| 高滢,董雪冰,翟爱玲.1369例司法精神病学鉴定案例中有无精神障碍者鉴定前诊疗情况比较[J].四川精神卫生杂志,2019,32(4):328-332.,Comparison of diagnosis and treatment before judicial psychiatric identification of 1369 patients to be identified with or without psychosis[J].SICHUAN MENTAL HEALTH,2019,32(4):328-332 |
| 1369例司法精神病学鉴定案例中有无精神障碍者鉴定前诊疗情况比较 |
| Comparison of diagnosis and treatment before judicial psychiatric identification of 1369 patients to be identified with or without psychosis |
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| DOI：10.11886/j.issn.1007-3256.2019.04.008 |
| 中文关键词: 司法精神病学 精神障碍 鉴定诊断 诊疗史 |
| 英文关键词:Forensic psychiatry Mental disorders Identification diagnosis History of diagnosis and treatment |
| 基金项目:山东省医药卫生科技发展计划项目（2013WS0053） |
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| 【摘要】 目的 探讨司法精神病学鉴定中精神障碍者与无精神障碍者既往诊疗情况的差异,以期提高司法精神病学鉴定中对无精神障碍犯罪嫌疑人的识别和鉴别能力?方法 采用自编调查表收集2014年 -2017年在某司法鉴定所进行刑事责任能力鉴定的1369例被鉴定人的一般信息和鉴定前诊疗信息,根据鉴定诊断分为精神障碍组(n=964)和无精神障碍组(n=405),对两组人口学资料?精神异常史以及就诊情况进行比较,并对无精神障碍组的既往临床诊断进行分析?结果 精神障碍组和无精神障碍组年龄?职业?犯罪类型(人身攻击类?经济侵犯类)?既往精神异常史?就诊史以及就诊的时间与方式比较差异均有统计学意义(P<0.05或 0.01)?精神障碍组的精神异常史率和就诊率均高于无精神障碍组(87.3% vs.37.8%,χ2=352.874,P<0.01;65.2% vs.44.0%,χ2 =53.459,P<0.01);无精神障碍组案发后就诊率高于精神障碍组(33.7% vs.12.1%,χ2=46.302,P<0.01);无精神障碍组中就诊次数较精神障碍组少(u=37714.000,P<0.01)?精神分裂症类?癔症/应激相关障碍神经症类和心境障碍是无精神障碍组最常见的临床诊断?结论 与精神障碍者相比,无精神障碍者既往多无精神异常史,临床就诊率低,更倾向于案发后就诊和单次就诊,常被诊断为精神分裂症类?癔症应激相关障碍神经症类和心境障碍? |
| 英文摘要: |
| Objective To explore the difference of the previous diagnosis and treatment between the patients with and without mental disorders, in order to improve the ability of identifying and distinguishing criminal suspects without mental disorders in forensic psychiatry identification. Methods The general information and pre - identification diagnosis and treatment information of 1 369 subjects who were evaluated for criminal responsibility in a forensic identification institute from 2014 to 2017 were collected using a self- designed questionnaire. According to the identification diagnosis, the patients were divided into the group with mental disorders( n = 964) and the group without mental disorders ( n = 405) . The demographic data, history of mental disorders and medical situation were compared between the two groups, and the previous clinical diagnoses of the group without mental disorders were analyzed.Results There were statistically significant differences in age, occupation, type of crimes( personal attack, economic infringement) ,previous history of mental disorders, medical history, time and method of medical treatment between the two groups ( P < 0. 05 or0. 01 ) . The rate of abnormal history and consultation in the group with mental disorders were higher than those in the group without mental disorders( 87. 3% vs. 37. 8% , χ2 = 352. 874, P < 0. 01 ; 65. 2% vs. 44. 0% , χ2 = 53. 459, P < 0. 01 ) . The rate of hospital visiting after commited crimes was higher in the group without mental disorders than the group with mental disorders ( 33. 7% vs.12. 1 % , χ2 = 46. 302, P < 0. 01 ) . The number of visits in the group without mental disorders was less than that in the group with mental disorders ( u = 37714. 000, P < 0. 01 ) . Schizophrenia, hysteria /stress - related disorders /neurosisand mood disorders were the most common clinical diagnoses in the group without mental disorders. Conclusion Compared with those with mental disorders, those without mental disorders had lower proportion of history of mental disorders and lower rate of clinical visits, and tended to have a higher proportion of medical visits after cases and single case, and the usual clinical diagnoses were schizophrenia, hysteria/stress-related disorders/neurosis, and mood disorders. |
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