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1.
温州地区近6年907例精神病司法鉴定案例分析   总被引:2,自引:0,他引:2  
目的 探讨近 6年精神病司法鉴定案例的特征。方法 对浙江温州鹿城精神病医院1998~ 1999年 (A组 ) 2 0 2例 ,2 0 0 0~ 2 0 0 1年 (B组 ) 36 8例 ,2 0 0 2~ 2 0 0 3年 (C组 ) 337例进行对照研究。结果 近 6年 ,女性和无业构成比上升 (P <0 .0 1)。责任能力评定下降 ,服刑能力、民事行为能力评定上升 (P <0 .0 1)。精神损伤评定构成比上升 (P <0 .0 5 )。诊断为精神分裂症、情感性精神病逐年上升(P <0 .0 1)。无责任能力评定上升 (P <0 .0 1) ,完全责任能力评定下降 (P <0 .0 1)。法院委托鉴定上升 (P <0 .0 5 )。结论 近 6年中精神病司法学呈现不同的特点 ,并逐步向规范化、法规化迈进 ,服务范围和对象将会扩大  相似文献   

2.
80年代与90年代精神疾病司法鉴定案例比较分析   总被引:1,自引:0,他引:1  
目的 探讨 80年代与 90年代司法精神病鉴定变化的特点。方法 对盐城市精神司法鉴定委员会鉴定技术组 1980年至 1999年鉴定的 1111例案例 ,分为 80年代组与 90年代组进行比较。 (80年代组 198例 ,90年代组 913例 )结果  90年代组比 80年代组 :在鉴定诊断中 ,人格障碍减少 (P <0 0 5 )其它无显著变化 ,两组中居第一位的为精神发育迟滞 ,分别占 36 6 %和 33 8% ;在法律能力评定中 ,刑事责任能力评定有所减少 (P <0 0 5 ) ,性防卫能力评定中有所增加 (P <0 0 5 ) ,两组中居第一位的为刑事责任能力评定分别为70 4 %和 78 3% ;在刑事责任能力评定中 ,完全责任能力在减少 (P <0 0 1) ,而部分责任能力在增加 (P <0 0 1) ,两组中居第一位为完全刑事责任能力分别占 4 6 7%和 5 6 1% ;在鉴定案例犯罪类型中 ,盗窃案件增多 (P <0 0 1) ,政治案件和流氓案件减少 (P分别 <0 0 5和 <0 0 1)。结论 我国的司法精神病学正在不断发展  相似文献   

3.
目的探讨近10年司法精神病学鉴定案例的特征。方法将四川大学华西基础医学与法医学院法医精神病学教研室,于1997年~2006年鉴定的3016例案件,分为前5年组和后5年组进行对照研究。结果近10年中,被鉴定人的女性构成比有所上升(P〈0.05),凶杀案件、纵火案件构成比下降,性侵害案件、盗窃案件,以及性自卫能力和伤残评定的构成比均有上升(P〈0.05)。鉴定诊断中,精神发育迟滞和脑外伤所致精神障碍的比例有所增高,而癫痫所致精神障碍和人格障碍的比例有所下降(P〈0.05);刑事案件受害者中精神病患者的家人被伤害的比例增高(P〈0.05);做出完全责任能力评定的比例下降,无责任能力评定的比例增加(P〈0.05)。送检单位中法院和其他机关的比例明显增加(P〈0.05)。结论近10年中司法精神病学鉴定呈现不同的特点,司法精神病学也将面临更多的挑战和难题。  相似文献   

