精神分裂症症状与暴力作案特征分析

目的:探讨精神分裂症患者精神症状与暴力作案特点之间的关系。方法:通过使用暴力作案刑事责任能力评定量表(CRRS-V)结合Rogers刑事责任能力评定量表(R-CRAS)与简明精神病评定量表(BPRS)等工具,对54例诊断为精神分裂症的被鉴定人精神症状与暴力作案的特点进行相关分析。结果:精神病性症状同评定工具反映的多数作案特点以及鉴定时的表现之间存在密切联系,但作案时的环境辨认情况以及作案隐蔽性同精神症状间无明显关系。结论:精神分裂症患者的作案行为与多种因素有关。但不能单凭某一因素对责任能力进行评估。     

232例司法精神医学鉴定为无精神病的凶杀案例分析

目的：探索司法精神医学鉴定诊断为无精神病凶杀案例的特点。方法：对232例司法精神医学鉴定中被诊断为“无精神病”的凶杀案例资料进行回顾性分析。结果：无精神病占凶杀案例鉴定总数的69．9％,被鉴定人作案动机明确,自我保护良好,“精神症状”及提出鉴定的理由有一定的特点。结论：掌握精神疾病患者与精神正常者不同的作案规律和特征,多因素综合分析有助于凶杀案无精神病的司法鉴定。     

部分刑事责任能力精神病违法者的犯罪学特征及其相关分析

目的研究在刑事案件中部分刑事责任能力精神病违法者的犯罪学特征以及这些特征与部分刑事责任能力的相关性,为司法精神病学鉴定提供客观的科学依据。方法对300例符合纳入和排除标准的研究对象使用自制的调查表进行研究,所得资料使用SPSS10.0软件进行统计分析。统计方法包括统计描述、spearman相关分析及多元成组t检验等。结果部分刑事责任能力精神病违法者犯罪时有一定的犯罪动机者为81.3%,作案前有可疑的诱发因素者占研究总体的73.0%,作案前对作案对象、工具有选择者分别占总体的64.7%和62%,59.7%对作案时间无选择,为临时起意。作案后50%的被鉴定人缺乏逃避掩盖等反侦察手段,或有可疑的反侦察行为者39.7%,无伪装75.0%或可疑伪装22%。被鉴定人的生活自理能力、工作学习能力轻度损害者分别为80.4%和74.3%。相关分析发现部分刑事责任能力与作案动机的相关系数为r=0.116(P=0.049)、与作案先兆(r=0.114,P=0.048)、作案的诱因(r=0.172,P=0.003)、作案地点选择(r=0.139,P=0.016)、作案工具选择(r=0.170,P=0.003)、作案后的反侦察手段(r=0.132,P=0.022)及自知力(r=0.293,P=0.000)。结论部分刑事责任精神病能力违法者是符合CCMD或/和ICD-10精神与行为障碍分类的精神障碍患者,作案多有犯罪动机,作案前有可疑的诱发事件,作案前对作案对象、工具有选择,作案后缺乏逃避掩盖等反侦察手段,或有可疑的反侦察行为。部分刑事责任能力精神病违法者在犯罪学特征与多项犯罪学特征呈正相关,其中与自知力和作案前诱因两项相关性较强,可将上述特征量化并结合作案当时的精神病理学特点,为部分刑事责任能力的评定提供较为客观的依据     

司法精神病鉴定中所见的旅途精神病

作者对４８６例精神病人凶杀伤害案司法精神病鉴定结果，以中国精神疾病分类方案与诊断标准第２版修订本中旅途精神病诊断标准进行再诊断。结果：其中３０例（２０例原来诊断为分裂样精神病，１０例为反应性精神病）被诊断为旅途精神病（占６．２％）。本组病例在长途旅行、列车严重拥挤下急性发病作案，急性应激源、心理紧张、疲劳、严重丧失睡眠、缺少氧气、缺少饮水和进食等为其发病因素。临床表现以被害妄想、片断性幻觉、情感障碍为主要症状，病程短暂，几天内自行缓解。结合文献对该疾病诊断标准，重点从发案环境、作案特点、精神病理性症状、病程转归等方面进行了分析，探讨了我国司法鉴定中旅途精神病诊断的有关问题。     

酒所致精神障碍的司法精神病学鉴定

目的　探讨不同类型的酒所致的精神障碍患者作案和司法精神病学的鉴定特点。方法　采用对照研究的方法 ,根据被鉴定人的临床特点 ,按国内绝大多数学者的分类意见 ,将 12 2名被鉴定人分为普通醉酒 ( 98例 )、复杂性醉酒 ( 10例 )和酒所致的精神病性障碍 ( 14例 ) 3组。进行对照分析。结果　 3组被鉴定人作案的类型、性质 ,对作案过程的回忆 ,作案的动机 ,责任能力的评定等方面均存在统计学意义上的差异 (P <0 0 5 )。结论　普通醉酒、复杂性醉酒、酒所致精神障碍三者间作案的特征有明显不同。对各种类型的酒中毒者的刑事责任能力评定应坚持从严的原则 ,以防止广大人民群众的生命安全受到威胁 ,减少社会财产损失。对特殊人群应加强教育 ,改变饮酒方式 ,稳定社会治安。     

