medigraphic.com
ISSN 1025-0255 (Electronic)

2022, Number 1

<< Back Next >>

AMC 2022; 26 (1)

Paraphilic disorder: clinical characterization and treatment

de Dios-Blanco E, Duany-Navarro A, Vizcaíno-Alonso MC

Language: Spanish
References: 36
Page:
PDF size: 767.61 Kb.


ABSTRACT

Introduction: Paraphilic disorder are non tradicional sexual behaviors like the sexual activity with the boys/girls, to exhibit the genital to an unaware person or others.
Objective: To systematize the theoretical bases that sustain the clinical characterization and the treatment of the paraphilic disorder in the world and in Cuba.
Methods: The bibliographical search was made in the electronic databases ClinicalKey and PubMed, Cuban investigations were used.
Results: Paraphilia is any intense and persistent sexual interest that is not the interest in the genital stimulation or preparatory caresses with a human normal, mature physically, with consenting persons; they are paraphilics disorders when the paraphilia causes distress or deterioration in the social, labor or others. Excellent clinical characteristics: they prevail in the masculine sex, cognitive distortions exist, comorbidities among different types of paraphilics disorders, dysfunctions for use of substances and disorders personality. The pharmacological treatment embraces the selective serotonin reuptake inhibitors, in Cuba the Sertraline is used (100-200 mg/day); analogues of the hormone Gonadotropin-Releasing Hormone Agonists and antiandrogens used in the country Androcur (50-100 mg/day). Technical of cognitive and behavioral psychotherapy: covered sensitization, empathy development toward the victims and cognitive restructuring.
Conclusions: Clinically it is indispensable to differentiate the paraphilia of the paraphilics disorders, considered mental illnesses, with generally chronic course and generally comorbid psychiatric. In Cuba, for their treatment it is used the Sertraline or Androcur and technical of cognitive and behavioral psychotherapy.


REFERENCES

  1. Stekel W. El Fetichismo. Desórdenes en relación al sexo. Buenos Aires: Editorial Imán; 1952.

  2. Masters HW, Johnson EV, Kolodny CR. La Sexualidad Humana. La Habana: Editorial Científico Técnica; 1987.

  3. Garcia FD, Thibaut F. Current concepts in the pharmacotherapy of paraphilias. Drug. 2011 Abr;71(6):771-90.

  4. Thibaut F, Cosyns P, Fedoroff JP, Briken P, Goethals K, Bradford JMW, et al. The World Federation of Societies of Biological Psychiatry (WFSBP) 2020 guidelines for the pharmacological treatment of paraphilic disorders. World J Biol Psychiatry. 2020 Jul;21(6):412-490. doi: 10.1080/15622975.2020.1744723.

  5. Kaplan MS, Krueger RB. Cognitive-Behavioral Treatment of the Paraphilias. Isr J Psychiatry Relat Sci [Internet]. 2012 [citado 28 Ene 2020];49(4):291-6. Disponible en: Disponible en: https://cdn.doctorsonly.co.il/2013/03/08-Cognitive-behavioral-treatment.pdf 5.

  6. Labelle A, Bourget D, Bradford JMW, Alda M, Tessier P. Familial Paraphilia: A Pilot Study with the Construction of Genograms. ISRN Psychiatry [Internet]. 2012 [citado 26 Dic 2021];2012:692813. Disponible en: Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3658696/ 6. .

  7. Kruger THC, Sinke C, Kneer J, Tenbergen G, Khan AQ, BurkertA, et al. Child sexual offenders show prenatal and epigenetic alterations of the androgen system. Transl Psychiatry [Internet]. 2019 Ene [citado 20 Nov 2021];9(1):28. Disponible en: Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6338724/ 7. .

  8. Sánchez Hernández H. Hallazgos neurobiológicos recientes de la pedofilia. Archivos de Criminología, Seguridad Privada y Criminalística [Internet]. 2018 [citado 30 Nov 2021];21:38-43. Disponible en: Disponible en: https://dialnet.unirioja.es/servlet/articulo?codigo=6533408 8.

  9. Lett TA, Mohnke SA, Amelung T, Brandl EJ, Schiltz K, Pohl A, et al. Multimodal neuroimaging measures and intelligence influence pedophile child sexual offense behavior. Eur Neuropsychopharmacol [Internet]. 2018 [citado 14 Dic 2021];28(7):818-827. Disponible en: Disponible en: https://daneshyari.com/article/preview/6790366.pdf 9.

