Abolition du discernement : état des lieux des pratiques des experts psychiatres dans l’ouest de la France

Abstract

ObjectivesThe goal of this study was to determine the characteristics of subjects considered to be criminally irresponsible due to abolition of judgment pursuant to article 122-1, §1 of the French Penal Code. Materials and methodsThis retrospective study gathered every forensic assessment in 2016 that concluded in criminal irresponsibility from eight forensic psychiatrists practicing in the west of France. We proceeded to study the frequency of abolitions, the socio-demographic characteristics of the subjects, the psychiatric pathologies as defined by the DSM-5, the crimes committed, the clinical justifications and the conclusions of the forensic psychiatrist concerning the potential forced hospitalisation of the subject, the psychiatric dangerousness, curability and the ability to readapt of the subject. ResultsThirty-eight assessments out of the 763 collected concluded in abolition of judgment, a frequency of 4.98%. The subjects suffered from a schizophrenia spectrum disorder or a paranoid delusional disorder (85.2%). The most present clinical elements were paranoid delusions of persecution (23.1%), from intuitive, interpretative, hallucinatory or mental automatism mechanisms (39.7%) and dissociative syndrome (10.7%). Subjects with abolished judgment weren’t always considered dangerous (for 34.3% of individuals) even if a schizophrenia diagnosis was correlated (f=0.03). Forced hospitalisation was proposed in 50% of assessments and associated with the conclusion of dangerousness (f=0.01). ConclusionsSchizophrenia spectrum disorders or paranoid delusional disorders are the most common pathologies in forensic psychiatric assessments concluding in abolition of judgment.