ABSTRACT
This study investigated the effect of leuprolide acetate treatment on sex offenders' sexual fantasies and behaviors, as well as on their criminogenic psychological character and the risk of second conviction. The study participants consisted of 22 sex offenders who were confined to the National Institute of Forensic Psychiatry. Among them, 9 patients were given off-label leuprolide acetate for three months to inhibit sexual impulses, whereas the others were not given any medication. All sex offenders underwent two psychological evaluations; the first evaluation was conducted before starting medication, and the second was conducted after medication. Wilson's Sex Fantasy Questionnaire (WSFQ), the Rape Myth Acceptance Scale (RMAS), and the Endorsement of Violence Scale (EVS) were used for evaluation. Leuprolide acetate-treated sex offenders showed a statistically significant decline in the total WSFQ score (p < 0.05). However, the RMAS and EVS scores did not differ after leuprolide acetate treatment, indicating that cognitive distortions like rape myth acceptance and endorsement of violence were unchanged after leuprolide medication. Leuprolide acetate may reduce deviant sexual impulses and fantasies, as suggested by previous research form Korea and other countries. However, it probably cannot alter cognitive distortion. On the basis of these findings, we recommend a combination of leuprolide medication and other therapies, like cognitive behavioral therapy, for the treatment of paraphilic sex offenders.