Sixteen patients who had been treated with psychotherapy and pharmacotherapy for sex offenses in an outpatient clinic for sex offenders from 1988 to 1991 were contacted to participate in a retrospective study of their treatment. These subjects had been part of an outpatient treatment program for sex offenders and had either been arrested and convicted of sexual offenses or had been engaging in illegal behavior involving a paraphilia (pedophilia, exhibitionism, voyeurism, and obscene phone calls). During the course of their treatment, they had been referred to one of our physicians for evaluation for pharmacotherapy because of a lack of response to psychological treatment, intense and recurrent sexual obsessions, difficulty in controlling their paraphilic urges, and concomitant and unremitting symptoms of anxiety and depression. Thirteen patients agreed to participate in the study and were administered the Hamilton Anxiety and Depression Scales, the Beck Depression Inventory, and the Yale-Brown Obsessive-Compulsive Scale. The patients were also asked to respond to a semi-structured interview. There was a significant reduction in scores on all measures. Generally we found a reduction in anxiety and depression, a greater ability to engage in the process of psychotherapy, a decrease in paraphilic obsessions, an increased control over paraphilic compulsive sexual behavior, a reduction in other non-paraphilic compulsive sexual behavior, a reduction in non-sexual obsessive-compulsive behaviors, an increased understanding of their cycle of compulsive sexual behavior and improved concentration. memory, and other cognitive processes.
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