Le « Stalking » ou harcèlement est un problème social commun souvent causé par un trouble psychiatrique chez ses auteurs et produisant des dommages psychologiques et sociaux chez leurs victimes. Malheureusement, cela n’est pas formellement reconnu dans les systèmes de classification actuels (DSM-5 et CIM-10). Évaluer et gérer les risques liés au harcèlement est une tâche qui incombe souvent à des psychiatres. Le traitement de ces problèmes de comportement devrait cibler les mécanismes psychopathologiques sous-jacents spécifiques, qui nécessitent une évaluation diagnostique minutieuse. Les harceleurs et les victimes ont un besoin urgent de développer des traitements spécifiques. Ici, les auteurs donnent un aperçu du harcèlement à travers un prisme clinique de psychiatrie générale et médicolégale.

Stalking is a common social problem often driven by psychiatric disorder in its perpetrators and productive of psychological and social damage in its victims. Unfortunately, it is not formally acknowledged in current classificatory systems (DSM-5 and ICD-10). Here, authors provide an overview of stalking through a clinical prism of general and forensic psychiatry. Stalking is a chronic behaviour consisting of willful, malicious and, repeated following and harassing of another person. Stalking can take its toll on victim's mental status. Sequelae are legion including depression (with suicidality), anxiety (panic and PTSD), catagelophobia, worsening of medical conditions, personality changes/paranoia, and, substance abuse. A total of 90 % of stalkers are men. A total of 80 % of victims are women. Stalking acts can express a range of motivations including anger, jealousy, rage over abandonment, striving for power, or, a need to control the victim. Evidence from fMRI studies demonstrated a heightened activity of subcortical dopaminergic pathways of reward system and possible low activity of central serotonin. Generally speaking, stalkers mostly do not become violent (associated homicide in 2 %). The Stalking and Harassement Behaviour Scale is commonly deployed in clinical and forensic settings. Types of stakers include erotomanic, love obsessional (including intimacy seekers and incompetent suiters), simple obsessional (including rejected and resentful categories), and false victimiztaion syndrome. Anti-stalking laws were borne out as a result of public concerns that community members were powerless to protect themselves against harassing behaviours. Stalkers are most likely to be found among the diagnostic classes of psychotic disorders or (severe) personality disorders. Treatment of these behavioural problems should target the specific underlying psychopathological mechanisms, which require careful diagnostic assessment. Both stalkers and victims are in urgent need of the development of specific treatments.