精神障碍者辨认能力的影响因素分析  

Analysis of Influencing Factors of the Substantial Capacity of Appreciation of Offenders with Mental Disorders

作　　者：周鹏 张强 刘少文 郭英伟[1,2] 邵群惠 ZHOU Peng;ZHANG Qiang;LIU Shaowen(Shantou University Mental Health Center,Shantou 515065,China)

机构地区：[1]汕头大学精神卫生中心,汕头515065 [2]汕头大学医学院—曼尼托巴大学医学院生物精神病学联合实验室

出　　处：《国际精神病学杂志》2024年第4期1170-1174,共5页Journal Of International Psychiatry

基　　金：汕头市科技计划医疗卫生类别项目(编号:230509146495868)。

摘　　要：目的探讨一般人口学,临床特征与辨认能力评定的关系,为判断辨认能力提供客观依据。方法样本来自汕头大学司法鉴定中心2003~2021年的165例法医精神病学鉴定案例,收集一般人口学及临床特征资料,对精神障碍者案发时的临床特征进行回归分析,探讨影响辨认能力评定的相关因素。结果在一般人口学方面,与辨认能力完整组相比,辨认能力丧失组文盲比例较多(P<0.05),其他一般人口学资料在三组间比较差异无统计学意义(P>0.05)。精神分裂症谱系障碍者在辨认能力丧失组的比例高达86.36%。在临床特征方面,精神障碍者辨认能力评定相关因素的影响程度排序如下:思维障碍因子(OR=5.878,P=0.001),情绪状态(OR=4.419,P=0.019),精神病性症状(OR=4.291,P=0.009),缺乏活力因子(OR=3.354,P=0.015),社会功能缺陷量表(SDSS)得分(OR=2.952,P=0.013)。结论案发时有精神病性症状,情绪状态异常的被鉴定人辨认能力丧失的风险高;缺乏活力因子,思维障碍因子,SDSS得分越高的被鉴定人辨认能力丧失的风险越高。Objective To analyze the characteristics of the offenders with mental disorders and explore the relationship between clinical characteristics and the substantial capacity of appreciation.And then provide an objective basis for the judgment of the capacity of appreciation.Methods A total of 165 forensic psychiatric cases were collected from the Forensic Medical Identification Center of Shantou University from 2003 to 2021.The general demographic and clinical-relatedinformation were collected.Regression analysis was used to investigate the related factors affecting the judgment of the substanial appreciation capacity.Results Compared with the group with normal capacity of appreciation,more illiterate people were identified in the group with no capacity of appreciation(P<0.05).There was no significant difference in other general demographic data among the three groups(P>0.05).The proportion of patients with schizophrenia spectrum disorder in the group with no capacity of appreciation was as high as 86.36%.Among the clinical features,the thought disturbancefactor(OR=5.878,P=0.001),emotional state factor(OR=4.419,P=0.019),psychotic symptoms factor(OR=4.291,P=0.009),inactivity factor(OR=3.354,P=0.015),and the SDSS score(OR=2.952,P=0.013)were the most specific factors related with the capacity of appreciation.Conclusion This study suggests that authenticated persons with psychotic symptoms and abnormal emotional state are more likely to be assessed as indiscriminality.The inactivity factor,thought disturbance factor and the SDSS score,may be regarded as the high risk factors for the loss capacity of appreciation.

关 键 词：精神障碍者 法医精神病学鉴定 刑事责任能力 辨认能力 

分 类 号：R749.99[医药卫生—神经病学与精神病学]