Gorsane M A, Kebir O, Salmona I, Rahioui H, Laqueille X
15, rue d'Arcole, 75004 Paris, France.
Service d'addictologie « Moreau de Tours », centre hospitalier Sainte-Anne, GHU Paris Psychiatrie & neurosciences, Paris, France.
Encephale. 2021 Feb;47(1):43-48. doi: 10.1016/j.encep.2020.04.018. Epub 2020 Sep 11.
In total, 14% to 30 % of individuals with gambling disorder engage in illegal acts to finance such behavior. This clinical situation could be explained by higher gambling severity, associated substance use disorder, antisocial personality disorder and economic factors (debts, financial problems). The present work focuses, more broadly, on criminal responsibility of problematic gamblers.
We will discuss this question through different typical situations that medical experts of criminal responsibility may have to face. We will address each of the following cases: 1) isolated problematic gambling; 2) problematic gambling associated with antisocial personality disorder; 3) problematic gambling associated with a manic episode; 4) problematic gambling associated with substance use disorders; and 5) problematic gambling associated wiht dopamine agonist treatment.
Isolated problematic gambling, (not associated with any psychiatric or addictive disorder): it seems consensual that individuals committing infractions in this case are criminally responsible. However, impeded ability to action control and possible sentence attenuation could be discussed in case of severe gambling disorder. Problematic gambling associated with antisocial personality disorder: if the penal offence reports solely to personality disorder, criminal responsibility would be attributed. However, if illegal or violent acting is directly linked to co-cocurrent delusional symptoms, it could be a cause of criminal non-responsibility. Problematic gambling associated with manic episode: manic episode related offence could lead to negation of criminal responsibility, while a hypomanic episode may provide grounds for sentence reduction. Problematic gambling associated with substance use disorders: in France, addiction is not considered to remove nor to impede a person's ability to understand or control his actions and is excluded from criminal non-responsibility causes. However, substance induced delusional or confusional episodes could abolish a subject's discernment or his ability to control his actions yielding to penal non-responsibility. Problematic gambling associated with dopamine agonist treatment: Criminal responsibility for dopamine agonist induced gambling related illegal acts is still controversial. Nevertheless, people committing an infraction linked to associated dementia or dopamine agonist induced mania should be considered as criminally non-responsible.
Some clinical dimensions such as craving intensity, compulsivity, disorder's severity, volitional control might be forensic targets to assess criminal responsibility.
总计14%至30%的赌博障碍患者会实施非法行为以资助此类行为。这种临床情况可以用更高的赌博严重程度、相关物质使用障碍、反社会人格障碍和经济因素（债务、财务问题）来解释。本研究更广泛地关注问题赌徒的刑事责任。
我们将通过刑事责任医学专家可能不得不面对的不同典型情况来讨论这个问题。我们将探讨以下每种情况：1）孤立的问题赌博；2）与反社会人格障碍相关的问题赌博；3）与躁狂发作相关的问题赌博；4）与物质使用障碍相关的问题赌博；以及5）与多巴胺激动剂治疗相关的问题赌博。
孤立的问题赌博（与任何精神或成瘾性障碍无关）：在这种情况下实施违法行为的个人应承担刑事责任，这似乎是一致的看法。然而，在严重赌博障碍的情况下，可以讨论行动控制能力受损和可能的刑罚减轻。与反社会人格障碍相关的问题赌博：如果刑事犯罪仅归因于人格障碍，则应追究刑事责任。然而，如果非法或暴力行为直接与同时出现的妄想症状相关，则可能导致不负刑事责任。与躁狂发作相关的问题赌博：与躁狂发作相关的犯罪可能导致刑事责任的否定，而轻躁狂发作可能成为减刑的理由。与物质使用障碍相关的问题赌博：在法国，成瘾不被视为消除或阻碍一个人理解或控制其行为的能力，并且被排除在不负刑事责任的原因之外。然而，物质诱发的妄想或意识模糊发作可能会消除一个人的辨别力或控制其行为的能力，从而导致不负刑事责任。与多巴胺激动剂治疗相关的问题赌博：多巴胺激动剂诱发的与赌博相关的非法行为应承担的刑事责任仍存在争议。然而，实施与相关痴呆或多巴胺激动剂诱发的躁狂相关的违法行为的人应被视为不负刑事责任。
一些临床维度，如渴望强度、强迫性、障碍的严重程度、意志控制，可能是评估刑事责任的法医目标。
