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Resume L’emprise psychologique a ete definie comme une pulsion de destruction, donnant lieu a une agressivite active, offensive, alimentee par l’energie sexuelle mais aussi comme une violence fondamentale. Elle a ete analysee d’un point de vue psychosocial comme sous l’angle d’une dualite intimiste, qu’elle soit regie par les affects (cf. sentiments amoureux) ou les emotions (cf. effet Pygmalion). Ce mode de relation se deploie a travers la manipulation, la perversion qui ont pour but d’assurer l’ascendance, la souffrance sur l’autre, a travers son appropriation, au moyen de violences tous azimuts qui l’assailliront, allant de la soumission a la depersonnalisation, grâce au controle et a la negation de cet autre, et plus generalement, le conditionnement. Cet article reprend les definitions de l’emprise, de l’identite et de l’identification, pour une meilleure comprehension du profil de l’empriseur(e), souvent nomme(e) pervers(e) narcissique et celui de l’emprise(e) ainsi que la relation qui les unit. Il retrace des elements psychologiques, neurobiologiques, utiles a la prise en soins des victimes. La violence psychologique a l’origine de troubles psychotraumatiques primaires et secondaires est aussi envisagee a l’aune de son importance grandissante parmi les formes de violences observees dans les unites medicojudiciaires comme dans la societe. Les mecanismes de l’emprise decrits sont aujourd’hui des cles de comprehension de la violence intime mais aussi societale.

There are three strands to the collection of information required for conducting a psychological autopsy: the interview with relatives; consultation of the forensic data and other elements of the criminal investigation; and a retrospective analysis based on a reconstruction of the psychological profile of the deceased person.

Very few areas of pediatrics have expanded so rapidly in clinical importance in recent years as that of sexual abuse of children. Children may be sexually abused by family members or nonfamily members and are more frequently abused by males. Adolescents are perpetrators in at least 20% of reported cases; only a small minority of sexual abuse allegations involve women. Emergency physicians, clinical forensic physicians, and pediatricians may encounter sexually abused children in their practices. This chapter provides an overview of child sexual abuse, and describes physical and medical examination.

Most developed countries, including continental European countries, are concerned by the phenomenon of alcohol and drug abuse and its collateral effect, that is, driving under the influence of alcohol and drugs. Most countries prohibit driving under the influence of any substance, and current data show how important the problem is today. Alcohol is the psychoactive substance most frequently detected in the general driving population, followed by cannabis. The results of some recent studies suggest that, for some populations, the risks of driving under the influence of cannabis are or soon will be greater than the risks of driving under the influence of alcohol, resulting in an increasingly negative impact on driving security.

Although the torture of children is viewed as a dark chapter in history now consigned to the past, as illustrated by ‘Bluebeard,’ Gilles de Rais, and the Nazi medical experiments, the phenomenon has not ceased to exist despite the introduction of the Nuremberg code in 1947 and UNICEF recommendations. Today torture of children to obtain a confession or other information, for punishment of real or perceived offenses on the basis of discrimination based on racial, ethnic, or political affiliation, is practiced in many places around the world. Largely observed in armed conflicts, torture is not only frequent among refugees, but also in peacetime against children with disabilities in psychiatric wards, or when children are in custody or detention. Violence and torture of children living on the street are not infrequent. Children can also be tortured as a form of punishment for their parents. Means of torture are roughly similar in children to those described in adults in the UN Istanbul protocol. Assessing the physical, psychological, and sexual signs of child torture is one of the aims of modern clinical forensic medicine.

Physical abuse of children is currently a common problem worldwide, even though, in the second half of the twentieth century, society began to take greater notice of violence against children. The WHO’s World Report on Violence and Health in 2002 and the Report of the independent expert for the UN study on violence against children in 2006 have defined the current problem of violence against children. Child physical abuse detection and prevention is a part of a much larger problem of public health, child protection, and human rights.

According to The World Health Organization (WHO), death by suicide was ranked 15th of the 20 leading causes of death in 2012 and suicide rates have increased by 60% worldwide in the past 45 years. Suicide is therefore a major public health problem, especially among young and elderly people. There are multiple factors determining the prevalence of suicide such as alcohol abuse, conflicts, presence of major physical diseases, social and economics factors and of course psychological factors. Methods of suicide do not differ greatly from one country to another, but vary according to the possibility of access to lethal methods.

