Results are presented of an open retrospective study in which 46malepatients withparaphilic sexual disorders were followed for 5 or more years in the Johns Hopkins Sexual Disorders Unit. All patients received equivalent amounts of group psychotherapy. Of these, 17/46 (37%) relapsed. The rate of relapse among subjects receiving treatment with medroxy-progesterone acetate (MPA) was 4 out of 27 subjects (15%) whereas the rate of relapse among subjects not receiving MPA was 13/19 (68%) (Chi-square = 13.80; df = 1; p = 0.0002). The lower rate of relapse among subjects who were receiving MPAcontinued to be demonstrated when other variables were accounted for including age, race, marital status, employment, socioeconomic status, diagnosis, and sexual orientation. It is concluded that among paraphilic male outpatients treated with weekly psychotherapy for 5 or more years, the addition of MPA is associated with a decrease in the rate of relapse. Limitations of this study and suggestions for future research are discussed.
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