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Bernardi N, Delteil C, Kania É, Giravalli P, Tuchtan L, Guay JP, Piercecchi MD, Bartoli C, Guivarch J. Psychiatric disorders and management of sexual offenders in the prison psychiatric consultation unit of Marseille. J Forensic Sci 2024; 69:574-583. [PMID: 38083832 DOI: 10.1111/1556-4029.15450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 03/07/2024]
Abstract
Since 2017, complaints of sexual violence have increased in France. At the same time, the management of sexual offenders has been at the center of international public health policies. The prevalence of mental disorders among sexual offenders is an essential field of research. There are some published studies on the prevalence of psychiatric disorders in sexual offenders in detention, but there are few recent published studies among French individuals who were detained. Our objectives were to determine the prevalence of psychiatric disorders among persons detained for sexual offenses and the level of care received according to their diagnosis. For this purpose, we carried out a retrospective observational study from January 2017 to October 2021 of all adult sexual offenders, whether accused or convicted, who were seen in the psychiatric consultation unit of Les Baumettes prison, Marseille, France. The primary outcome measure was the psychiatric diagnosis entered in the medical records. One hundred forty-two patients were included in analysis. All patients were men, and the majority (n = 97, 68.3%) of these patients presented with at least one psychiatric disorder, principally a personality disorder (31.7%). 10.6% presented with a schizophrenic disorder, 4.9% a bipolar disorder, 3.5% a depressive disorder, 5.6% pedophilic paraphilia, and 25.4% an addictive disorder. Their management and comorbid addictions were analyzed in subgroups for each psychiatric disorder. Patients appeared to receive an appropriate level of care for their diagnosed disorder. It seems important to develop structured assessment of recidivism risk for better management of sexual offenders.
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Affiliation(s)
- Noémie Bernardi
- Service de Médecine Légale, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Clémence Delteil
- Service de Médecine Légale, Assistance Publique-Hôpitaux de Marseille, Marseille, France
- Aix Marseille Univ, CNRS, EFS, ADES, Marseille, France
| | - Éric Kania
- Département de Psychiatrie et Addictologie en Détention, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Pascale Giravalli
- Département de Psychiatrie et Addictologie en Détention, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Lucile Tuchtan
- Service de Médecine Légale, Assistance Publique-Hôpitaux de Marseille, Marseille, France
- Aix Marseille Univ, CNRS, EFS, ADES, Marseille, France
| | - Jean-Pierre Guay
- School of Criminology, Université de Montréal, Montréal, Quebec, Canada
- Centre International de Criminologie Comparée, Montréal, Quebec, Canada
- Institut national de psychiatrie légale Philippe-Pinel, Montréal, Quebec, Canada
| | - Marie-Dominique Piercecchi
- Service de Médecine Légale, Assistance Publique-Hôpitaux de Marseille, Marseille, France
- Aix Marseille Univ, CNRS, EFS, ADES, Marseille, France
| | - Christophe Bartoli
- Service de Médecine Légale, Assistance Publique-Hôpitaux de Marseille, Marseille, France
- Aix Marseille Univ, CNRS, EFS, ADES, Marseille, France
- Service de Médecine en Détention, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Jokthan Guivarch
- Aix-Marseille université, Institut de neurosciences de la Timone, AMU, CNRS, CanoP, UMR 7289, Marseille, France
- Service de Pédopsychiatrie, Assistance Publique-Hôpitaux de Marseille, Hôpital Sainte-Marguerite, Marseille, France
- Is'Crim, Institut des Sciences Criminelles, Université de Poitiers, Poitiers, France
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Eck M, Da Costa J, Wathelet M, Beunas C, d'Ovidio K, Moncany AH, Thomas P, Fovet T. [Prevalence of mental disorders in French prisons: A systematic review]. L'ENCEPHALE 2024:S0013-7006(24)00018-6. [PMID: 38378405 DOI: 10.1016/j.encep.2023.11.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 11/20/2023] [Accepted: 11/24/2023] [Indexed: 02/22/2024]
Abstract
