Aims: Two main therapeutic programs were offered to patients suffering from alcohol use disorders (AUDs): avoid the alcohol by abstinence or controlling their consumption. After information and motivational sessions, the patient chooses his own therapeutic plan. However, patients with AUD exhibit poor decision-making. The purpose of this study was to investigate the decision-making in AUD by comparing patients who chose to reduce and control their consumption to those who chose abstinence program. Methods: Sixty-seven subjects with alcohol use disorder were included (AUD group) for treatment, choosing either a relapse prevention program (RPP) or a harm reduction program (HRP). Patients were compared to a healthy control group (n = 31). Cognitive skills were assessed through the Montreal Cognitive Assessment test, the National Adult Reading Test, the Trail Making Test and the Iowa Gambling Task (IGT). Results: Thirty-seven patients with AUD chose the RPP while 30 followed a HRP. The AUD group performed worse than controls on the IGT. The RPP group had significantly lower performance than both HRP and control groups (these later groups being not statistically different). No correlation was observed between the available clinical, cognitive and intellectual measures. Conclusion: This study confirms that the decision-making process of patients with an alcohol use disorder is impaired. However, the 2 groups differ on the IGT scores, despite comparable clinical and cognitive profiles. The patients’ decision-making abilities could be a useful guide when developing therapeutic programs.

Introduction: A female spouse homicide occurs in France every two days, in majority of cases after an episode of physical violence against the woman. Our objective was to determine socio-demographic, clinical and criminological characteristics of the male authors of a spouse homicide. Methods: We have studied 210 records of psychiatric expertise of homicides perpetrated between 1995 and 2005 in West of France. We have analyzed the socio-demographic, clinical and criminological characteristics of the authors of a female intimate partner homicide (n=30) and compared to the authors of a non female intimate partner homicide (n=180). Results: The authors of a female intimate partner homicide were older (38.4 years old (yo) versus 32.7 yo, p=.019) and had significantly more frequently a personal history of violence (50% versus 28%, p=.045) than the authors of a non-female intimate partner homicide. Compared to the non-female spouse homicides, female spouse homicides were not associated with other criminal behaviours (6.7% versus 21.7%, p=.055). A mental disorder was found in the minority of cases (13.3% versus 18,.3%, p=.506). Paranoid delusional disorder was the most frequent severe mental disorder in the authors of female intimate partner homicide (10%). Conclusion: Our results confirm the general and the specific risk factors of violence in female intimate-partner homicide. Legal and health care professionals should be aware that women are vulnerable to intimate partner violence and homicide from both nonmarital and former partners as well as from current husbands. The history of domestic violence should be researched by the clinicians.