Current neurological hypotheses of paraphilia posit that sexual deviance is associated with frontal and/or temporal lobe damage. This broad conception is based on few investigations, however, and the first goal of this study was to review the existing data derived from neuropsychiatry, neuroimaging and neuropsychology. It is concluded that although fronto-temporal dysfunctions are sporadically reported among sexual offenders, the evidence is scarce and it might not be specific to this type of offending. The second objective of this investigation was to gather preliminary neuropsychological data with more homogeneous subgroups of sexual offenders. A profile of lower-order executive dysfunctions (e.g. sustained attention and inhibition) and verbal deficits with intact or good capacities for higher-order executive functioning (e.g. reasoning and cognitive flexibility) and visuo-spatial processing was preferentially found among sexual offenders, suggesting basal fronto-temporal anomalies. Importantly, pedophiles were more consistently and severely impaired than rapists of adults. However, this basal fronto-temporal profile is not characteristic of sexual deviance, as it is also found in association with delinquency and criminality in general. Future neuropsychological and brain imaging studies should consider subgroups of sexual offenders and recruit non-sexual violent persons and non-violent individuals in order to disentangle the complex relations between brain anomalies and sexual deviance.

No abstract

Current neurological hypotheses of paraphilia posit that sexual deviance is associated with frontal and/or temporal lobe damage. This broad conception is based on few investigations, however, and the first goal of this study was to review the existing data derived from neuropsychiatry, neuroimaging and neuropsychology. It is concluded that although fronto-temporal dysfunctions are sporadically reported among sexual offenders, the evidence is scarce and it might not be specific to this type of offending. The second objective of this investigation was to gather preliminary neuropsychological data with more homogeneous subgroups of sexual offenders. A profile of lower-order executive dysfunctions (e.g. sustained attention and inhibition) and verbal deficits with intact or good capacities for higher-order executive functioning (e.g. reasoning and cognitive flexibility) and visuo-spatial processing was preferentially found among sexual offenders, suggesting basal fronto-temporal anomalies. Importantly, pedophiles were more consistently and severely impaired than rapists of adults. However, this basal fronto-temporal profile is not characteristic of sexual deviance, as it is also found in association with delinquency and criminality in general. Future neuropsychological and brain imaging studies should consider subgroups of sexual offenders and recruit non-sexual violent persons and non-violent individuals in order to disentangle the complex relations between brain anomalies and sexual deviance.

No abstract

The present article reviews different concepts of atypical depression. Of these, major depression associated with panic disorder would have a specific meaning according to some pharmacological and prognosis studies. It seems that this type of depression is quite frequent and has a significantly worse prognosis than major depression alone. Controlled studies comparing the efficacy of tricyclic antidepressants to phenelzine concluded in favour of the latter in general. It is generally thought that atypical depression would respond better to monoamine oxidase inhibitors (MAOI), but it would seem that it is mainly major depression associated with panic disorder that could predict this kind of response to treatment. Second generation antidepressants have not been studied systematically for this purpose even though preliminary reports seem promising.