4.
新疆地区10年精神疾病司法鉴定回顾性对照研究   总被引:8,自引:2,他引:6  
目的 探讨我国新《刑法》和《刑事诉讼法》实施前后新疆地区 10年间精神疾病司法鉴定的临床特征及变化特点。方法 以 1997年 10月 1日新《刑法》实施日为分界线 ,对 1992年 10月 1日至 2 0 0 2年 9月 30日鉴定的2 0 0 9名病例进行回顾性对照分析。前 5年为A组 ,后 5年为B组。结果 ① 10年间以刑事责任能力鉴定为主(5 8 4 4 % )。被鉴定人均为青壮年 (2 9 5 3± 11 2 4 )岁 ,接受国民教育的时间短 (7 5 1± 4 13)年 ,男性较多 (6 9 19% )。2组相比 ,B组刑事责任能力鉴定的构成比下降 (P <0 0 5 )。精神损伤鉴定和限定责任能力所占的比例明显升高 (P<0 0 1) ;女性被鉴定人增多 (P <0 0 1) ,受教育时间延长 (P <0 0 1)。 2组诊断排序中前三位为精神分裂症(2 9 4 7% ) ;精神发育迟滞 (16 5 3% ) ;无精神病 (10 4 0 % )。酒所致精神病障碍的比例 (6 5 2 % )远高于文献报道。结论 新《刑法》和《刑事诉讼法》实施后 ,司法精神病学鉴定的临床特征和内容发生了很大变化。  相似文献   

5.
民事行为能力的司法精神病学鉴定   总被引:7,自引:0,他引:7  
作者试图通过对 33例民事行为能力司法精神病学鉴定的分析 ,探索此类鉴定的一般特点 ,就鉴定中的难点和问题进行讨论。作者单位 :10 0 0 40 北京市法庭科学技术鉴定研究所 (马长锁、常林、刘鑫、邢学毅 ) ;北京医科大学精神卫生研究所 (方明昭 )1 对象1 997年 8月~ 1 999年 8月于北京市法庭科学技术鉴定研究所进行司法精神病学鉴定的案例 ,共33例 ,鉴定目的均为民事行为能力。2 结果2 .1 被鉴定人一般资料被鉴定人 33例 ,其中男 2 0例 ,女 1 3例 ;平均年龄 ( 4 5.4± 1 6.5)岁 ;未婚 7人 ,已婚 2 3人 ,离异 3人。文化程度在小学及以下 …  相似文献   

6.
1998~2000年某医院司法精神病学鉴定案例的比较   总被引:1,自引:0,他引:1  
为探讨近年来司法精神病学鉴定案例的特征 ,对 1998~2 0 0 0年我院精神病司法鉴定案件进行对比分析。对象和方法 样本源于 1998年 1月至 2 0 0 0年 12月经我院司法鉴定的案例 ,共 370例。其中 1998年 10 7例 ,1999年 95例 ,2 0 0 0年 16 8例。本研究为病例对照研究。采用自制调查表 ,详细收集鉴定案由、法律能力、疾病分类、责任能力评定等 ,并比较三组的资料。数据处理采用 χ2 检验。结果 三年中女性被鉴定人的构成比逐年上升 (χ2 =8 6 8,P <0 0 5 ) ;其中 1998年为 15 0 % (16例 ) ,1999年为2 7 4% (2 6例 ) ,2 0 0 0年 (以下按此…  相似文献   

7.
80年代与9O年代精神疾病司法鉴定案例比较分析   总被引:1,自引:0,他引:1  
目的探讨80年代与90年代司法精神病鉴定变化的特点.方法对盐城市精神司法鉴定委员会鉴定技术组1980年至1999年鉴定的1111例案例,分为80年代组与90年代组进行比较.(80年代组198例,90年代组913例)结果 90年代组比80年代组在鉴定诊断中,人格障碍减少(P<0.05)其它无显著变化,两组中居第一位的为精神发育迟滞,分别占36.6%和33.8%;在法律能力评定中,刑事责任能力评定有所减少(P<0.05),性防卫能力评定中有所增加(P<0.05),两组中居第一位的为刑事责任能力评定分别为70.4%和78.3%;在刑事责任能力评定中,完全责任能力在减少(P<0.01),而部分责任能力在增加(P<0.01),两组中居第一位为完全刑事责任能力分别占46.7%和56.1%;在鉴定案例犯罪类型中,盗窃案件增多(P<0.01),政治案件和流氓案件减少(P分别<0.05和<0.01).结论我国的司法精神病学正在不断发展.  相似文献   

