What is the criminal responsibility of the perpetrator of an offense committed under the influence of alcohol?

Context. - Excessive consumption of alcohol is a major problem for public health in France and in particular in Pays de la Loire and Brittany. It is considered a factor encouraging criminal behaviors. There is a paradox between the alcohol consumption considered by judges as aggravating circumstances of the infraction on one hand and scientific data establishing that in certain circumstances (amount, consumption habits, background, polydrug use, ...) alcohol could change the judgment and discernment of the consumer on the other hand. However, during criminal proceedings, the expert psychiatrist may be called upon to assess the degree of discernment of the perpetrator of the committed infraction under the influence of alcohol. Depending on whether the judge pronounce an intact, an altered or an abolished discernment - after having taken into account the conclusions of the expert psychiatrist - the perpetrator of the infraction will be considered as entirely or partially responsible or as irresponsible. Goal.- The goal is to assess the proportion of abolition or alteration of discernment that is proposed by psychiatrists when an infraction is committed under the influence of alcohol. Patient and methodology. - The study is retrospective and multicentric. It includes the criminal appraisals relating to the liability that have been performed by psychiatrists of the Courts of Appeal of Rennes and Angers over the period from the 1st January 2015 to the 31st December 2016. The exclusion criteria are criminal appraisals which do not relate to criminal liability and criminal investigations for infractions that are not committed under the influence of alcohol. Results. - We browse 529 psychiatric appraisals and 104 of them were included. Appraisals that did not correspond to evaluation of responsibility (appraisals of victim, appraisals of guardianship or curatorship, appraisals of dangerousness after sentencing), appraisals for which author of the facts did not consume alcohol or data on alcohol consumption was not available, were excluded. Seven experts psychiatrists practicing in Brittany and Pays de la Loire did contribute to the study. The statistical analysis did not brought to light an impact of alcohol consumption on the degree of discernment assessed by the experts. The existence of an alcohol-related disorder in the perpetrator was not significantly associated with an impairment of discernment. On the other hand, the presence of psychiatric comorbidity (p < 0,001) and the existence of a psychiatric care after the commission of the offense (p < 0,02) were the only data significantly associated with an impairment of discernment. Conclusion. - The consumption of alcohol during a criminal offense is not retained by the experts as a factor disturbing discernment. (C) 2019 Published by Elsevier Masson SAS.