  10. Ristow I, Li M, Colic L, Marr V, Födisch C, von Düring F, et al. Pedophilic sex offenders are characterized by reduced GABA concentration cingulate cortex. Neuroimage Clin [Internet]. 2018 [citado 30 Nov 2021];18:335-341. Disponible en: Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5987735/ 10. .

  11. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 5ta11. ed. Washington, DC: New School Library; 2013.

  12. Wincze PJ. Paphilic Disorders. En: Ferri Fred, editor. Ferri's Clinical Advisor [Internet]. España: Elsevier; 2018 [citado 30 Nov 2021]. Disponible en: Disponible en: http://www.clinicalkey.es/#!/content/book/3-s2.0-B9780323672542006471 12.

  13. Seto MC, Kingston DA, Bourget D. Assessment of the paraphilias. Psychiatr Clin North Am. 2014 Jun;37(2):149-61. doi: 10.1016/j.psc.2014.03.001.

  14. de Dios Blanco E. Trastornos parafílicos: características clínicas de pacientes masculinos atendidos por Sexología Clínica. Rev hosp psiq hab [Internet]. 2016 [citado 20 Nov 2021];13(3):[aprox. 12 p.]. Disponible en: Disponible en: http://www.revistahph.sld.cu/2016/Nro%203/trastorno%20parafilico.html 14.

  15. de Dios Blanco E. Parafilias: estudio de caso de cuatro pacientes [tesis]. Ciudad de La Habana: CENESEX ; 2005.

  16. de Dios Blanco E, Vasallo C, Quintana MJ, Carnero CD. Parafilias: un estudio de caso. Sex Soc [Internet]. 2006 [citado 11 Ene 2021];12(31):[aprox. 5p.]. Disponible en: Disponible en: http://www.revsexologiaysociedad.sld.cu/index.php/ sexologia y sociedad/artícele/view/325/379 16.

  17. Gómez Gil E. Trastornos sexuales. En: Rozman Borstnar C, Cardellach López F, editores. Farreras Rozman Medicina Interna [Internet]. 18 ed. España: Elseiver 2016 [citado 11 Ene 2021];[aprox. 29 p.]. Disponible en: Disponible en: https://www.clinicalkey.es/#!/search/Farreras%2520Rozman.%2520Medicina%2520Interna 17.

  18. World Health Organization. International Classification of Disease for Mortality and Morbidity Eleventh Revision CIE-11. Ginebra: WHO; 2018.

  19. Bhatia K, Parekh U. Frotteurism. En: Stat Pearls. Treasure Island (FL): Stat Pearls Publishing; 2020.

  20. Shafer CL. Trastornos sexuales y disfunción sexual. En: Stern TA, Fava M, Wilens TE, Rosenbaum JF, editores. Tratado de Psiquiatría Clínica. España: Elsevier ; 2018 [citado 20 Nov 2021];[aprox. 30 p.]. Disponible en: http://www.clinicalkey.es/#!/content/book/3-s2.0 B9788490229965001903

  21. Sendler DJ . Contemporary understanding of zoophilia - A multinational survey study. J Forensic Leg Med [Internet]. 2019 Feb [citado 20 Nov 2021];62:44-51. Disponible en: Disponible en: https://pubmed.ncbi.nlm.nih.gov/30639855/ 21.

  22. Hurtado Murillo F. Rasgos de personalidad y características descriptivas de los ofensores sexuales en base a la evidencia científica. Psicosom psiquiatr [Internet]. 2017 [citado 20 Nov 2021];3(1):37-40. Disponible en: Disponible en: https://raco.cat/index.php/PsicosomPsiquiatr/article/view/393487/486927 22.

  23. American Psychiatric Association (DSM-IV-TR). Manual diagnóstico y estadístico de los trastornos mentales. Texto revisado. Barcelona: Masson, S.A. ; 2000.

  24. Szumski F, Zielona-Jenek M. Child molesters’ cognitive distortions. Conceptualizations of the term. Psychiatry Pol [Internet]. 2016 [citado 18 Ene 2020];50(5):1053-63. Disponible en: Disponible en: http://www.psychiatriapolska.pl/uploads/images/PP_5_2016/ENGver1053Szumski_PsychiatrPol2016v50i5.pdf 24.

