Prevalence of pedophilia in a forensic psychiatric population in Switzerland: a comparative study of contact vs non-contact and pedophilic vs non-pedophilic offenders.

Introduction: Sexual offenses against minors represent a major public health and judicial concern. Pedophilia, defined as a persistent sexual preference for prepubescent children, is frequently assessed in forensic psychiatry, particularly in the context of evaluating criminal responsibility and risk offending, yet its clinical significance and relationship to offending behavior remain debated. This study aimed to determine the prevalence of pedophilia among individuals accused of sexual offenses against minors under 14 of age in Switzerland and to compare offenders with and without this diagnosis. Methods: A retrospective analysis was conducted on 51 male individuals referred for forensic psychiatric evaluation between 2018 and 2021 in Geneva. Data from forensic reports included sociodemographic characteristics, psychiatric history, ICD-10 diagnoses, and offense details. Comparisons were performed between individuals accused of contact versus non-contact offenses, and secondarily between those with and without pedophilia. Results: Pedophilia was diagnosed in 58.8% of participants. This diagnosis was associated with higher rates of personality and substance use disorders. However, no significant differences were found between contact and non-contact offenders regarding the prevalence of pedophilia and no distinctive profile emerged within the pedophilic group. Discussion: These findings confirm the high prevalence of pedophilia in forensic populations and underscore their clinical heterogeneity. They highlight the need for comprehensive, individualized forensic assessments integrating diagnostic, contextual, and dispositional factors, and suggest that future research should further examine the interaction between pedophilic interests, self-control, and situational opportunities.