INTRODUCTION The prevalence of psychiatric disorders among prisoners remains a major public health issue worldwide. In France, despite the increasing number of persons who are incarcerated (+30% between 1992 and 2002 with a 120% prison overcrowding), and a historical concern about the mental health of persons in detention and its management, no systematic review has been published on this subject. The aim of this article is to present the results of a systematic review of the literature on the prevalence of psychiatric disorders in French prisons. METHOD The reporting of this systematic review conforms to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) checklist. We searched the PubMed and Web of Science databases. We used combinations of keywords relating to prison (prison*, jail*, inmate*), to psychiatry ("mental health", psychiatr*), and to France (France, French). This work was completed with a search through the digital libraries of the École des Hautes Études en Santé Publique (EHESP) and of the Système Universitaire de Documentation (Sudoc) to obtain data from academic works and the gray literature. References cited in studies included in this review were also examined. All references published up to September 2022, written in English or French, presenting the results of original quantitative studies on the prevalence of psychiatric disorders in correctional settings were included. Two researchers independently extracted data from included references according to a pre-established protocol. RESULTS Among 501 records identified, a total of 35 papers based on 24 epidemiological studies met the eligibility criteria for inclusion in this review: 16 were cross-sectional, 7 retrospective and 1 both cross-sectional and retrospective. All papers were published between 1999 and 2022. We found one European study, 5 international studies, 18 regional or local studies. Of these, 21 studies had all-male or mixed gender samples (but when the sample was mixed gender, it was always at least 92% male). Almost half of the studies (n=11) involved a small sample of fewer than 500 persons. Half of the studies involved a sample of recently incarcerated persons: 6 involved a random sample of persons in detention, and 1 involved a sample of people incarcerated for more than 5 years. The last 5 studies focused on persons aged over 50 years and incarcerated for more than one year (n=1), incarcerated for sexual offences (n=2), placed in disciplinary cells (n=1) or in a special wing for radicalized or suspected radicalized individuals (n=1). Nine studies used standardized and validated diagnostic tools. According to the 4 studies involving representative samples and using standardized and validated diagnostic tools, the prevalence of the following psychiatric disorders was: 29.4-44.4% for anxiety disorders, 5-14.2% for PTSD, 28-31.2% for mood disorders, 6.9-17% for psychotic disorders, 32% for personality disorders and 11% for ADHD. CONCLUSION This systematic review of the literature highlights the high prevalence of psychiatric disorders in French prisons. The data collected are in line with international studies. The great methodological heterogeneity of the papers included in this review calls for further rigorous research to better understand the rates of mental disorders in French prisons and to explore their determinants.
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Affiliation(s)
- Marion Eck
- Pôle de psychiatrie légale et de conduites addictives en milieu pénitentiaire, centre hospitalier Gérard Marchant, 31057 Toulouse, France; Inserm, U1172 - Lille neuroscience & cognition, université de Lille, 59000 Lille, France.
| | - Julien Da Costa
- Pôle de psychiatrie légale et de conduites addictives en milieu pénitentiaire, centre hospitalier Gérard Marchant, 31057 Toulouse, France
| | - Marielle Wathelet
- Pôle de psychiatrie, médecine légale et médecine en milieu pénitentiaire, CHU de Lille, 59000 Lille, France; Fédération régionale de recherche en psychiatrie et santé mentale Hauts-de-France (F2RSM Psy), Saint-André-lez-Lille, France
| | - Clément Beunas
- Fédération régionale de recherche en psychiatrie et santé mentale Hauts-de-France (F2RSM Psy), Saint-André-lez-Lille, France
| | - Kévin d'Ovidio
- Fédération régionale de recherche en psychiatrie et santé mentale Hauts-de-France (F2RSM Psy), Saint-André-lez-Lille, France
| | - Anne-Hélène Moncany
- Pôle de psychiatrie légale et de conduites addictives en milieu pénitentiaire, centre hospitalier Gérard Marchant, 31057 Toulouse, France
| | - Pierre Thomas
- Inserm, U1172 - Lille neuroscience & cognition, université de Lille, 59000 Lille, France; Pôle de psychiatrie, médecine légale et médecine en milieu pénitentiaire, CHU de Lille, 59000 Lille, France
| | - Thomas Fovet
- Inserm, U1172 - Lille neuroscience & cognition, université de Lille, 59000 Lille, France; Pôle de psychiatrie, médecine légale et médecine en milieu pénitentiaire, CHU de Lille, 59000 Lille, France
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