Fovet Thomas, Baillet Maëlle, Horn Mathilde, Chan-Chee Christine, Cottencin Olivier, Thomas Pierre, Vaiva Guillaume, D'Hondt Fabien, Amad Ali, Lamer Antoine
Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, Lille, France.
Psychiatry and Addiction Medicine Department, CHU Lille, Lille, France.
Front Psychiatry. 2022 Apr 5;13:812790. doi: 10.3389/fpsyt.2022.812790. eCollection 2022.
Criminal responsibility is a key concept in the criminal sanctioning of people diagnosed with mental health disorders who have committed crimes. In France, based on the recommendations of one or more expert psychiatrists, a judge can declare a person not criminally responsible on account of mental disorder (NCRMD) if, at the time of the offense, the person was presenting a psychiatric disorder that abolished or altered his/her capacity for discernment and/or ability to control his/her actions. In such a case, the judge also generally orders an involuntary psychiatric hospitalization. The objectives of this study were to (1) describe longitudinal retrospective administrative data of psychiatric hospitalizations for people found NCRMD, (2) identify the age, sex, and principal diagnoses of these individuals, and (3) characterize the trajectories of their psychiatric care before and after NCRMD psychiatric hospitalization.
We used discharge reports from the French national hospital database called (PMSI) to gather longitudinal data that describe psychiatric hospitalizations for people found NCRMD between 2011 and 2020, the age, sex, and principal diagnoses of these patients, the length of their hospitalization, and the trajectories of their psychiatric care before and after their NCRMD psychiatric hospitalization.
We identified 3,020 patients who were hospitalized for psychiatric care after having been found NCRMD between 2011 and 2020. The number of admissions on these grounds has remained stable over this period, ranging from 263 in 2011 to 227 in 2021. They were mostly young men diagnosed with a psychotic disorder (62%). The majority (87%) were hospitalized in general psychiatric hospitals, and only 13% were admitted to maximum-security units (). The median duration of hospitalization for these patients was 13 months. Our results show that 73% of the patients had already been hospitalized prior to their NRCMD hospitalization. The rehospitalization rate within 5 years of discharge from NCRMD psychiatric hospitalization was 62%.
We conducted the first study investigating the psychiatric hospital treatment of people declared NCRMD in France. There is an urgent need for further studies to investigate the clinical characteristics of these patients.
刑事责任是对患有精神健康障碍且实施犯罪行为的人进行刑事制裁的关键概念。在法国，根据一名或多名专家精神科医生的建议，如果一个人在犯罪时患有精神疾病，导致其辨别能力和/或控制行为的能力丧失或改变，法官可以宣布该人因精神障碍而无刑事责任能力（NCRMD）。在这种情况下，法官通常还会下令对其进行非自愿精神科住院治疗。本研究的目的是：（1）描述被认定为无刑事责任能力者的精神科住院治疗的纵向回顾性行政数据；（2）确定这些人的年龄、性别和主要诊断；（3）描述他们在无刑事责任能力精神科住院治疗前后的精神科护理轨迹。
我们使用法国国家医院数据库（PMSI）的出院报告来收集纵向数据，这些数据描述了2011年至2020年间被认定为无刑事责任能力者的精神科住院治疗情况、这些患者的年龄、性别和主要诊断、住院时间以及他们在无刑事责任能力精神科住院治疗前后的精神科护理轨迹。
我们确定了2011年至2020年间因被认定为无刑事责任能力而接受精神科住院治疗的3020名患者。在此期间，基于这些理由的入院人数保持稳定，从2011年的263人到2021年的227人不等。他们大多是被诊断患有精神障碍的年轻男性（62%）。大多数人（87%）在普通精神科医院住院，只有13%被收治到最高安全级别的病房。这些患者的中位住院时间为13个月。我们的结果显示，73%的患者在其无刑事责任能力住院治疗之前就已经住院过。从无刑事责任能力精神科住院治疗出院后5年内的再次住院率为62%。
我们进行了第一项研究，调查法国被宣布为无刑事责任能力者的精神科住院治疗情况。迫切需要进一步研究来调查这些患者的临床特征。
