《精神卫生法》实施前后司法精神病鉴定案例的特征分析
发布时间：2019-02-25 09:45
【摘要】：背景2013年5月1日一部历经30年立法过程的《中华人民共和国精神卫生法》(下称：精神卫生法)正式施行。这部法律主要是保护广大精神障碍患者的合法权益,确保精神障碍患者不因疏于管理而出现伤害自身、社会、他人的行为。随着精神医学的发展,精神障碍的诊断及分类系统、鉴定诊断、责任能力评定标准等发生了变化,司法精神病学鉴定也呈现很多新的变化。因此探讨《精神卫生法》实施前后司法精神病学鉴定案例的特点具有重要的理论意义和实践意义。目的分析精神卫生法实施前后1年司法精神病学鉴定案例的现况及特点,旨在探讨精神卫生法的实施对司法精神病鉴定的影响,寻求提高鉴定质量的措施。方法以2012年5月1日——2014年4月30日期间,在郑州市第八人民医院司法鉴定科所做的鉴定案例共406例为研究对象,其中以精神卫生法实施的时间为界限,2012年5月1日——2013年4月30日鉴定案例为A组(183例),2013年5月1日——2014年4月30日鉴定案例为B组(223例)。采用自制调查量表对两组案例进行综合评价,分析两组案例的现状及特点；对较为突出的刑事案件(涉嫌暴力行为案例)、民事案件(交通事故案例)进行相关分析及回归分析。全部资料采用SPSS16.0进行数据录入和数据处理,采用描述统计、χ2检验、Pearson相关、Logistic回归分析等统计方法进行数据分析,均为双侧检验,显著性水平α=0.05。结果1.两组司法精神病鉴定案例分布特征：案件性质：民事案件(交通事故案例)比例较A组明显增多,而刑事案件(涉嫌暴力行为案例)比例有明显减少(P0.05)。鉴定诊断：脑外伤致精神障碍的案例比例较A组增多,精神分裂症、无精神病的案例比例较A组明显减少(P0.05)。2.两组刑事案件(涉嫌暴力行为案例)特征：鉴定诊断：两组位居前列的医学诊断均是精神分裂症、无精神病、情感障碍,两组比较无差异性(P0.05)；责任能力评定：被评定为完全、部分责任能力的案例比例较A组明显增多,而被评定为无责任能力的案例比例较A组明显减少(P0.05)。经Logistic回归分析,影响责任能力判定的因素为：既往精神病史、物质滥用史、选择作案场所、作案动机、案发前的精神状态以及案发后行为。3.两组民事案件(民事类交通事故案例)特征：伤残等级评定：被评定为Ⅰ-Ⅲ级伤残的案例比例占50%以上,两组比较无差异性(P0.05)。通过智能损伤的回归分析发现影响智能损伤的因素为脑损伤部位、昏迷时间。智能损伤与大脑的损伤部位、损伤性质、昏迷时间、脑电图、神经系统症状、简易智力状态量表(MMSE)显著相关。结论精神卫生法实施后1.民事案件(民事类交通事故案例)比例有明显增多,而刑事案件(涉嫌暴力行为案例)比例有明显减少；2.刑事案件(涉嫌暴力行为案例)构成中责任能力评定趋近于严格；3.民事案件(民事类交通事故案例)智能损伤的影响因素为脑损伤部位和昏迷时间；智能损伤与大脑的损伤部位、损伤性质、昏迷时间、脑电图、神经系统症状、简易智力状态量表(MMSE)显著相关,可作为司法精神病学伤残等级鉴定客观、有效的参考指标。
[Abstract]:Background: The Mental Health Law of the People's Republic of China (hereinafter referred to as Mental Health Law), which has passed the 30-year legislative process on May 1, 2013, is officially implemented. The law is mainly to protect the legitimate rights and interests of patients with mental disorders, and to ensure that the patients with mental disorders do not harm themselves, society and others because of the neglect of management. With the development of mental medicine, the diagnosis and classification system of mental disorder, the identification and diagnosis, the standard of the assessment of responsibility ability, and so on, the forensic psychiatric appraisal also presents a lot of new changes. Therefore, it is of great theoretical and practical significance to study the characteristics of the case of forensic psychiatry before and after the implementation of the Mental Health Law. Objective To analyze the status and characteristics of the case of forensic psychiatry before and after the implementation of mental health law. The purpose of this study is to explore the effect of mental health law on the forensic psychiatric evaluation and to seek the measures to improve the quality of forensic psychiatry. Methods In the period from May 1, 2012 to April 30, 2014, a total of 406 cases were identified as study subjects in the appraisal department of the Eighth People's Hospital of Zhengzhou. Among them, the time of implementation of mental health law is the limit, and the appraisal case on May 1, 2012 _ April 30, 2013 is A (183 cases), and the appraisal case on May 1, 2013 _ April 30, 2014 is Group B (223 cases). The two groups of cases were comprehensively evaluated by the self-made survey scale, and the current situation and the characteristics of the two groups were analyzed. The related analysis and regression analysis of the more prominent criminal cases (cases of suspected violence), civil cases (cases of traffic accidents) were carried out. All the data were data input and data treated with SPSS16. 