司法精神医学鉴定中精神分裂症患者暴力行为的对照研究

暴力犯罪案占司法精神医学鉴定案例数的比例较大,其暴力行为多在精神病性症状支配下所为[1,2],掌握精神病患者与精神正常者不同的作案规律和特征,是鉴别是否由精神病症状所致暴力犯罪的基本要素。本研究探讨司法精神医学鉴定中精神分裂症患者暴力行为的特点及相关因素。1对象和方法1.1对象1982年1月至2005年10月青海省第三人民医院司法鉴定室鉴定的暴力犯罪案例153例,占全部案例的27.42%。其中凶杀案58例、伤害案48例、抢劫案26例、强奸案14例、纵火案7例;鉴定诊断为精神分裂症者55例,心境障碍23例,精神发育迟滞21例,酒精所致精神障碍14例,…     

精神病患者性受害的司法精神医学鉴定分析

目的探讨精神病患者性受害的特点和性自我防卫能力。方法回顾性分析185例不同精神疾病患者性受害司法精神医学鉴定资料，探讨不同精神疾病性受害特点和性自我防卫能力的判定原则。结果性受害被害人鉴足占司法精神医学鉴定总数11．71％；所鉴定精神病患者性受害中以精神发育迟滞居首位（54．59％），其余依次为精神分裂症（34．05％），情感性精神障碍（6．49％）和其他精神障碍（4．86％）。其性受害的特点和性自我防卫能力因病种不同而各有差异。结论判定性受害者是否有性自我防卫能力最关键的问题是判定被害女性对两性行为的意义、性质及后果是否缺乏辨认能力或丧失控制能力。     

ICD-10(V)在中国司法精神病学中的应用情况

1 我国司法精神病鉴定中精神障碍诊断标准的适用情况 司法精神病鉴定作为精神医学的亚学科,有其特殊性,需要医学要件与法学要件的相互结合.司法精神病鉴定的主要任务是被鉴定人的能力鉴定,鉴定的主要目的是评定嫌疑人实施行为时有无精神异常,及行为与精神异常的关系.医学要件需要确认嫌疑人是否患有精神障碍,是何种精神障碍.     

酒后致恶性案件司法鉴定分析

目的探讨酒所致的精神障碍者作案和司法精神病学鉴定的特点。方法对87例酒后致恶性案件司法鉴定资料进行回顾性调查分析。结果被鉴定人作案的类型、性质,对作案过程的回忆,作案动机,责任能力的评定等方面均存在差异(χ2=75.173,P0.001)。普通醉酒,复杂性醉酒、酒所致精神障碍者三者间作案的特征有明显的不同(χ2=130.078,P0.001)。结论各种类型酒中毒者的刑事责任能力评定应坚持从严的原则,对特殊人群应加强普法教育,改变他们的不良饮酒习惯,避免因酒后引发恶性案件的发生,促进社会和谐。     

ICD-10（Ⅴ）在中国司法精神病学中的应用情况

1我国司法精神病鉴定中精神障碍诊断标准的适用情况 司法精神病鉴定作为精神医学的亚学科，有其特殊性，需要医学要件与法学要件的相互结合。司法精神病鉴定的主要任务是被鉴定人的能力鉴定，鉴定的主要目的是评定嫌疑人实施行为时有无精神异常，及行为与精神异常的关系。医学要件需要确认嫌疑人是否患有精神障碍，是何种精神障碍。现行的诊断标准，     

酒精所致精神障碍患者生活事件和社会支持调查

目的：了解生活事件和社会支持与酒精所致精神障碍发病的关系。方法：采用生活事件量表和社会支持评定量表作评定工具．对47例酒精所致精神障碍患者和47例正常人进行对照研究。结果：酒精所致精神障碍患者负性事件、独立性事件、家庭有关问题、工作学习中的问题及生活事件频数和紧张值均显著高于正常人组，而主观感受分、客观支持分、支持利用分及社会支持量表总分均低于正常人组。结论：不良生活事件频数和紧张值及社会支持不足与酒精所致精神障碍的发病密切相关。     

京户籍重性精神疾病患者基本用药有望不花钱

据中国广播网报道:今年年内,北京市户籍的部分精神病人在进行药物治疗时,将很可能由政府买单。该政策对疾病的种类和药物的类型进行了规定。痴呆、癫痫所致精神障碍、颅脑损伤所致精神障碍、慢性酒精中毒所致精神障碍、精神分裂症、持久的妄想性障碍、分裂情感性障碍、躁狂发作、双相情感障碍、抑郁发作、复发性抑郁障碍、中度及以上精神发育迟滞、精神发育迟缓伴发精神障碍等13种疾病在列。这些病人在使用基     

