女性精神障碍患者被性侵害司法鉴定案例分析

目的：探讨女性精神障碍患者被性侵害案例的特征。方法对273例女性精神障碍患者被性侵害的鉴定资料进行回顾性分析。结果被性侵害的女性精神障碍患者中以精神发育迟滞者居多（68．1％）,其次为精神分裂症（19．4％）;性自我防卫能力削弱者（55．3％）明显多于性自我防卫能力丧失者（26．7％）及性自我防卫能力存在者（18．0）;无性自我防卫能力者以精神分裂症居多（57．5％）,其次为重度精神发育迟滞（21．9％）、中度精神发育迟滞（12．3％）、器质性精神障碍（5．5％）。结论女性精神障碍患者性自卫能力丧失或削弱者居多,社会及家庭应加强对女性精神障碍患者的监护与管理。     

女性精神障碍患者受性侵害案例临床特征分析

目的探讨女性精神障碍患者受性侵害案例的临床特征。方法采用自编性侵害测评问卷对89例受性侵害女性的鉴定资料进行回顾性分析。结果77．5％的受性侵害者年龄在14a～30a；中小学文化以下占78．6％，文盲占57．3％；农民占64％，无业占29．2％；71．9％性自我防卫能力丧失或削弱，且均为精神发育迟滞和精神分裂症患者；性侵害者与受性侵害者是熟人或亲属者占84．3％，由受性侵害者家属或本人提出鉴定要求者占74．1％。结论受性侵害者人口学特点为青少年妇女、农民或无业、文盲者。中度以上精神发育迟滞和发作期精神分裂症患者的性自我防卫能力削弱，甚至丧失，这类女性精神障碍患者更容易受到性侵害。     

女性精神发育迟滞患者被强奸司法鉴定案例分析

目的探讨女性精神发育迟滞患者被强奸案例特征及性防卫能力等相关因素，为更好地保护女性精神病的合法权益提供依据。方法采用自制统计表对97例女性精神发育迟滞被强奸案例的鉴定资料进行统计分析。结果女性精神发育迟滞被强奸案例的年龄呈明显偏态分布，〈35a者占83．2％，以20a左右年龄段比例最高，随着年龄的增加呈逐渐下降趋势。文化程度低（89．7％、农民（80％），无业人员（12．6％）、有既往疾病史（37．8％）、有阳性家族史（21．2％）为多。结论女性精神发育迟滞患者由于其性防卫能力丧失或减弱，更容易出现性受害，且性受害后不易暴露。     

精神病司法鉴定中性自我防卫能力鉴定分析

目的探讨精神病司法鉴定中女性精神障碍患者被性侵害案例的特征。方法对91例女性精神障碍患者被性侵害案例的鉴定资料进行回顾性分析。结果被性侵害的女性精神障碍患者中以精神发育迟滞者居多（68．1％）,其次为精神分裂症（24．2％）;性自我防卫能力削弱者（63．7％）明显多于性自我防卫能力丧失者（34．1％）及性自我防卫能力存在者（2．2％）;无性自我防卫能力者以精神分裂症居多（58．1％）,其次为中度精神发育迟滞（22．6％）、轻度精神发育迟滞（9．7％）。结论女性精神障碍患者性自卫能力丧失或削弱者居多,社会及家庭应加强对女性精神障碍患者的监护与管理。     

45例酒精所致精神障碍临床分析

目的探讨酒精所致精神障碍的临床特征及躯体损害。方法对45例酒精所致精神障碍患者进行回顾性分析。结果酒精所致精神障碍患者以男性、文化程度较低、体力劳动者居多，社会功能受损明显，精神障碍以幻觉、被害妄想及行为紊乱为主。临床表现多合并躯体疾病，以肝脏疾病较为多见。结论酒精所致精神障碍患者宜早期戒酒治疗。     

精神障碍妇女性自我防卫能力评定的若干问题

本文复习近10年性自我防卫能力评定的有关丈献，结合个人长期司法精神病鉴定实践，对性自我防卫能力的法律基础、概念、以及评定中经常遇到的一些有争议的问题进行了详细的讨论。     

