223例器质性精神障碍司法鉴定分析

目的：探讨司法鉴定中器质性精神障碍的表现特点。方法：223例器质性精神障碍的司法鉴定案例资料，按是否意外事故所致，分为意外事故组177例和非意外事故组46例，对两组的病因诊断、一般情况、鉴定目的及症状进行比较分析。结果：意外事故组以青壮年为主，平均年龄为（33.7±14.3）岁;非意外事故组则以中老年为主，平均年龄（51.6±17.7）岁，两组比较差异有显著性（t=7.18，P〈0.01）。意外事故组以男性较多、文化程度较低及作伤残评定较多，而非意外事故组则以民事行为能力评定显著较多，两组在性别、年龄、文化程度、行为能力评定及伤残评定方面存在显著差异（P〈0.01或P〈0.001）。意外事故组主要病因诊断是脑外伤172例（97.2%），非意外事故组是阿尔茨海默病18例（39.1%）;意外事故组以遗忘综合症显著为多，非意外事故组则以智能障碍和情感障碍显著为多（P〈0.01）。结论：意外事故组因起病的方式、病因、病程甚至发展和预后均与非意外事故组不同，因此两组的症状表现形式及鉴定目的也有所不同。

Analysis of judicial expertise in 223 cases with organic mental disorder

Objective： To investigate the characteristics of organic mental disorders in judicial expertise. Method：We collected 223 cases of organic mental disorders and divided them into accident group （n = 177 ） and non-accident group （ n = 46）. The illness causes, general conditions, purposes of judicial expertise and symptoms were analyzed between the two groups. Results：There was a significant difference for age between the two groups, with more younger patients in accident group, aged （33.7 ± 14.3） years, and more middleand-old patients in non-accident group, aged（ 51.6 ± 17.7） years（t =7. 18 ,P 〈0.01 ）. with more male, lower education degree and being evaluated for disability for accident group, and more cases with civil capability evaluation for non-accident group （P 〈 0.01 or P 〈 0. 001 ）. The major etiology diagnosis was brain trauma （ n = 172, 97.2% ） or Alzheimer disease （n = 18, 39.1% ） for accident group and non-accident group, respectively. There was significant difference in symptoms between the two groups, with more amnestic syndrome for accident group and more mental deficiency and mood disorder for non-accident group （ P 〈 0.01 ）. Conclusion： The onset style, illness course, illness duration, development and prognosis in accident group were different from that in non-accident group, which result in different symptoms and purposes of judicial expertise.