8.
司法精神病学鉴定216例分析   总被引:1,自引:1,他引:0  
目的探讨跨入21世纪后司法精神病学鉴定的特点和发展。方法对本院2003年~2005年司法精神病鉴定案例216例进行统计分析,对比上世纪90年代报道的司法精神病学鉴定资料,分析其差异性意义。结果本世纪初3个年度司法鉴定案型仍以凶杀、伤害所占比例为高,但与上世纪90年代比无明显增加,涉及案由较前相似。依次可分为凶杀伤害、抢劫盗窃、经济案、性受害、扰乱社会治安、强奸猥亵、诈骗贩假、绑架劫机等。结论20世纪末和21世纪初对比说明了司法精神病学鉴定随着法学的发展,发现经济案件发生率有增高趋势,在分析作案动机时难度加大。司法工作的规范化及民众的法制意识增强是21世纪司法精神病鉴定的新特征,从而使司法精神病学鉴定中对责任能力的评定掌握更严格,更趋于体现公平、公正、科学、合理。  相似文献   

9.
27例司法精神病重新鉴定案例的分析   总被引:4,自引:2,他引:2  
作者分析了近6年来的27例司法精神病重新鉴定的案例,发现严重犯罪案件的重鉴率比其他案件高。二次鉴定的21例中,诊断一致率为66.67%,法定能力评定一致率为71.43%。三次鉴定的6例中,有2例与前二次鉴定结论全异。作者分析了重鉴原因及鉴定结论不一致的有关因素,并提出了提高司法精神病学鉴定质量的建议。  相似文献   

10.
目的探讨高血压脑出血采用微创血肿清除术治疗的临床效果。方法回顾性分析我院2012年11月至2015年11月收治的高血压脑出血患者共120例。将120例高血压脑出血患者按照1:1:1比例,随机分为A组(传统治疗组,n=40)、B组(引导立体定向组,n=40)、C组(微创血肿清除术组,n=40)。对比三组治疗效果。结果术后6个月,C组恢复良好率明显优于A组、B组,结果有显著性差异(P0.05);术后6个月,A组、B组、C组患者术后再出血发生率分别为10.0%(4/40)、10.0%(4/40)、0.0%(0/40),C组明显低于A组、B组,结果有显著性差异(P0.05);C组残余血肿量明显优于A组、B组,结果有显著性差异(P0.05)。结论在高血压脑出血患者的临床治疗过程中,采用微创血肿清除术治疗,能获得较传统治疗、引导立体定向治疗更为理想的效果,值得进行深入研究和推广。  相似文献   

11.
Neuronal migration disorders are the result of disturbed brain development. In such disorders, neurons are abnormally located. In diagnosing these conditions, magnetic resonance imaging is superior to any other imaging technique. This enables us to improve our knowledge of the clinical correlates of neuronal migration. With reference to migrational disorder, a retrospective study of all 303 patients with epileptic seizures referred for magnetic resonance imaging during a 3-year period was performed, 13 patients (aged 12-41, mean age 27) were identified. They represent 4.3% of the entire study group. Of the patients with known epilepsy, 6.7% and of the mentally retarded, 13.7% had migrational disorders. Four patients had schizencephaly as the dominant finding, one was classified as hemimegalencephaly, 2 had isolated heterotopias, and 6 had localized pachy- and/or poly-microgyria. The clinical pictures are complex. Ectopias of grey matter are recognised foci of epilepsy, but from an epileptological and a clinical viewpoint little attention has been given to these disorders. The present study shows that malmigration is not rare in epilepsy patients, especially not in the mentally retarded.  相似文献   

12.
Diagnostic Difficulties and Treatment Implications   总被引:1,自引:0,他引:1  
Robert J. Gumnit 《Epilepsia》1987,28(S3):S9-S13
Summary: Differentiation between types of epileptic seizures has been aided in recent years by the introduction of intensive neurodiagnostic techniques and the development of increasingly detailed classification systems. Paradoxically, these developments have not simplified the task of matching the appropriate antiepileptic drug to a particular seizure type. It is reasonable to assume that anticonvulsant drugs will have different effects on different types of seizures, but faulty, circular reasoning can enter the picture if one also assumes that responses of seizures to different drugs signify different seizure types. There are several examples of differential diagnoses that can fall prey to this problem, including the diagnosis between partial seizures with secondary generalization and generalized tonic-clonic seizures, and the diagnosis between complex partial seizures and absence seizures with automatisms, among others. Considerations of etiology in future classification systems can further complicate the problem: should one then choose an anticonvulsant drug on the basis of individual seizure type or on the basis of the type of epilepsy? Ramifications of this issue extend even to the drug approval process. Official sanction is not given for use of a drug for a seizure type not included in the original efficacy studies, even if later scientific evidence shows that seizure type to be related to a type that is included. New trials must be undertaken. These problems arise from how we choose to classify seizures.  相似文献   

