PMID- 30263177
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240331
IS  - 2078-6786 (Electronic)
IS  - 1608-9685 (Print)
IS  - 1608-9685 (Linking)
VI  - 23
DP  - 2017
TI  - The use of cyproterone acetate in a forensic psychiatric cohort of male sex 
      offenders and its associations with sexual activity and sexual functioning.
PG  - 982
LID - 10.4102/sajpsychiatry.v23i0.982 [doi]
LID - 982
AB  - BACKGROUND: Cyproterone acetate (CPA) is a steroidal anti-androgenic medication 
      used in the field of psychiatry for the treatment of paraphilic disorders, 
      hypersexuality, and inappropriate sexual behaviour which may be present in 
      patients with disorders such as mild and major neurocognitive disorders. In the 
      forensic psychiatric population, it is prescribed for these indications 
      especially for patients with a history of committing a sexual offence or who are 
      at moderate to high risk of recidivism. OBJECTIVES: To investigate the use of CPA 
      in a forensic psychiatric cohort of male sex offenders and its associations with 
      sexual activity and sexual functioning. METHODS: Seventy-six forensic psychiatric 
      patients from Weskoppies Hospital in Pretoria, South Africa, participated in the 
      study which measured their sexual functioning. A specifically designed 
      questionnaire was used to capture relevant background information. The use of CPA 
      was studied. The Changes in Sexual Functioning Questionnaire, Male Clinical 
      Version (CSFQ-M-C) was used to measure sexual functioning of participants. The 
      CSFQ-M-C scores, and those of all its subscales, of participants on CPA were 
      compared to those not on the drug. Relevant statistical analyses were performed. 
      RESULTS: Thirteen out of the 76 participants were being treated with CPA 
      (17.11%). In total, 53.85% of the participants on CPA and 65.08% not on CPA had 
      scores indicating the presence of sexual dysfunction. The total CSFQ-M-C scores 
      for participants on CPA (mean = 40.54; median = 42) were not statistically 
      significantly lower than those not on the drug (mean = 41.22; median = 41). More 
      notable is that the use of CPA in this population was associated with lower 
      levels of desire, frequency of and pleasure from sexual activity. There was an 
      association between having intellectual disability and being treated with CPA. 
      CONCLUSION: That all the participants were being treated with psychotropic 
      medication could account for the high percentage of sexual dysfunction in any or 
      all areas of sexual functioning and contribute to the small difference in 
      CSFQ-M-C scores between the two groups. Only a tentative conclusion can be made 
      that CPA may be more effective in decreasing levels of desire, frequency and 
      pleasure related to sexual activity than other areas of sexual functioning. The 
      indication for the use of CPA in this population should be assessed clinically 
      according to patient circumstances and risk assessment.
FAU - Lippi, Gian
AU  - Lippi G
AD  - Department of Psychiatry, Faculty of Health Sciences, University of Pretoria, 
      South Africa.
AD  - Forensic Unit, Weskoppies Hospital, South Africa.
FAU - van Staden, Paul J
AU  - van Staden PJ
AUID- ORCID: 0000-0002-5710-5984
AD  - Department of Statistics, Faculty of Natural and Agricultural Sciences, 
      University of Pretoria, South Africa.
LA  - eng
PT  - Journal Article
DEP - 20170310
PL  - South Africa
TA  - S Afr J Psychiatr
JT  - The South African journal of psychiatry : SAJP : the journal of the Society of 
      Psychiatrists of South Africa
JID - 100958626
PMC - PMC6138062
COIS- The authors declare that they have no financial or personal relationships which 
      may have inappropriately influenced them in writing this article.
EDAT- 2017/03/10 00:00
MHDA- 2017/03/10 00:01
PMCR- 2017/03/10
CRDT- 2018/09/29 06:00
PHST- 2016/02/29 00:00 [received]
PHST- 2016/09/12 00:00 [accepted]
PHST- 2018/09/29 06:00 [entrez]
PHST- 2017/03/10 00:00 [pubmed]
PHST- 2017/03/10 00:01 [medline]
PHST- 2017/03/10 00:00 [pmc-release]
AID - SAJPsy-23-982 [pii]
AID - 10.4102/sajpsychiatry.v23i0.982 [doi]
PST - epublish
SO  - S Afr J Psychiatr. 2017 Mar 10;23:982. doi: 10.4102/sajpsychiatry.v23i0.982. 
      eCollection 2017.