86例酒精所致精神障碍患者临床分析

目的　探讨酒精所致精神障碍的临床特点。方法　采用半定式表格分别对 86例住我院诊断酒精所致精神障碍的患者资料进行回顾性调查。结果　酒精所致精神障碍以男性 ( 96.5 % )、低文化水平 ( 68.6% )、体力劳动者 ( 77.8% )居多 ;女性( 3 .5 % )饮酒有增多倾向 ,年龄呈低龄化趋势 ( 4 0 .5± 1 3 .7岁 ) ,离婚、分居者 (共 2 3 .3 % )较多 ,社会功能受损明显 ;开始持续饮酒越年轻 ,出现精神障碍时间越短。近期疗效尚好 (近愈 94.2 % )。结论　酒精所致精神障碍多与饮酒时间有关 ,对患者心理、生理和社会功能有不同程度的损害。应大力宣传长期过量饮酒的危害 ,早期干预。     

老年期精神障碍126例临床分析

目的 研究老年期精神障碍的特点。方法 对精神障碍患者进行临床及相关因素分析。结果 老年期精神障碍以精神分裂症、脑血管病所致精神障碍、AD及神经症较多见。生活事件与老年期精神障碍关系密切。发生率高达33．33％．常见的首发症状有失眠、记忆力减退、多疑等。结论 加强老年精神卫生的研究对提高老年人精神卫生水平具有重要意义。     

赌"六合彩"致精神障碍浅析

目的 分析赌“六合彩”所致的精神障碍。方法 对１３例致精神障碍患者进行临床资料、“六合彩”赌博特点及患者发病感受等调查。结果 大多数患者对赌博的期骗性缺乏认识，发病与“六合彩”赌输有直接或间接的关系，多归属为心因性精神障碍。结论 戒赌，克服不良心理，有心理障碍或精神问题及早就医。     

293例精神残疾15年后重新评定结果分析

目的探讨精神病残疾人重新评定的特点。方法收集了293例用国家统一的残疾标准和检查方法进行残疾等级重新评定。结果15年后重新评定本组残疾人,发现死亡率为3.22%,两次评定的诊断误诊率为0.71%,有35.48%的残疾人伴发1种以上的其他躯体性疾病,两次评定残疾等级变化差异有统计学意义(P0.01),说明残疾程度有加重趋势。结论加强残疾康复的同时,还应重视患者躯体疾病的防治,并建议精神病残疾等级评定工作,应设立初评和重新评定。     

Prevalence of disability observed in an Oxfordshire practice

A register was compiled of disabled patients in an Oxfordshire practice; patients were considered to be disabled when an impairment appreciably affected their day-to-day life. The rates of disability rose with age. Three-quarters of the disabled patients had one disability, 21% two and 5% three or more disabilities. The most common source of disability was disorders of the nervous system followed by circulatory and musculoskeletal conditions. More than two-thirds of the disabilities were capable of amelioration and 4% could be completely resolved. Most patients had come to terms with their disability, only 8% finding adjustment difficult.     

Prognostic value of trophoblastic proliferation in complete hydatidiform moles in predicting persistent disease

The clinical outcome of patients with complete hydatidiform moles (CHM) is variable. The correlation between trophoblastic proliferation and development of persistent disease was evaluated. A hundred and fifty-one cases with the initial diagnosis of CHM were re-evaluated histopathologically. The need for chemotherapy and occurrence of metastatic disease was correlated with the histologic grade using a three-level score. Twelve out of 151 cases were re-evaluated as hydropic abortion, partial moles, or were insufficient for morphologic examination, representing a diagnostic agreement of 92%. A total of 63.4% of the CHM presented with low trophoblastic proliferation with focal areas of slight hyperplasia (grade 1), and 23.7% with moderate proliferation with slight anaplasia and medium-sized sheets of free trophoblast in between the villies (grade 2). In all, 12.9% of the cases showed marked hyperplasia with marked anaplasia and involvement of nearly all villies, as well as a large amount of intervillous trophoblastic sheets (grade 3). Twenty-six of the CHM (19%) required chemotherapy. Grade 3, on histology, showed a positive correlation with the necessity of chemotherapy (p=0.04), but not with the occurrence of metastatic disease. Histomorphology might predict the risk of persistent disease, indicating the necessity for closer a follow-up, but further studies are required.     

Catastrophic Health Expenditures for Households with Disabled Members: Evidence from the Korean Health Panel

Persons with disabilities use more health care services due to ill health and face higher health care expenses and burden. This study explored the incidence of catastrophic health expenditures of households with persons with disabilities compared to that of those without such persons. We used the Korean Health Panel (KHP) dataset for the years 2010 and 2011. The final sample was 5,610 households; 800 (14.3%) of these were households with a person with a disability and 4,810 (85.7%) were households without such a person. Households with a person with a disability faced higher catastrophic health expenditures, spending about 1.2 to 1.4 times more of their annual living expenditures for out-of-pocket medical expenses, compared to households without persons with disabilities. Households having low economic status and members with chronic disease were more likely to face catastrophic health expenditures, while those receiving public assistance were less likely. Exemption or reduction of out-of-pocket payments in the National Health Insurance and additional financial support are needed so that the people with disabilities can use medical services without suffering financial crisis.     