13.
Cognitive Dysfunction Associated with Antiepileptic Drug Therapy   总被引:7,自引:5,他引:2  
Eileen P.G. Vining 《Epilepsia》1987,28(S2):S18-S22
Summary: Epilepsy is frequently associated with cognitive dysfunction. However, the reasons for this correlation are unclear. Possible influential factors include patient age; duration, frequency, etiology, and type of seizures; hereditary factors; psychosocial issues; and antiepileptic drug (AED) therapy. Whereas many of these factors are beyond the physician's control, AED therapy is one element that can be addressed in treatment decisions by recognizing the potential cognitive effects of particular AEDs. For example, phenobarbital impairs memory and concentration; phenytoin affects attention, problem solving ability, and performance of visuomotor tasks. In contrast, carbamazepine may affect concentration, while valproate would appear to have minimal effects on cognition. Moreover, cognitive effects of AEDs are amplified with coadministration of multiple anticonvulsants (polytherapy). A review of studies on the cognitive effects of monotherapy with AEDs, as opposed to those of polytherapy, provides evidence that drug-related cognitive dysfunction can be reversed if patients are switched to a simpler therapeutic regimen. Future research should be directed toward developing reliable measures for assessing and monitoring cognition, and understanding the particular cognitive side effects of each AED. Physicians also need to revise their opinions about which side effects are "tolerable" for epileptic patients.  相似文献   

14.
B. J. Wilder 《Epilepsia》1987,28(S2):S1-S7
Summary: The long-standing practice of polypharmacy in treating epilepsy is giving way to use of monotherapy. Monotherapy can improve seizure control as well as reduce the risk of serious idiosyncratic reactions, dose-related side effects, and complex drug interactions. Monotherapy also offers improved compliance and cost-effectiveness. The basis of monotherapy is accurate diagnosis and assessment of the patient's seizure type(s), followed by selection of a single appropriate anticonvulsant drug. Many patients currently treated with multiple anticonvulsants can be successfully converted to monotherapy with a carefully monitored program in which troublesome and redundant drugs are gradually withdrawn from the therapeutic regimen.  相似文献   

15.
Summary: Carbamazepine and phenytoin are drugs of choice in initial monotherapy for adult partial and secondarily generalized tonic-clonic seizures. These designations reflect the results of the Veterans Administration Epilepsy Cooperative Study Group of 1985. An earlier comparative study of carbamazepine and phenytoin by Ramsay and associates found both drugs equally effective in controlling new-onset seizures. Among the advantages of carbamazepine is that it causes relatively few cognitive and dysmorphic side effects. Its disadvantages are its unavailability in parenteral formulation and its metabolic autoinduction. The latter must be compensated for by planned dosage increases to maintain therapeutic plasma steady-state levels during the first 2 or 3 months of treatment. Carbamazepine is judged a drug of choice in the treatment of these secondarily generalized tonic-clonic seizures, and the drug of choice in children, adolescents, and women susceptible to the dysmorphic side effects associated with other anticonvulsant agents.  相似文献   

16.
Summary: Four broad categories of basic phenomena are pertinent to developing ways to prevent epilepsy. These include mechanisms of epileptogenesis, ictal initiation and temporary entrainment by the seizure discharge of normally functioning brain, seizure propagation, and control mechanisms that function both to restrain the cascade of epileptic events culminating in a seizure and to arrest the epileptic event and restore the interictal state. In newborns and children, hypoxia-ischemia is a major factor leading to epileptogenesis, and several schemes are proposed to classify, quantify, and prevent hypoxic-ischemic encephalopathy. Control mechanisms must be better understood in order to develop prophylactic recommendations for epilepsy, and an experimental model of "kindling antagonism" may increase our understanding of these. Programs of prevention of seizures in children will evolve only if basic researchers and clinicians work productively together to develop an adequate understanding of factors important in epileptogenesis and antiepileptogenic control mechanisms.  相似文献   

