Medical Management of Problematic Sexual Arousal for People With a Sexual Conviction in England and Wales: Challenges, Learning and Progress

IF 1.9 4区医学 Q3 CRIMINOLOGY & PENOLOGY

Criminal Behaviour and Mental Health Pub Date : 2026-04-09 Epub Date: 2026-03-21 DOI:10.1002/cbm.70030

Belinda Winder, D. Grubin, M. Underwood, Z. Antoniadis, M. Carvalheiro, E. Marshall, C. Norman, R. Bourne, A. Kaul

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Abstract

Background

In England and Wales, the primary treatments for individuals convicted of sexual offences are psychological. However, medication to manage problematic sexual arousal (MMPSA) is gaining importance as an alternative. This article reviews the current evidence surrounding the MMPSA approach.

Aim

This paper synthesises challenges encountered, advancements achieved and learnings accumulated over 16 years of the MMPSA treatment pathway from 2009 to 2025 in England and Wales.

Methods

Drawing on a programme of mixed-methods research, including cohort studies, case studies, qualitative interviews with patients and professionals and implementation evaluations, this paper seeks to bring together key findings to present a consolidated picture of the research on the MMPSA pathway to date. The focus is on synthesising findings and identifying implications for service delivery.

Results

Evaluations of treatment outcomes showed promising results regarding the effectiveness of the MMPSA service. Qualitative analyses and case studies provided insightful details regarding patient and staff concerns that may hinder the efficiency and reach of the treatment pathway. Research with community clinicians highlighted issues regarding the ‘off-label’ use of medication for this purpose.

Conclusions

The MMPSA treatment service is available in a limited number of prisons in England and Wales. Supported by promising service evaluations and existing literature, a larger population could benefit from MMPSA treatment. Furthermore, the MMPSA service would benefit from improvements to create smoother transitions for individuals leaving prison and entering the community, and it should ideally be expanded to ensure that those in the community can also access the MMPSA service.

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在英格兰和威尔士的性信念的人有问题的性唤起的医疗管理：挑战，学习和进步。

背景：在英格兰和威尔士，对性犯罪罪犯的主要治疗是心理治疗。然而，治疗性唤起问题的药物（MMPSA）作为一种替代方法正变得越来越重要。本文回顾了目前围绕MMPSA方法的证据。目的：本文综合了英格兰和威尔士从2009年到2025年16年来MMPSA治疗途径所遇到的挑战、取得的进展和积累的经验。方法：利用混合方法研究计划，包括队列研究，案例研究，对患者和专业人员的定性访谈以及实施评估，本文试图将主要发现汇集在一起，以呈现迄今为止MMPSA途径研究的综合图景。重点是综合调查结果和确定对提供服务的影响。结果：对治疗结果的评估显示了MMPSA服务有效性的良好结果。定性分析和案例研究提供了关于患者和工作人员可能阻碍治疗途径的效率和覆盖面的问题的深刻细节。与社区临床医生的研究强调了关于“标签外”使用药物的问题。结论：MMPSA治疗服务在英格兰和威尔士的有限监狱中可用。有前景的服务评估和现有文献支持，更大的人群可以从MMPSA治疗中受益。此外，MMPSA服务将受益于改进，为个人离开监狱和进入社区创造更顺畅的过渡，理想情况下，它应该扩大，以确保社区中的人也可以使用MMPSA服务。

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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来源期刊

Criminal Behaviour and Mental Health Multiple-

CiteScore

1.60

自引率

0.00%

发文量

期刊介绍： Criminal Behaviour & Mental Health – CBMH – aims to publish original material on any aspect of the relationship between mental state and criminal behaviour. Thus, we are interested in mental mechanisms associated with offending, regardless of whether the individual concerned has a mental disorder or not. We are interested in factors that influence such relationships, and particularly welcome studies about pathways into and out of crime. These will include studies of normal and abnormal development, of mental disorder and how that may lead to offending for a subgroup of sufferers, together with information about factors which mediate such a relationship.