43例司法精神医学鉴定为精神分裂症的凶杀案例分析

目的探讨司法精神医学鉴定诊断为精神分裂症凶杀作案行为及作案后表现的特点。方法对43例司法精神医学鉴定中被诊断为精神分裂症的凶杀案例资料进行回顾性分析。结果精神分裂症占凶杀案例鉴定为有精神障碍总数的43%；被鉴定人作案先兆、动机、预谋、作案方式、作案后表现均有一定的特点。结论精神病理因素影响精神分裂症作案后的表现，综合分析作案行为及作案后的表现，有助于精神分裂症患者凶杀行为的辨认、控制能力评定。     

答读者来信(二)

司徒梅读者: 你好!根据你提供的资料,被鉴定人具有如下特点:①案发前3年有明确的严重颅脑外伤史;②现人格改变十分明显,无智能损害及精神病性症状;③危害行为特征:刺激与反应不相称,系小事与人斗殴,怒不可遏,致受害人重伤而死亡;④审讯中对作案过程能回忆,但不后悔.因此,据此可考虑被鉴定人系患脑挫裂伤所致的人格改变.脑器质性病变所致的人格改变在司法精神病鉴定中较为常见,该类患者可出现各种危害行为.如伤害、盗窃和性侵犯行为,其中以伤害较为多见.他们情绪不稳,激惹性明显增高,常在与环境发生一点矛盾时,出现明显的攻击性行为,特别是伴有额叶损伤的患者常出现社会道德伦理的改变,而出现各种违纪、违法行为.     

旅途性精神病20例临床分析

目的 总结旅途性精神病的临床特点。方法 对本院收治的20例符合CCMD-2R诊断标准的旅途性精神病的临床资料进行回顾性分析。结果 本病多发生于外出打工、探亲等既往很少外出旅行的人员之中；起病急，多有关系、被害妄想及意识清晰度降低，病程短，预后好。结论 旅途性精神病有自己的临床特点。     

旅途性精神病2O例临床分析

目的总结旅途性精神病的临床特点.方法对本院收治的20例符合CCMD-2-R诊断标准的旅途性精神病的临床资料进行回顾性分析.结果本病多发生于外出打工、探亲等既往很少外出旅行的人员之中;起病急,多有关系、被害妄想及意识清晰度降低,病程短,预后好.结论旅途性精神病有自己的临床特点.     

司法鉴定中精神分裂症患者与无精神病者暴力行为的对照研究

目的通过对精神分裂症患者和无精神病者鉴定资料的对照研究来探讨分裂症患者暴力行为的特殊性。方法按自制的统一表格详细收集有关被鉴定人的一般人口学资料、临床特点、犯罪特点、鉴定案由、法律能力评定等项目,探讨影响分裂症患者辨认能力、控制能力的因素。结果两组被鉴定人在职业、作案动机、预谋、自我保护和作案先兆等一些与案情有关的特点上存在显著差异。结论精神病理因素对精神分裂症患者辨认和控制能力有重要的影响。     

近11年精神疾病症状谱变化的调查

目的 了解1989～2000年住院精神病人症状谱的变化规律，为临床医生的工作提供参考。方法 对1989年及2000年住我院的精神病人时点调查结果进行对照研究。结果 分别搜集116例及156例病例资料的统计表明，11年中，(1)住院精神病人的平均年龄显增加；(2)关系妄想、被控制妄想、思维散漫、情绪低落、强迫症状、自知力缺失等症状显增加；(3)情感淡漠、行为障碍、象征性思维等症状显减少。结论 人口老龄化、社会竞争激烈、心理素质弱可能是导致精神疾病症状谱发生变化的主要原因。     

精神疾病中的凶杀行为与责任能力评定

目的探讨精神疾病与凶杀行为的关系及责任能力评定的现状.方法采用回顾性研究方法,对既往鉴定中精神疾病凶杀案例进行分析研究.结果精神分裂症和偏执性精神病患者凶杀行为的发生率显著高于其他危害行为(P均小于0.01),而精神发育迟滞、人格障碍及性变态出现凶杀行为,显著低于其他危害行为(P均小于0.01).对精神疾病患者凶杀行为责任能力评定绝大多数为无责任能力,少数为限定责任能力,极少为有责任能力.结论精神病人各类危害社会行为中以凶杀的发生率最高,危害性极大,应加强防范.尽管现时对精神病人危害行为任责任能力的评定趋严,但其凶杀行为的责任能力仍以无责任能力为主.     