17.
Hepatic Considerations in the Use of Antiepileptic Drugs   总被引:5,自引:4,他引:1  
Summary: Virtually all of the major antiepileptic drugs (AEDs) can cause hepatotoxicity, although fatal hepatic reactions are rare. The mechanisms, incidences, and risk profiles for such reactions differ from drug to drug. With carbamazepine and phenytoin, hepatotoxicity may be due to drug hypersensitivity. Although the profiles of patients at risk have not been well-defined for these two antiepileptic drugs, it would appear from reports in the literature that older adolescents and adults are at higher risk than children of developing serious or fatal hepatotoxicity. Once hepatotoxicity develops, mortality rates are 10–38% with phenytoin and 25% for carbamazepine. The risk profile for valproate fatal hepatotoxicity has been more clearly defined. Those at primary risk of fatal hepatic dysfunction are children under the age of 2 years who are receiving multiple anticonvulsants and also have significant medical problems in addition to severe epilepsy. The risk is considerably lower for patients over the age of 2 years on valproate monotherapy. In contrast to the risk profile with other AEDs, adults receiving valproate as monotherapy have the lowest risk of hepatotoxicity. Fatal hepatic dysfunction coincident with valproate may be the result of aberrant drug metabolism. Concomitant use of AEDs that induce microsomal P450 enzymes (e.g., phenytoin and phenobarbital) may enhance the production of a toxic metabolite, and hence the greater risk of hepatotoxicity with polypharmacy.  相似文献   

18.
Summary: Vascular malformations (VMs) are associated with epilepsy. The natural history of the various VMs, clinical presentation, and tendency to provoke epilepsy determine treatment strategies. Investigations have probed the mechanisms of epileptogenesis associated with these lesions. Electrophysiologic changes are associated with epileptogenic cortex adjacent to VMs. Putative pathophysiologic mechanisms of epileptogenesis include neuronal cell loss, glial proliferation and abnormal glial physiology, altered neurotransmitter levels, free radical formation, and aberrant second messenger physiology.  相似文献   

19.
Dextromethorphan: Cellular Effects Reducing Neuronal Hyperactivity   总被引:5,自引:1,他引:4  
G. Trube  R. Netzer 《Epilepsia》1994,35(S5):S62-S67
Summary: Dextromethorphan is a dextrorotary morphinan without affinity for opioid receptors, commonly used as an antitussive medication. During the past 5 years, interest in the compound and its demethylated derivative, dextrorphan, has been revived because additional neuroprotective and an-tiepileptic properties were found in in vitro studies, animal experiments, and a few clinical cases. Both morphinans are able to inhibit N -methyl-D-aspartate (NMDA) receptor channels and voltage-operated calcium and sodium channels with different potencies. The inhibition of the NMDA receptor is believed to be the predominant mechanism of action responsible for the anticonvulsant and neuroprotective properties of the compounds.  相似文献   

20.
Transcranial Electrical Stimulation (tES) encompasses all methods of non-invasive current application to the brain used in research and clinical practice. We present the first comprehensive and technical review, explaining the evolution of tES in both terminology and dosage over the past 100 years of research to present day. Current transcranial Pulsed Current Stimulation (tPCS) approaches such as Cranial Electrotherapy Stimulation (CES) descended from Electrosleep (ES) through Cranial Electro-stimulation Therapy (CET), Transcerebral Electrotherapy (TCET), and NeuroElectric Therapy (NET) while others like Transcutaneous Cranial Electrical Stimulation (TCES) descended from Electroanesthesia (EA) through Limoge, and Interferential Stimulation. Prior to a contemporary resurgence in interest, variations of transcranial Direct Current Stimulation were explored intermittently, including Polarizing current, Galvanic Vestibular Stimulation (GVS), and Transcranial Micropolarization. The development of these approaches alongside Electroconvulsive Therapy (ECT) and pharmacological developments are considered. Both the roots and unique features of contemporary approaches such as transcranial Alternating Current Stimulation (tACS) and transcranial Random Noise Stimulation (tRNS) are discussed. Trends and incremental developments in electrode montage and waveform spanning decades are presented leading to the present day. Commercial devices, seminal conferences, and regulatory decisions are noted. We conclude with six rules on how increasing medical and technological sophistication may now be leveraged for broader success and adoption of tES.  相似文献   

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