A unique case of iatrogenic hebephiliac behavior emerging late in life in a patient with Gordon Holmes Syndrome

Psychiatry research case reports Pub Date : 2024-09-29 DOI:10.1016/j.psycr.2024.100237

Riccardo Loconte , Gianluca Sesso , Cristina Scarpazza , Pietro Pietrini

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Abstract

Background

Pedophilic or hebephiliac behavior is defined iatrogenic when emerging for the first time as a side effect of medications. To date, pedophilic or hebephiliac behavior emerging after testosterone replacement therapy (TRT) has never been described.

Case presentation

a patient diagnosed with Gordon-Holmes syndrome (GHS), a genetic condition characterized by cerebellar ataxia and hypogonadotropic hypogonadism (HH), at the age of 55 developed hebephiliac attitudes after starting TRT. A multidisciplinary approach integrating psychiatric evaluation, general (IQ) and specific (social cognition) neuropsychological assessment, and structural brain MRI was important to characterize the patient's clinical and functional profile.

Discussion

We discuss how the co-occurrence of HH, requiring hormone replacement therapy, combined with the patient's borderline IQ explains the sexual offenses against pre-adolescents in light of the Insufficient but Non-Redundant Parts of Unnecessary but Sufficient Conditions (INUS) model of causation. In other words, both the administration of TRT and the borderline IQ are configured as INUS causes for understanding the illegal behavior.

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戈登-霍姆斯综合征患者晚年出现先天性虹膜睫状体行为的独特病例

背景如果恋童癖或嗜雌癖行为是首次出现的药物副作用，则被定义为先天性的。病例介绍一名患者在 55 岁时被诊断患有戈登-霍姆斯综合征（GHS），这是一种以小脑共济失调和性腺功能减退症（HH）为特征的遗传病。讨论我们根据 "非必要但充分条件的不充分但非冗余部分"（INUS）因果关系模型，讨论了需要激素替代疗法的 HH 并发症与患者的边缘智商如何解释针对青少年前儿童的性犯罪。换句话说，TRT 的使用和边缘智商都被设定为 INUS 原因，从而理解了非法行为。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Psychiatry research case reports Medicine and Dentistry (General)

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