[Women and mental health]. / Santé mentale au féminin: entre vulnérabilité intrinsèque et impacts des facteurs psychosociaux?

Women's mental health is determined not only by individual factors, in which genetics and hormones play a role, but also by relational and community factors. Women of any age more frequently suffer from certain mental disorders and have more comorbidity rates. Specificities in women exist in clinical presentations, as well as in the use of psychotropic medication, the incidence of side effets and in adherence to care. The role of primary care physicians is crucial for the prevention and detection of mental disorders in women, particularly in vulnerable ones, as well as in their psychological support, organization and continuity of care. A comprehensive approach is required, which includes measures against isolation, insecurity, stigmatization and inequality.

[Fifty feminine shades of domestic violence: time for doctors to get involved!]. / Cinquante nuances de violences domestiques au féminin: l'implication des médecins est essentielle.

Domestic violences are very common and constitute a criminal offence. Women are mainly victims but can also be perpetrators. Domestic violences have a major health impact on people, families and society. The primary care physician holds a major role in the targeted detection of domestic violences and their prevention. He must know their specificities and adapt his response according to the situations. This specific response does not prevent a rational approach: we propose to distinguish between different types of women's vulnerability. Management must involve an efficient network taking into account individual, family, community and social factors. In this context, use of regularly updated information from official websites is mandatory.

[Parasuicide and violence: criminological aspects from a study of 21,314 male army recruits in Switzerland]. / Comportements suicidaires et violences: réflexions criminologiques à partir d'une étude portant sur 21,314 jeunes recrues suisses.

Suicidal behaviors are not uncommon, but rarely admitted in the families and in society at large. Violence is a public health and social problem of growing concern. Research on the relationship between violence and suicidal behaviors is scarce for the last decades, perhaps because suicide is no longer considered an offense. The present study is based on a sample of 21,314 valid interviews with 20 year old Swiss men, representing over 70% of this cohort. The questionnaire contained over 900 variables, addressing issues such as previous history of parasuicide, self-reported violent acts and injuries, during childhood and adolescence, as well as over the last year before recruits training. The questionnaire also contains various items about mental health, familial and social conditions and situational factors. We used an ordinal scale for measuring violence and operationalisations of mental disturbances according to theoretical and empirical concepts such as conduct disorder and antisocial personality disorder according to DSM IV, the dissocial syndrome according to Rauchfleisch's (1981) definition; 2,6% of the recruits reported at least one suicide attempt during the last year, one third even multiple attempts. Life-time prevalence at age 20 was 3,9%. Suicide attempters often showed signs of psychiatric disorders, especially for a dissocial (OR=6,9) or an antisocial (OR=5,8) syndrome. Other studies have shown that the rate of suicide in France and Switzerland is very high compared to other European countries. Our study confirms the existence of a real behavioural and existential problem among young Swiss men. Half of the suicide attempters had a history of physical violence against others and 20% were themselves victims of violent acts during the previous year. Suicide attempters who were victims were also more violent than those who were not victimized. A suicide attempt during the previous year is a marker for violent behaviours (OR=2,1) and victimisation (OR=1,9) during this same year. We also found a positive link between multiple attempted suicides and the commission of serious violence. It is concluded that parasuicide among young men is related to other violent acts and should be considered as a positive marker of violent behavior in general and victimisation by crime. It seems that suicide is a transgression of social and cultural values because of the amount of aggression behind it, even if it is not a criminal offense. Suicide attempts of young men should receive more attention by professionals in the field of medicine, psychology and social work. Treatment of these men not only prevents an individual mental health problem but also contributes to crime prevention at the community level. Criminological theories could inspire further studies in suicidology, in order to improve the multidisciplinary knowledge of the phenomenology and etiology of parasuicide. In the same way, criminologists as policy makers should attach more attention to parasuicide given its many theoretical and practical connections with crime.

[Not Available]. / Sévices à des enfants ou insensibilité congénitale à la douleur?

Congenital insensitivity to pain is a rare illness that can cause accidental external and internal injuries in children. When child abuse is suspected, the awareness of this illness can complicate any medicolegal interpretation of findings.Several components are needed to diagnose congenital insensitivity to pain: lack of sensitivity to pain since birth; involvement of the whole body; integrity of osteotendinous reflexes; and other sensitivity processes and negative paraclinical, including histological, examinations.This article describes the case of two siblings examined during an emergency legal procedure at the forensic medicine unit of the Grenobles University Hospital Centre in France. The medico-legal interpretation of facts and examinations must be conservative in case of legal complications and must follow an analysis of the child's and family's medicosocial problems since the child's birth. The family's socioeducational support and the communication of information on this illness should be a priority to avoid any misunderstanding and overrun in the child's management and monitoring.