Very preterm birth is associated with disabilities in multiple developmental domains

OBJECTIVE: Follow-up studies in very preterm children usually present outcome for separate developmental domains. Presence of disabilities in more than one developmental domain will show a more serious outcome picture for extreme preterm infants and may be related to a different degree of perinatal problems. METHODS: At 5.5 years corrected age, outcome in the neurological, motor, cognitive, and behavioral domain was studied in 157 children born < 30 weeks gestation. The children were divided into a normal, a single, or a multiple disability group. Group differences in background, clinical characteristics, and neurodevelopmental outcome at 2 years were evaluated. RESULTS: Thirty-nine percent had a normal developmental outcome, 17% had a single disability, and 44% had multiple disabilities. Multiple disabilities were associated with lower birth weight, BPD, and difficulties according to neurodevelopmental assessments at 2 years. CONCLUSION: Assessments of different developmental domains show that most very preterm children had multiple disabilities.     

Neurodevelopmental dysfunction and specific learning disabilities in school-aged twins

The frequency of the developmental dysfunction and specific learning disabilities were assessed in the retrospective study in the group of 56 school-aged twins. The relationships between genetic, perinatal and social factors and learning disability were also determined. It was found that 12.5% of twins had learning disabilities. The most common neurodevelopmental dysfunction were language disorders, poor graphomotor fluency and poor fine motor dexterity. It was also found that educational difficulty were associated with prematurity, low Apgar scores, neonatal complications and familial predisposition.     

Prevalence of left heart contrast in healthy,young, asymptomatic humans at rest breathing room air

Our purpose was to report the prevalence of healthy, young, asymptomatic humans who demonstrate left heart contrast at rest, breathing room air. We evaluated 176 subjects (18–41 years old) using transthoracic saline contrast echocardiography. Left heart contrast appearing ≤3 cardiac cycles, consistent with a patent foramen ovale (PFO), was detected in 67 (38%) subjects. Left heart contrast appearing >3 cardiac cycles, consistent with the transpulmonary passage of contrast, was detected in 49 (28%) subjects. Of these 49 subjects, 31 were re-evaluated after breathing 100% O₂ for 10–15 min and 6 (19%) continued to demonstrate the transpulmonary passage of contrast. Additionally, 18 of these 49 subjects were re-evaluated in the upright position and 1 (5%) continued to demonstrate the transpulmonary passage of contrast. These data suggest that ∼30% of healthy, young, asymptomatic subjects demonstrate the transpulmonary passage of contrast at rest which is reduced by breathing 100% O₂ and assuming an upright body position.     

Re-evaluation of the Auxotab (inolex) Enteric 1 System for identification of Enterobacteriaceae

The improved Auxotab Enteric I System was re-evaluated and found to correlate 98% with conventional methods for the identification ofEnterobacteriaceae. Possible Reasons for previous poor results with this system are discussed.     

学习不良初中生心理健康状况的配对研究

目的　探讨学习不良初中生的心理健康状况及其与学习不良的关系。方法　采用 1∶ 1配对的对照研究方法 ,应用中学生心理健康量表 ( MSSMHS)对 1 1 0名初中生进行测查。结果　MSSMHS测查中 ,学习不良组的心理异常检出率高于对照组 ,差异有显著性意义 ( P<0 .0 5 ) ;学习不良组共有 9项指标高于对照组 ,差异有显著性意义 ( P<0 .0 5 ) ;学习不良组强迫、人际关系敏感、焦虑、学习压力及情绪不平衡因子轻度异常。结论　学习不良初中生的心理健康问题不容忽视     

Factors associated with increasing functional decline in multimorbid independently living older people

Objectives

With increasing age the levels of activities of daily living (ADL) deteriorate. In this study we aimed to investigate which demographic characteristics and disorders are associated with ADL disabilities in multi-morbid older people.

Study design

We performed a cross-sectional study with baseline patient data from a large Dutch trial in independently living multi-morbid older people combined with the reimbursed healthcare data for the same subjects.

Main outcome measures

The primary outcome of our study was the level of independence of activities of daily living (ADL) as assessed with the Modified Katz Activities of Daily Living (KATZ-15) scale.

Results

In our study we were able to include 1187 persons (63.0% female) for whom both questionnaire data and reimbursed healthcare data was available. In total, 59% had a Katz-15 score of 1 or higher. The strongest associations with ADL disabilities in women were psychiatric disorders, with prevalence rate (PR) estimates of 1.37 (95% confidence interval (CI): 1.17–1.60) and transient ischaemic attacks and cerebrovasculair accidents in men, with PR estimates of 1.94 (95% CI: 1.41–2.66). Although univariate analysis seemed to also reveal associations with socio-demographic factors such as living together with a partner or the socio-economic status, these factors were not independently associated with ADL disabilities.

Conclusions

In this cross-sectional study we found that 71% of the multi-morbid female elderly had a sub-optimal level of activities of daily living, as assessed with the Katz-15 scale. The results of our study show that multiple disorders are associated with ADL disabilities in multi-morbid older men and women. We found socio-demographic characteristics not to be independently associated ADL disabilities.