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There are many different specifications about incest and they do not refer to the same concept: each society gives it borders which are valid for a community in a specific time. Regulation about incest is constantly evolving as shown by the last act of February 8, 2010 that brings the term of "incest" in the penal French Code. Nowadays, about 2 millions French people are victims of incest. In France, incest cases constitute 20% of Assisi trials, they represent 75% of sexual assaults of minor cases and more than 57% of rape of minors. On the forensic accounting in 2007, sexual violence authors are the second largest contingent of subjects incarcerated, behind assault and battery authors. Senon and Manzanera estimate that only 1 to 5% of sexual offenders suffer from a mental disease. By a literature review, we found there is a significant variability in prevalence estimation about psychiatric comorbidities in sexual offenders' population. In international classifications categories such as pedophilia are identified by the term of "sexual preference disorder" in ICD-10, or by the term of "paraphilia" in DSM-IV-TR. In both these classifications, the notion of incest is not clearly stated as a separate entity but finds itself inserted into the concept of pedophilia. Psychiatric classifications are not intended to study sexual offenses but they are useful, during forensic psychiatric assessment, to identify a mental illness causing transgressive sexual behavior or to identify a psychiatric comorbidity. However, statistically, very few sex offenders are recognized criminally irresponsible because of their mental illness, according to Article 122-1 paragraph 1 of the French Criminal Code. Psychiatric experts are "technicians" in the service of justice: they have to carry out the missions entrusted to them by the judges, based on their skills and knowledge in the subject concerned. The psychiatrist expert may be questioned before the judgment on the issue of criminal responsibility, and, if convicted, on the appropriateness of an injunction care. In a current context of media dramatization, we choose to question about links between crime and pathology in a population of incestuous fathers. Nowadays, irrespective of the chosen theorical frameworks, there is a consensus to denounce the shortcut by which a subject can be defined by its act. Despite the clinical polymorphism of deviant behavior, the infinite variety of psychopathological configurations in which these behaviors may appear, one point seems to have the experts agreement: the fact that these sexual behavior disorders are much less sexual disorders themselves than "defense solution" attempts versus major anxieties about feeling identity. Authors' ethiopathogenic hypotheses that refer to psychodynamic theories are the following: in most cases, there is at the forefront a serious disturbance of narcissism, a fragile sense of continuity of identity, and the threat of collapse depression, linked to major anxiety about alteration or disappearance of self-representation. Incest, by its transgressive dimension, asks each of us. Major health problem, it cannot be answered only by punishment but requires a diverse precautionary approach where societal debate (and its educational decisions), and psychiatric theorizing are decisive. [ABSTRACT FROM AUTHOR]

Abstract: The hymeneal examination is often considered as the key of the gyneacological examination of a young girl victim of sexual assault, mainly because the concept of penetration is important under the French criminal code. However, the amount medical literature related to this topic is poor. The hymen examination must be conducted under strict conditions, by qualified personnel and as soon as possible after the alleged assault.The only kind of anomaly that can confirm a penetration is an injury to the posterior hymen extending up its base. The sensitivity of this sign is, however, low and its absence does not suggest that of penetration. A vaginal penetration does not always break the hymen, especially among adolescents. Moreover, the hymen can heal and thus it makes the examination difficult when it occurs a long time after the facts. Examination of the hymen is rarely the decisive factor in the forensic assessment of a young victim of sexual assault. [Copyright &y& Elsevier]

Résumé: L''expertise psychiatrique pénale ne peut se concevoir comme acte médical que si l''expert exerce son observation clinique dans les limites proposées par le cadre du code de déontologie. À partir de cette dérogation déontologique possible, le médecin va pouvoir répondre comme auxiliaire de justice aux questions posées par un magistrat. La part complexe de ce travail tient au projet spécifique du cadre pénal qui amène le juge à orienter ces questions vers la manifestation de la vérité judiciaire. À partir de cette interrogation, le juge est amené à solliciter et à formuler des questions dont le contenu sort de l''observation médicale. Il est alors du devoir du médecin de cerner et de traduire ce qui de l''observable chez le sujet examiné est utile et nécessaire au travail de la justice. Cela demande à définir des termes qui sont de l''ordre du judiciaire comme crédibilité, vérité, et suggestibilité. Enfin, l''expertise d''une victime est le plus souvent le premier contact d''une personne avec un psychiatre. [Copyright &y& Elsevier]

Abstract: In legal proceedings the expert witness testimony may be considered a medical act only if the expert conducts his clinical observations within the limits established by the medical code of ethics. This will then allow the psychiatrist to help the judge reach a more informed legal decision. The difficulty inherent in this process is for the expert to give an exact answer (“yes” or “no”) to the questions formulated in order for the judge to arrive at an accurate decision. To better understand the evidence presented, the judge may ask empirical questions that require the expert witness to give testimony going beyond the information directly gathered through clinical observations. It is the expert witness'' responsibility to determine what amount of interpretation of material drawn from a clinical observation is appropriate to help the judge make a legal decision. This requires defining legal standards such as credibility, truth, and suggestibility. One must also recognize that the clinical observation of a victim is often the person''s first contact with a psychiatrist. [Copyright &y& Elsevier]

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