International consensus is clear about the important role of crime scene management and the need to utilize specialists at the crime scene. The European Network of Forensic Science Institutes (ENFSI) is working to ensure that a common approach is adopted throughout Europe. In 2008, a working group published ‘Guidance in the Field of Crime Scene Investigation.’ Knowledge of the nature and quality of samplings as well as accurate operational methods at the crime scene is shared by crime scene technicians and the forensic team (including forensic physicians) present at the scene. The use of databases and links to central laboratories and European collaboration have resulted in real progress in such inquiries.

The new legislation of forensic medicine has brought many important changes in how forensic medicine is practiced in France since its application in January 2011. Forensic medicine is now mainly exercised in hospital settings across France and its overseas territories. Clear progress has been made but forensic coverage remains insufficient, with an uneven quality of service being offered. Forensic psychology and psychiatry have not been clearly taken in charge by this reform, causing a gap between the evolution of forensic medicine stricto sensu and its nearest sectors.

Substance misuse is an area of high mortality and morbidity with associated social problems, including criminality or road accidentology. Over the last decade, there have been significant developments in the field of addiction, including neurobiology and neuroimaging. Better knowledge of psychoactive substances addiction allows effective pharmacotherapeutic and psychosocial interventions. With greater understanding of each substance-related problem, the constituents of these interventions are being honed further to give more tailored treatments. The results from large-scale outcome evaluations show significant positive benefits for the individual and society. The challenge ahead is for greater detection of substance misuse with increased availability of effective interventions. Due to the high prevalence of substance misuse, this is even truer for the forensic setting.

Abortion has been a classic topic for any forensic physician. Forensic medicine treatises and books have widely described the legal aspects and the toxicological, local, and infectious complications of abortion. Very restrictive laws regarding abortion roughly followed religious principles from the main monotheistic religions, and adhered to the Hippocratic Oath.

Library researches allow the authors to present the evolutionary history of the couple justice-medicine in Antiquity. The history of the forensic expertise cannot be dissociated from that of medicine, nor of that of the laws and not of advantage of that of the societies. Legal approach of the compensation for the damages caused by medical acts which will give rise to the legal one, as well as the evaluation of the physical injury go back to one very moved back time. In the first times, justice is a divine tradition, and they are the priests who are agents of medical knowledge. Then, from the wire of the centuries, medicine escapes the ministers of religion and the men set up laws, which are the reflection of the society in which they evolve. Initially, the acts seem to have the prevalence on the physical injury, which can result from it. Then, starting from the after-effects the concept of damage interest appears.

Objectifs Diverses protheses de soutien uretrobulbaire pour traiter l’incontinence apres chirurgie de la prostate sont actuellement proposees : ici, les resultats cliniques a 1 an de la prothese M-Sling sont presentes. Methodes Etude prospective multicentrique francaise de soins courants incluant 86 patients incontinents apres prostatectomie totale et perdant de 4 a 500 g par 24 h plus d’un an apres l’intervention de prostatectomie totale qui ont ete implantes avec une prothese de soutien uretro-bulbaire a 4 bras et suivis pendant un an. Tous les patients ont ete evalues prospectivement, en preoperatoire et a un an par le nombre de protections, Q Max, RPM, indice de satisfaction, score EVA et registre des complications. Resultats A un an, absence de complication chirugicale de grade de Clavien superieure a 1 : 3 retentions postoperatoires prolongeant le sondage de 24 a 72 h. Vingt-quatre sur 86 (28,4 %) patients ne portaient pas de protection, 24 (27,27 %) portaient une protection occasionnelle ou de securite, 27 (30,68 %) mouillaient une protection par 24 h, 5 (5,68 %) deux protections, 5 (5,68 %) trois protections et 2 donnees manquantes. Quarante-quatre pour cent des patients etaient tres satisfaits des resultats, 34 % satisfaits, 21 % insatisfaits, 1 patient tres insatisfait. Quatre patients presentaient un Q Max 60 ml. La douleur perineale postoperatoire etait en moyenne a 3,52 (± 1,42) EVA a 48 h, 1,95 (± 1,36) EVA a 2 mois et 1,33 (± 0,47) EVA a un an. Conclusion La prothese M-Sling est bien toleree et ses resultats comparables a ceux publies pour d’autres protheses. Des essais comparatifs sont imperatifs.