A Case of Withdrawal Psychosis from Internet Addiction Disorder

Similar to substance use disorder, patients with Internet addiction disorder (IAD) show excessive use, tolerance and withdrawal symptoms. We report a case of a patient with withdrawal psychosis who showed persecutory delusion and disorganized behaviors in addition to common withdrawal symptoms such as agitation and irritability. A 25-year-old male developed a full-blown psychotic episode within one day after discontinuing an Internet game that he had been playing for at least eight hours a day for two years. Upon admission, he had no abnormal brain imaging findings and laboratory tests. With antipsychotic medication (quetiapine up to 800 mg), his psychotic symptoms rapidly subsided and after four days of treatment, he no longer showed any signs of psychosis. This case report suggests that brief psychosis can develop during withdrawal from long-term excessive use of an Internet and the central pathology beneath the IAD is more likely a form of addiction than impulse control.     

Délire paranoïaque de revendication et passages à l’acte justiciers

Objectives

The present clinical research explores the underlying logic of litigious paranoid delusion, more specifically in its querulous and pseudo-altruistic forms. This research examines both the causality and the psychic functions fulfilled by episodes of vengeful acting out and in some cases murder.

Stereotyped behaviors or punding after quetiapine administration in Parkinson's disease

Quetiapine has been suggested to be useful for the treatment of psychosis in patients with Parkinson's disease without prominent deterioration of motor functions. We present two patients with Parkinson's disease in whom administration of quetiapine for drug-induced psychosis caused characteristic stereotyped behaviors or punding. Since stereotyped behaviors are usually associated with excessive dopaminergic activity, it is clinically important to note that stereotyped behaviors or punding may be induced by an atypical antipsychotic drug for the treatment of psychosis in patients with Parkinson's disease.     

Klinefelter's Syndrome and Epileptic Psychosis: A Case Report

Abstract: We present here a case of Klinefelter's syndrome with epileptic psychosis. The patient was a 30-year-old male, who suffered from epilepsy for 23 years. He showed auditory hallucination, delusion of reference and delusion of grandeur. At present there are some cases of Klinefelter's syndrome with various psychiatric symptoms, but there are few cases of Klinefelter's syndrome with epileptic psychosis. These various neuropsychiatric symptoms of the present case are thought to be associated with a specific effect of chromosomal abnormality through the cerebral dysfunction.     

Three patients with Parkinson's disease whose therapeutic levels were successfully improved after administration of quetiapine for suppression of psychosis]

Psychosis characterized by hallucination or delusion, which occurs during drug therapy of parkinsonian patients, is one of the limiting factors for the control of motor symptoms or complications. In the present study, we encountered three patients with Parkinson's disease (PD) at advanced stages; all three patients had severe psychosis and severe wearing-off phenomenon and one had severe orthostatic hypotension. Their psychotic symptoms were successfully treated by administration of quetiapine, resulting in the favorable control of motor fluctuations and elevation of therapeutic levels unless any aggravation of parkinsonism occurs. Although the measure against drug-induced psychosis is principally a reduction of the doses or withdrawal of causative drugs, the effective use of antipsychotic drugs, such as quetiapine, is helpful to suppress psychosis and allow the patient to adjust to antiparkinsonian drugs for the control of symptoms other than psychosis.     

Periodic psychosis of puberty: a review on near-monthly episodes.

Published cases of periodic psychosis of puberty and related papers were reviewed. The clinical picture is near-monthly recurrence of episodes of stupor or excitement lasting about 1 or 2 weeks, which are accompanied by delusion and in some cases also by hallucinations or confusion. This condition was found to occur more commonly in girls than in boys, and in half of the girls reported the episodes tended to start a few days before menses. Adolescents with mental retardation were more commonly affected, and this suggests that organic brain damage may play a role in the etiology in some cases. Short-term prognosis is usually favorable, but at long-term follow-up, nearly half of them were found to be suffering from affective or schizophrenic illness. The clinical importance of recognizing this psychosis early in the course of illness is emphasized.     

Delusion of theft and phantom intruder delusion in demented elderly patients in Japan

Delusion of theft and phantom intruder delusion are among the most frequent delusions in dementia. The purpose of this study was to clarify the clinical characteristics of patients with these symptoms. The authors conducted a questionnaire survey; items included age, gender, dementia diagnosis, cognitive function, and activities of daily living. Other clinical characteristics were evaluated using the quality of life questionnaire for dementia. A total of 217 patients with dementia were rated. Frequencies of delusion of theft were as follows: frequent, 7%; sometimes, 11%; rare, 16%; and none, 66%. Frequencies of phantom intruder delusion were as follows: frequent, 4%; sometimes, 10%; rare, 9%; and none, 77%. Comparison between positive and negative groups with these symptoms revealed that positive groups had higher scores in 2 of 6 domains of the quality of life questionnaire for dementia, namely, negative affect and actions, and restlessness. The positive group with delusion of theft had higher scores in cognitive function and activities of daily living than did the negative group. These results suggest that negative affect and action and restlessness might be related to delusion of theft or phantom intruder delusion and that delusion of theft frequently occurs in the early stage of dementia.