139 offenders; 90 (64.7%) had been released.

[Activity of sanitary surveillances/offices in Warsaw at the time of the second republic of Poland].

At the time of the Second Republic of Poland, Warsaw, the capital of the rebirth country, was a neglected town as regards sanitary conditions. The genesis of this situation dates back to the period of the national bondage by the Russian partitioner, and since 1915 by the German invader who did not care about the problems associated with public health. The sanitary and hygienic conditions worsened significantly in 1916, after incorporating into Warsaw large out-of-town regions whose housing was of the rural character with numerous wooden cottages, field roads, without any sanitary sewage system.

[Activity of sanitary supervision in big cities at the time of the second republic of Poland based on example of Lódz].

At the time of the Second Republic of Poland łódź was a city with a very unfavourable sanitary and hygienic situation. It resulted from the long-lasting municipal negligence, dating back to the I World War, which included bad living conditions of the working class, problems with sewers and canalisation, and other shortages associated with the sanitary and maintenance status. All these factors contributed to prevalence of infectious diseases and other health threads.

Sexual sadism and sadistic personality disorder in sexual homicide.

Controversies exist about the diagnostic validity of sexual sadism and its relation to sadistic personality disorder in sex offenders. The aim of this study was to investigate which diagnostic, developmental, and criminal characteristics differentiate sexual sadistic from non-sadistic sexual homicide perpetrators. Psychiatric court reports on 166 men who had committed a sexual homicide were evaluated regarding psychiatric, sexual and criminal history.

[Paraphilia, sexual preference disorders. Diagnosis, etiology, epidemiology, treatment and prevention].

Hostility towards relationships is one prominent characteristic symptom for disorders of sexual preference (ICD-10) and paraphilias (DSM-IV). Paraphilic symptoms sometimes progress to obsessive or addictive- like forms leading to a loss of self-control but can occur also as single incidents or as episodic events. Besides constitutional aspects, problems in the development of close relationships to primary caregivers (attachment) play an important role in the development of these disorders.