《精神衛(wèi)生法》實(shí)施前后司法精神病鑒定案例的特征分析
發(fā)布時(shí)間：2019-02-25 09:45
【摘要】：背景2013年5月1日一部歷經(jīng)30年立法過程的《中華人民共和國精神衛(wèi)生法》(下稱：精神衛(wèi)生法)正式施行。這部法律主要是保護(hù)廣大精神障礙患者的合法權(quán)益,確保精神障礙患者不因疏于管理而出現(xiàn)傷害自身、社會(huì)、他人的行為。隨著精神醫(yī)學(xué)的發(fā)展,精神障礙的診斷及分類系統(tǒng)、鑒定診斷、責(zé)任能力評(píng)定標(biāo)準(zhǔn)等發(fā)生了變化,司法精神病學(xué)鑒定也呈現(xiàn)很多新的變化。因此探討《精神衛(wèi)生法》實(shí)施前后司法精神病學(xué)鑒定案例的特點(diǎn)具有重要的理論意義和實(shí)踐意義。目的分析精神衛(wèi)生法實(shí)施前后1年司法精神病學(xué)鑒定案例的現(xiàn)況及特點(diǎn),旨在探討精神衛(wèi)生法的實(shí)施對(duì)司法精神病鑒定的影響,尋求提高鑒定質(zhì)量的措施。方法以2012年5月1日——2014年4月30日期間,在鄭州市第八人民醫(yī)院司法鑒定科所做的鑒定案例共406例為研究對(duì)象,其中以精神衛(wèi)生法實(shí)施的時(shí)間為界限,2012年5月1日——2013年4月30日鑒定案例為A組(183例),2013年5月1日——2014年4月30日鑒定案例為B組(223例)。采用自制調(diào)查量表對(duì)兩組案例進(jìn)行綜合評(píng)價(jià),分析兩組案例的現(xiàn)狀及特點(diǎn)；對(duì)較為突出的刑事案件(涉嫌暴力行為案例)、民事案件(交通事故案例)進(jìn)行相關(guān)分析及回歸分析。全部資料采用SPSS16.0進(jìn)行數(shù)據(jù)錄入和數(shù)據(jù)處理,采用描述統(tǒng)計(jì)、χ2檢驗(yàn)、Pearson相關(guān)、Logistic回歸分析等統(tǒng)計(jì)方法進(jìn)行數(shù)據(jù)分析,均為雙側(cè)檢驗(yàn),顯著性水平α=0.05。結(jié)果1.兩組司法精神病鑒定案例分布特征：案件性質(zhì)：民事案件(交通事故案例)比例較A組明顯增多,而刑事案件(涉嫌暴力行為案例)比例有明顯減少(P0.05)。鑒定診斷：腦外傷致精神障礙的案例比例較A組增多,精神分裂癥、無精神病的案例比例較A組明顯減少(P0.05)。2.兩組刑事案件(涉嫌暴力行為案例)特征：鑒定診斷：兩組位居前列的醫(yī)學(xué)診斷均是精神分裂癥、無精神病、情感障礙,兩組比較無差異性(P0.05)；責(zé)任能力評(píng)定：被評(píng)定為完全、部分責(zé)任能力的案例比例較A組明顯增多,而被評(píng)定為無責(zé)任能力的案例比例較A組明顯減少(P0.05)。經(jīng)Logistic回歸分析,影響責(zé)任能力判定的因素為：既往精神病史、物質(zhì)濫用史、選擇作案場(chǎng)所、作案動(dòng)機(jī)、案發(fā)前的精神狀態(tài)以及案發(fā)后行為。3.兩組民事案件(民事類交通事故案例)特征：傷殘等級(jí)評(píng)定：被評(píng)定為Ⅰ-Ⅲ級(jí)傷殘的案例比例占50%以上,兩組比較無差異性(P0.05)。通過智能損傷的回歸分析發(fā)現(xiàn)影響智能損傷的因素為腦損傷部位、昏迷時(shí)間。智能損傷與大腦的損傷部位、損傷性質(zhì)、昏迷時(shí)間、腦電圖、神經(jīng)系統(tǒng)癥狀、簡(jiǎn)易智力狀態(tài)量表(MMSE)顯著相關(guān)。結(jié)論精神衛(wèi)生法實(shí)施后1.民事案件(民事類交通事故案例)比例有明顯增多,而刑事案件(涉嫌暴力行為案例)比例有明顯減少；2.刑事案件(涉嫌暴力行為案例)構(gòu)成中責(zé)任能力評(píng)定趨近于嚴(yán)格；3.民事案件(民事類交通事故案例)智能損傷的影響因素為腦損傷部位和昏迷時(shí)間；智能損傷與大腦的損傷部位、損傷性質(zhì)、昏迷時(shí)間、腦電圖、神經(jīng)系統(tǒng)癥狀、簡(jiǎn)易智力狀態(tài)量表(MMSE)顯著相關(guān),可作為司法精神病學(xué)傷殘等級(jí)鑒定客觀、有效的參考指標(biāo)。
[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.
【學(xué)位授予單位】：新鄉(xiāng)醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：D922.16
本文編號(hào)：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.
【學(xué)位授予單位】：新鄉(xiāng)醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：D922.16
【參考文獻(xiàn)】
相關(guān)期刊論文 前1條
1 鄭瞻培;如何認(rèn)識(shí)司法精神病鑒定中的不同鑒定結(jié)論及工作改進(jìn)[J];中華精神科雜志;2000年04期
，本文編號(hào)：2430044
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