46. In previous reports, the CPT expressed objections to surgical castration as a means of treatment of sex offenders, since it was a mutilating, irreversible intervention. In the present report, the Committee welcomes the fact that, according to official data, not one single surgical castration had been carried out on sex offenders during the period 2013 to 2015, and it encourages all federal and Länder authorities to put a definitive end to surgical castration for treatment of sex offenders. According to the German authorities’ response, voluntary surgical castration is used only very exceptionally. However, the authorities do not envisage a definitive end to the use of this measure. 47. Finally, the CPT‘s report notes that the mental health legislation of several German Länder provides for the possibility to impose disciplinary sanctions on forensic psychiatric patients. As a matter of principle, the CPT has reservations about the use of disciplinary measures vis-à-vis psychiatric patients. Such measures aim to sanction patients’ behaviour, which is often likely to be related to a psychiatric disorder and should be approached from a therapeutic, rather than a punitive, standpoint. In their responses, the Bavarian authorities currently see no need to amend the relevant legal provisions on disciplinary sanctions, whereas the authorities of Saxony-Anhalt announce that the Committee’s recommendation would be discussed among the psychiatric establishments of this Land. Report and response published in June 2017 (CPT/Inf(2017)13 and CPT/Inf(2017)14) Report on the periodic visit to Italy in April 2016 and response of the Italian authorities (prison reform measures to reduce overcrowding; reform of forensic psychiatry; deprivation of liberty by law enforcement authorities; involuntary placement in civil psychiatric institutions) 48. In its report the CPT raises concern over allegations of physical ill-treatment and excessive use of force by members of the State Police and Carabinieri, as well as by prison staff. Moreover, persons in police custody do not always benefit from the safeguards afforded them by law. Material conditions are also criticised in the report, both in police and prison establishments. 49. All prison establishments visited suffered from structural material deficiencies and extensive refurbishment should be undertaken. The report takes stock of the unprecedented penitentiary reform following the 2013 pilot judgment Torreggiani and Others v. Italy of the European Court of Human Rights, leading to a decrease in the prison population and an increase in the prison estate capacity. Nevertheless, the prison population had again increased in 2016 and prison overcrowding persisted. In their response the Italian authorities describe in detail the refurbishments and other efforts undertaken with a view to improving detention conditions and reducing prison overcrowding. 50. In the report, the CPT is critical of the use of medical seclusion rooms for the prolonged isolation of prisoners with self-harming and/or suicidal tendencies; notably as regards the degrading manner in which it is applied, the absence of appropriate Publication highlights ► Page 19