Effects of chemical castration on sex offenders in relation to the kinetics of serum testosterone recovery: Implications for dosing schedule

Kyo Chul Koo, Jin Hyoung Ahn, Sung Joon Hong, Jae Woo Lee, Byungha Chung

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Introduction: A growing number of countries are adopting chemical castration as treatment and penalty for sex offenders. Aim: The aim of this study is to evaluate the outcome of chemical castration of sexual offenders with a focus on the kinetics of serum testosterone (T) recovery. Methods: This prospective analysis included 56 sex offenders imprisoned for sexual offenses at the National Forensic Hospital. Thirty-eight and 18 patients who received 3 and 6 months of leuprolide acetate injections were assigned to group A and group B, respectively. Main Outcome Measures: To evaluate treatment efficacy according treatment duration, psychobehavioral assessments and serum T levels were serially measured during the on-cycle and the following observational 12-month off-cycle. Results: Chemical castration and the associated decrease in serum T levels reduced the frequency and intensity of sexual thoughts in 76% and 71% of group A patients and in 78% and 72% of group B patients, respectively. Reductions in masturbation frequency were observed in 74% of group A and 83% of group B patients. The median Wilson's Sex Fantasy Questionnaire (SFQ) scores were also significantly reduced in both groups. In group A, an upsurge of serum T to the flare level was observed during the first 2 months of the off-cycle, accompanied by an intense sexual drive and fantasy. In group B, serum T gradually recovered to the baseline level and continued to upsurge beyond baseline levels during the observational period. SFQ scores of group A returned to pretreatment levels following the observational period; however, SFQ scores of group B remained suppressed. Lack of objective assessments for psychobehavioral outcomes was a limitation. Conclusions: The efficacy of chemical castration varied according to the treatment duration. Regarding the kinetics of serum T recovery, maintaining at least 6 months of treatment warranted stable control of an excessive sexual drive following treatment cessation.

Original languageEnglish
Pages (from-to)1316-1324
Number of pages9
JournalJournal of Sexual Medicine
Volume11
Issue number5
DOIs
Publication statusPublished - 2014 Jan 1

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Castration
Testosterone
Appointments and Schedules
Fantasy
Serum
Outcome Assessment (Health Care)
Masturbation
Leuprolide
Withholding Treatment
Therapeutics
Injections
Surveys and Questionnaires

All Science Journal Classification (ASJC) codes

  • Reproductive Medicine
  • Obstetrics and Gynaecology
  • Urology

Cite this

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title = "Effects of chemical castration on sex offenders in relation to the kinetics of serum testosterone recovery: Implications for dosing schedule",
abstract = "Introduction: A growing number of countries are adopting chemical castration as treatment and penalty for sex offenders. Aim: The aim of this study is to evaluate the outcome of chemical castration of sexual offenders with a focus on the kinetics of serum testosterone (T) recovery. Methods: This prospective analysis included 56 sex offenders imprisoned for sexual offenses at the National Forensic Hospital. Thirty-eight and 18 patients who received 3 and 6 months of leuprolide acetate injections were assigned to group A and group B, respectively. Main Outcome Measures: To evaluate treatment efficacy according treatment duration, psychobehavioral assessments and serum T levels were serially measured during the on-cycle and the following observational 12-month off-cycle. Results: Chemical castration and the associated decrease in serum T levels reduced the frequency and intensity of sexual thoughts in 76{\%} and 71{\%} of group A patients and in 78{\%} and 72{\%} of group B patients, respectively. Reductions in masturbation frequency were observed in 74{\%} of group A and 83{\%} of group B patients. The median Wilson's Sex Fantasy Questionnaire (SFQ) scores were also significantly reduced in both groups. In group A, an upsurge of serum T to the flare level was observed during the first 2 months of the off-cycle, accompanied by an intense sexual drive and fantasy. In group B, serum T gradually recovered to the baseline level and continued to upsurge beyond baseline levels during the observational period. SFQ scores of group A returned to pretreatment levels following the observational period; however, SFQ scores of group B remained suppressed. Lack of objective assessments for psychobehavioral outcomes was a limitation. Conclusions: The efficacy of chemical castration varied according to the treatment duration. Regarding the kinetics of serum T recovery, maintaining at least 6 months of treatment warranted stable control of an excessive sexual drive following treatment cessation.",
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Effects of chemical castration on sex offenders in relation to the kinetics of serum testosterone recovery : Implications for dosing schedule. / Koo, Kyo Chul; Ahn, Jin Hyoung; Hong, Sung Joon; Lee, Jae Woo; Chung, Byungha.

In: Journal of Sexual Medicine, Vol. 11, No. 5, 01.01.2014, p. 1316-1324.

Research output: Contribution to journalArticle

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AU - Ahn, Jin Hyoung

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AU - Chung, Byungha

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AB - Introduction: A growing number of countries are adopting chemical castration as treatment and penalty for sex offenders. Aim: The aim of this study is to evaluate the outcome of chemical castration of sexual offenders with a focus on the kinetics of serum testosterone (T) recovery. Methods: This prospective analysis included 56 sex offenders imprisoned for sexual offenses at the National Forensic Hospital. Thirty-eight and 18 patients who received 3 and 6 months of leuprolide acetate injections were assigned to group A and group B, respectively. Main Outcome Measures: To evaluate treatment efficacy according treatment duration, psychobehavioral assessments and serum T levels were serially measured during the on-cycle and the following observational 12-month off-cycle. Results: Chemical castration and the associated decrease in serum T levels reduced the frequency and intensity of sexual thoughts in 76% and 71% of group A patients and in 78% and 72% of group B patients, respectively. Reductions in masturbation frequency were observed in 74% of group A and 83% of group B patients. The median Wilson's Sex Fantasy Questionnaire (SFQ) scores were also significantly reduced in both groups. In group A, an upsurge of serum T to the flare level was observed during the first 2 months of the off-cycle, accompanied by an intense sexual drive and fantasy. In group B, serum T gradually recovered to the baseline level and continued to upsurge beyond baseline levels during the observational period. SFQ scores of group A returned to pretreatment levels following the observational period; however, SFQ scores of group B remained suppressed. Lack of objective assessments for psychobehavioral outcomes was a limitation. Conclusions: The efficacy of chemical castration varied according to the treatment duration. Regarding the kinetics of serum T recovery, maintaining at least 6 months of treatment warranted stable control of an excessive sexual drive following treatment cessation.

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