0. The data were analyzed by the statistical methods such as the statistical method, the second test, the Pearson correlation and the logistic regression analysis. The data were both side-to-side, and the significance level was 0. 05. Results 1. The characteristics of the two groups of judicial psychiatric appraisal cases: the nature of the cases: the proportion of civil cases (cases of traffic accidents) was significantly increased, and the proportion of criminal cases (cases of suspected violence) was significantly reduced (P0.05). Identification and diagnosis: the proportion of cases with mental disorder caused by head injury was higher than that in group A, and the proportion of cases with schizophrenia and non-psychosis was significantly decreased in group A (P0.05). Characteristics of two groups of criminal cases (suspected of violence): identification and diagnosis: the two groups were in the forefront of the medical diagnosis of schizophrenia, no mental illness, affective disorder, no difference between the two groups (P0.05), and the evaluation of the responsibility ability: the evaluation was set to be complete, The proportion of cases of partial responsibility was significantly increased in group A, and the proportion of cases rated as non-responsibility was significantly lower in group A (P0.05). Logistic regression analysis showed that the factors influencing the ability of responsibility were: the history of the past mental illness, the history of substance abuse, the choice of the place of the crime, the motive of the motive, the mental state before the crime, and the post-post act. The characteristics of the two groups of civil cases (cases of civil traffic accidents): the assessment of disability rating: the proportion of cases rated as Grade I-III was more than 50%, and there was no difference between the two groups (P0.05). Through the regression analysis of the intelligent injury, it was found that the factors that affected the intelligent injury were the part of the brain injury and the time of the coma. The damage to the brain, the lesion, the time of coma, the EEG, the nervous system and the simple mental state scale (MMSE) were significantly correlated. Conclusion After the implementation of mental health law, 1. There is a marked increase in the proportion of civil cases (cases of civil traffic accidents), and the proportion of criminal cases (cases of suspected violence) is significantly reduced; 2. The assessment of the responsibility capacity in criminal cases (cases of suspected violence) approach is strict; 3. The influence factors of the intelligent injury in civil cases (cases of civil traffic accidents) are the part of the brain injury and the time of the coma; the damage of the intelligent injury to the brain is related to the injury part, the lesion property, the coma time, the electroencephalogram, the nervous system symptom and the simple mental state scale (MMSE). can be used as an objective and effective reference index for forensic psychiatric disability grade identification.
