Pedophilic Disorder

Risk Factors
Criterion A
Criterion B
Criterion C
Criterion D
Criterion E
Criterion F

Episode Specifier

Severity Specifier

Specify if:

  • The likelihood of pedophilic disorder is diagnosed if there are multiple victims (likelihood increases with each victim), male victim (almost all pedophilic), non-cohabiting victims, pre-pubescent victims, child pornography offences, and/or positive phallometric testing.
  • Phallometric assessment, also known as penile plethysmography (PPG) is an investigation that measures changes in penile volume measured in response to visual stimuli (sensitivity of 55%, specificity of 96%, i.e. - if positive then very likely to have pedophilic disorder, but if negative it does not rule it out).[1]
  • The investigation involves a comparison of relative level of response by the individual and this is compared with sample of sex offenders.
  • Penile erectile responses are reflective of arousal, and erectile responses in the laboratory setting are reflective of what would occur in the community (arousal is related to the risk for offending)
  • Treatments for pedophilic disorder have been controversial due to various societal, cultural, and legal concerns. Additionally, there are few high quality research studies, and many obvious ethical concerns limit the study of treatments.
  • Cognitive-behaviour therapy and relapse prevention principles may have some evidence, with a specific focus on cognitive distortions, the offence cycle/cognitive-behavioural chain, responsibility, and empathy for victims. Relapse prevention is often a focus of these programs.
  • Individuals often receive these program while in custody and last between 1 to 2 years; for outpatients this may last between 12 to 16 weeks.
  • Since testosterone strongly influences sex behaviour in both males and females, anti-androgen therapy is the primary method of pharmacological treatment. This includes:
    • Medroxyprogesterone (MPA)[2]
    • Cyproterone acetate (CPA)
    • Leuprolide acetate (“chemical castration”)
  • Possible side effects from the use of these medications include weight gain (MPA), gallbladder/GI dysfunction, testicular atrophy/impaired sperm production, changes in insulin response (MPA), liver dysfunction (leuprolide/CPA), feminization (CPA), and/or bone demineralization (leuprolide/CPA)