  25. Gerwinn H, Weiß S, Tenbergen G, Amelung T, Födisch C, Pohl A, et al. Clinical characteristics associated with paedophilia and child sex offending - Differentiating sexual preference from offence status. EM-Consulte [Internet]. 2018 Jun [citado 30 Nov 2021];51:74-85. Disponible en: Disponible en: https://www.em-consulte.com/article/1220370/clinical-characteristics-associated-with-paedophil 25.

  26. Schöttle D, Briken P, Tüscher O, Turner D. Sexuality in autism: hypersexual and paraphilic behavior in women and men with high-functioning autism spectrum disorder. Dialogues Clin Neurosci [Internet]. 2017 Dic [citado 18 Ene 2020];19(4):381-93. Disponible en: Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5789215/ 26. .

  27. Labine MA, Cappello M, Garon R, Skogberg J, Shahrour W, Elmansy H. Case report: Caustic foreign body insertion into the male urethra. Urol Case Rep. 2020 Sep;33:101397. doi: 10.1016/j.eucr.2020.101397.

  28. Campo-Arias A, Castillo-Támara EE, Herazo E. Review of cases of zoophilia in patients with Parkinson’s disease. Rev Neurol [Internet]. 2018 Ago [citado 20 Nov 2019];67(4):129-32. Disponible en: Disponible en: https://pubmed.ncbi.nlm.nih.gov/30039840/ 28. .

  29. Stefanou MI, Vittore D, Wolz I, Klingberg S, Wildgruber D. Recurrent Episodes of Paraphilic Behavior Possibly Associated With Olanzapine and Aripiprazole Treatment in a Patient With Schizophrenia. Front Psychiatry [Internet]. 2020 [citado 20 Nov 2019];11:318. Disponible en: Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7212450/ 29. .

  30. Scarpazza C, Pennati A, Sartori G. Mental Insanity Assessment of Pedophilia: The Importance of the Trans-Disciplinary Approach. Reflections on Two Cases. Front Neurosci [Internet]. 2018 [citado 20 Nov 2019];12:335. Disponible en: Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5964183/ 30. .

  31. Villa Jiménez OM. Formulario Nacional de Medicamentos de Cuba [Internet]. La Habana: Centro Nacional de Información de Ciencias Médicas-Infomed; 2018 [citado 20 Nov 2021]. Disponible en: Disponible en: http://fnmedicamentos.sld.cu/index.php?P=aplicacionAndroid 31.

  32. Lipp G, van Staden PJ. The use of cyproterone acetate in a forensic psychiatric cohort of male sex offenders and its associations with sexual activity and sexual functioning. S Afr J Psychiatr [Internet]. 2017 [citado 20 Nov 2021];23:982. Disponible en: Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6138062/ 32. .

  33. Landgren V, Malki K, Bottai M, Arver S, Rahm C. Effect of Gonadotropin-Releasing Hormone Antagonist on Risk of Committing Child Sexual Abuse in Men With Pedophilic Disorder: A Randomized Clinical Trial. JAMA Psychiatry [Internet]. 2020 Sep [citado 19 Abr 2021];77(9):1-9. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7191435/33. .

  34. Chan O, Lam S. Combination of Psychiatric and Psychological Approaches in the Assessment and Treatment of Sexual Offenders. East Asian Arch Psychiatry [Internet]. 2018 [citado 20 Nov 2019];28:129-33. Disponible en: Disponible en: https://www.easap.asia/index.php/find-issues/past-issue/item/821-1812-v28n4-p129 34.

  35. Muse M, Frigola G. La Evaluación y Tratamiento de Trastornos Parafílicos. Med Psicosom [Internet]. 2003 [citado 03 Ene 2020];65:55-72. Disponible en: Disponible en: https://docplayer.es/8827332-La-evaluacion-y-tratamiento-de-trastornos-parafilicos.html 35.

  36. Vázquez Rosoni O, Gaete Fuentes G. Programa de tratamiento para el control de la agresión sexual CAS-R [Internet]. Santiago de Chile: Corporación OPCIÓN; 2013 [citado 03 Ene 2020]. Disponible en: Disponible en: https://opcion.cl/wp-content/uploads/2016/04/ManualCAS-R-Doc4.pdf 36.




2020     |     www.medigraphic.com