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Psychiatric disorders and management of sexual offenders in the prison psychiatric consultation unit of Marseille
Authors:Noémie Bernardi MD  Clémence Delteil MD  Éric Kania MD  Pascale Giravalli MD  Lucile Tuchtan MD  Jean-Pierre Guay PhD  Marie-Dominique Piercecchi MD  PhD  Christophe Bartoli MD  PhD  Jokthan Guivarch MD
Institution:1. Service de Médecine Légale, Assistance Publique-Hôpitaux de Marseille, Marseille, France;2. Département de Psychiatrie et Addictologie en Détention, Assistance Publique-Hôpitaux de Marseille, Marseille, France;3. Service de Médecine Légale, Assistance Publique-Hôpitaux de Marseille, Marseille, France

Aix Marseille Univ, CNRS, EFS, ADES, Marseille, France;4. 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;5. 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;6. 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

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.
Keywords:forensic psychiatry  management of sexual offenders  mental health care in prison  penal institution  psychiatric disorders  sexual offender
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