【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：D922.16
本文编号：2430044
[Abstract]:Background: The Mental Health Law of the People's Republic of China (hereinafter referred to as Mental Health Law), which has passed the 30-year legislative process on May 1, 2013, is officially implemented. The law is mainly to protect the legitimate rights and interests of patients with mental disorders, and to ensure that the patients with mental disorders do not harm themselves, society and others because of the neglect of management. With the development of mental medicine, the diagnosis and classification system of mental disorder, the identification and diagnosis, the standard of the assessment of responsibility ability, and so on, the forensic psychiatric appraisal also presents a lot of new changes. Therefore, it is of great theoretical and practical significance to study the characteristics of the case of forensic psychiatry before and after the implementation of the Mental Health Law. Objective To analyze the status and characteristics of the case of forensic psychiatry before and after the implementation of mental health law. The purpose of this study is to explore the effect of mental health law on the forensic psychiatric evaluation and to seek the measures to improve the quality of forensic psychiatry. Methods In the period from May 1, 2012 to April 30, 2014, a total of 406 cases were identified as study subjects in the appraisal department of the Eighth People's Hospital of Zhengzhou. Among them, the time of implementation of mental health law is the limit, and the appraisal case on May 1, 2012 _ April 30, 2013 is A (183 cases), and the appraisal case on May 1, 2013 _ April 30, 2014 is Group B (223 cases). The two groups of cases were comprehensively evaluated by the self-made survey scale, and the current situation and the characteristics of the two groups were analyzed. The related analysis and regression analysis of the more prominent criminal cases (cases of suspected violence), civil cases (cases of traffic accidents) were carried out. All the data were data input and data treated with SPSS16. 0. The data were analyzed by the statistical methods such as the statistical method, the second test, the Pearson correlation and the logistic regression analysis. The data were both side-to-side, and the significance level was 0. 05. Results 1. The characteristics of the two groups of judicial psychiatric appraisal cases: the nature of the cases: the proportion of civil cases (cases of traffic accidents) was significantly increased, and the proportion of criminal cases (cases of suspected violence) was significantly reduced (P0.05). Identification and diagnosis: the proportion of cases with mental disorder caused by head injury was higher than that in group A, and the proportion of cases with schizophrenia and non-psychosis was significantly decreased in group A (P0.05). Characteristics of two groups of criminal cases (suspected of violence): identification and diagnosis: the two groups were in the forefront of the medical diagnosis of schizophrenia, no mental illness, affective disorder, no difference between the two groups (P0.05), and the evaluation of the responsibility ability: the evaluation was set to be complete, The proportion of cases of partial responsibility was significantly increased in group A, and the proportion of cases rated as non-responsibility was significantly lower in group A (P0.05). Logistic regression analysis showed that the factors influencing the ability of responsibility were: the history of the past mental illness, the history of substance abuse, the choice of the place of the crime, the motive of the motive, the mental state before the crime, and the post-post act. The characteristics of the two groups of civil cases (cases of civil traffic accidents): the assessment of disability rating: the proportion of cases rated as Grade I-III was more than 50%, and there was no difference between the two groups (P0.05). Through the regression analysis of the intelligent injury, it was found that the factors that affected the intelligent injury were the part of the brain injury and the time of the coma. The damage to the brain, the lesion, the time of coma, the EEG, the nervous system and the simple mental state scale (MMSE) were significantly correlated. Conclusion After the implementation of mental health law, 1. There is a marked increase in the proportion of civil cases (cases of civil traffic accidents), and the proportion of criminal cases (cases of suspected violence) is significantly reduced; 2. The assessment of the responsibility capacity in criminal cases (cases of suspected violence) approach is strict; 3. The influence factors of the intelligent injury in civil cases (cases of civil traffic accidents) are the part of the brain injury and the time of the coma; the damage of the intelligent injury to the brain is related to the injury part, the lesion property, the coma time, the electroencephalogram, the nervous system symptom and the simple mental state scale (MMSE). can be used as an objective and effective reference index for forensic psychiatric disability grade identification.
【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：D922.16
【参考文献】
相关期刊论文 前1条
1 郑瞻培;如何认识司法精神病鉴定中的不同鉴定结论及工作改进[J];中华精神科杂志;2000年04期
，本文编号：2430044
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