Titre : | Expertise psychiatrique : quelle est la responsabilité pénale en cas de consommation de cannabis ? (2019) |
Titre traduit : | (Psychiatric expertise: What is the criminal responsibility for cannabis use?) |
Auteurs : | M. SAMUEL ; M. BENOIT ; N. N. ABOU |
Type de document : | Article : Périodique |
Dans : | Annales Médico-Psychologiques, Revue psychiatrique (Vol.177, n°4, Avril 2019) |
Article en page(s) : | 327-334 |
Langues: | Français |
Discipline : | PSY (Psychopathologie / Psychopathology) |
Mots-clés : |
Thésaurus mots-clés PSYCHIATRIE ; CANNABIS ; JUSTICE ; RESPONSABILITE PENALE ; EXPERTISE JUDICIAIRE ; PSYCHOPATHOLOGIE ; ETUDE RETROSPECTIVE ; COMORBIDITEThésaurus géographique FRANCE ; PROVENCE-ALPES-COTE D'AZUR |
Résumé : |
FRANÇAIS :
Introduction : La consommation de cannabis est depuis quelques années un problème de santé publique en France, notamment par la démocratisation de cette drogue chez les jeunes. Bien que la législation soit claire en ce qui concerne la responsabilité des personnes sous l'emprise de stupéfiants en cas d'infractions, il n'est pas rare que les personnes soient reconnues irresponsables ou partiellement responsables. L'objectif de cette étude est de déterminer si une consommation de cannabis au moment des faits est retenue par les experts comme un facteur de d'altération ou d'abolition du discernement. Méthode : Une étude descriptive rétrospective réalisée dans la région PACA auprès de six experts a recueilli 96 expertises pénales en responsabilité pour des infractions commises sous l'emprise de cannabis entre 2016 et 2018. Le critère d'évaluation principal était le discernement, défini soit comme aboli, altéré ou non modifié. Les objectifs secondaires étaient d'observer les facteurs associés à une modification de celui-ci. Résultats : La consommation de cannabis n'a pas d'impact sur le degré de discernement. La dépendance au cannabis chez l'auteur des faits n'est pas significativement associée à une atteinte du discernement. En revanche, le sexe masculin, l'existence d'un trouble de la personnalité, une immaturité affective, les antécédents psychiatriques, un suivi psychiatrique ou addictologique au moment des faits et une décompensation psychotique sont significativement associés à une atteinte du discernement. Conclusion : Ces résultats soulignent l'importance des mesures de prévention et de réduction des risques liés au cannabis, notamment dans ce contexte de légalisation ou dépénalisation du cannabis. ENGLISH: Objectives: In recent years, cannabis use has been a public health problem in France, particularly through the democratization of this drug among young people. The impact of chronic cannabis use on impulsivity and risk taking therefore questions the role of cannabis in offenses. Although the legislation is clear as regards the liability of persons under the influence of drugs in the event of an offense, it is not unusual for individuals to be found irresponsible or partially responsible. The purpose of this study is to determine whether cannabis use at the time of the facts is retained by the experts as a factor of alteration or abolition of discernment, but also to identify the elements associated with an impairment of discernment. Patients or materials and methods: A retrospective descriptive study conducted in the PACA region with 6 experts collected 96 criminal appraisals of responsibility for offenses committed under the influence of cannabis between 2016 and 2018. The inclusion criteria include the age of the alleged perpetrators that had to be between 18 and 65 years old and cannabis intoxication at the time of the facts. The expert reports for which the expert did not mention a possible cannabis intoxication at the time of the events but which he emphasized a significant daily consumption were included. The criterion of non-inclusion was the impossibility for the expert to pronounce on the existence or not of a psychic or neuropsychic disorder having abolished or impaired the discernment or control of the acts. Appraisals for which no use of cannabis at the time of the facts was found were excluded, likewise for the expertises whose question of discernment at the time of the facts according to article 122-1 of the Penal Code was not raised. (postsentencing expertise). The primary outcome measure was to determine whether or not the alleged perpetrator is responsible for the alleged acts. It then corresponds to the expert's conclusion concerning the question of the discernment and control of acts at the material time. Thus, three possible answers were obtained: discernment abolished, discernment altered or unmodified discernment. The secondary objectives were to determine the factors that may have an impact on the assessment of judgment and thus on criminal responsibility. Secondary outcomes included biographical information (age, sex, geography, placement, abuse or rape in childhood, parenthood, marital status, socioprofessional category), personal psychiatric history (personality disorder, bipolar disorder, and psychotic disorder, acute delirium and cannabic psychosis, impulsivity) and family psychiatric history. A criminal record as a victim but especially as an author was sought. If so, is the subject subject to or has been sentenced to socio-judicial follow-up (care ordered by the penitentiary, followed by Prison and Probation Services (SPIP), electronic surveillance)? Is the act currently being reproached committed in a state of legal recidivism? Finally, the toxicological profile was analyzed to determine whether cannabis use at the time of the event occurred in a context of cannabis addiction or harmful use, but also to assess concomitant use of other illicit substances or alcohol at the time facts. Results: Associations were searched for bivariate analysis (Chi² test or Fisher's exact test) and then multivariate analysis (logistic regression). The variables selected for the multivariate analysis are those for which P Conclusion: The results of the study are in line with those expected from the literature. Psychiatric co-morbidities at the time of the events and in particular psychoses (decompensation of schizophrenia and paranoid delusion) are the first causes of abolition of the discernment, with 2/3 of the people addicted to cannabis. With regard to the causes of discernment, psychoses are still strongly represented, but to these are added, among others, personality disorders (antisocial and borderline personality disorder) and intellectual deficit. It is important to note in this category, however, the high proportion of cannabis addicts (41.67%) and addictive comorbidities (33%). The vast majority of those whose discernment was neither altered nor abolished at the time of the incident, suffered no psychiatric pathology at the time of the offense. Where appropriate, the experts primarily diagnosed antisocial and borderline personality disorders. These results underline the importance of prevention and risk reduction measures related to cannabis, particularly in this context of legalization or decriminalization of cannabis. |
Domaine : | Drogues illicites / Illicit drugs |
Refs biblio. : | 8 |
Affiliation : | Université de Nice Sophia Antipolis, centre hospitalier d'Antibes, équipe de liaison et de soins en addictologie (ELSA) et centre spécialisé (CSAPA), DESC d'addictologie et formation aux expertises psychiatriques en cours, Antibes, France |
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