司法精神医学鉴定94例性受害案例分析

目的探讨女性精神病患者性受害者的疾病种类、精神状态及性防卫能力等因素,为更好地防范此类案件的发生提供依据。方法采用自制调查表对94例女性精神病患者性受害鉴定案例资料进行分析。结果女性受性侵害司法精神病鉴定案例中以精神发育迟滞患者为多见（69．15％）,其次为精神分裂症（14．89％）、癫痫及癫痫所致精神障碍（7．45％）等。59．58％性防卫能力丧失,32．98％性防卫能力削弱,而具有性防卫能力者仅占6．38％。在所有案例中,罪犯多数为受害人所熟悉的人,且多发生在受害人或罪犯家里,犯罪分子常采用食物诱惑或以言语威胁为手段,表明女性精神病患者性受害与其性防卫能力丧失或削弱有关。结论女性精神病患者性防卫能力多丧失或削弱,犯罪分子常以她们作为性侵害目标,为更好的保护这一弱势群体的合法权益,应在司法部门加大打击犯罪力度的同时,社会及其家属还要加强对女性精神病患者的性教育及监护治疗。     

女性精神分裂症和精神发育迟滞患者性防卫能力司法鉴定

目的探讨女性精神分裂症和精神发育迟滞患者性侵害时性防卫能力评定的有关因素。方法对193例女性精神分裂症和精神发育迟滞性侵害患者性防卫能力的司法鉴定资料进行分析。结果精神分裂症、精神发育迟滞分别占女性性侵害鉴定案件的12．2％、82．0％,两者文化程度、婚姻状况、精神病家族史、有无躯体疾病合并症及脑电图状况比较差异有显著性（P〈0．05或0．01）。本组患者性防卫能力鉴定为丧失占88．1％,削弱占7．3％,存在占4．7％;不同性防卫能力患者案件特征、性自我防卫能力量表评分及日常生活能力量表评分比较差异有显著性（P〈0．05或0．01）;精神分裂症及中重度精神发育迟滞患者多无性防卫能力,轻度精神发育迟滞患者中性防卫能力丧失占51．1％,削弱占28．9％,存在占20．0％。结论女性精神分裂症及中重度精神发育迟滞患者多无性防卫能力,轻度精神发育迟滞患者性防卫能力的评定是目前司法鉴定的难点,性侵害时的特点、案件特征、性自我防卫能力量表评分及日常生活能力量表评分是评定女性性防卫能力的因素,对评定女性性防卫能力有重要作用。     

癫痫性精神障碍司法鉴定12例分析

癫痫性精神障碍司法鉴定１２例分析王金祥，周平良（南昌市第二医院，南昌３３０００３江西省精神病院）本省有关癫痫性精神障碍的司法鉴定报告不多，笔者从某院１９８１年至１９９４年的司法精神病学鉴定案例中查出１２例癫痫性精神障碍鉴定案例分析如下。１资料分析１．...     

酒精中毒性精神障碍32例分析

近年来,随着社会经济的发展．人民的生活水平不断提高．酒的饮用也逐年上长,由此而带来的问题是,酒中毒的病人日益增多．现将我科7年收治的32例酒精中毒性精神障碍,在药物治疗的同时,配合心理治疗．获得满意效果报告如下。     

Male sexual assault

Reported cases of sexual assault in the United States increased 21% from 1974 to 1978. Recent literature discusses the medical, legal, and psychological management of the female sexual assault victim, but little has been written regarding appropriate management of male sexual assault. Twenty-nine male sexual assault victims were examined at University Hospital from 1976 to 1980. This study reviews evidence of genital and extragenital trauma and the percentage of those requiring gonorrhea prophylaxis. It further studies the background and characteristics of the sexual assault victim, characterization of the assailant, as well as the details and time of the assault. Information concerning male sexual assault and the unique problems associated with this group is scarce. This study is intended to aid in the development of an effective protocol in dealing with this group of patients and to sensitize physicians to this group of patients.     

女性精神病患者性自卫能力司法鉴定资料分析

目的探讨女性精神病患者性自卫能力的影响因素,依法维护女性的合法权益。方法采用自制调查表对被鉴定的72例女性精神病患者被强奸案例进行调查分析。结果被强奸的女性精神病患者中,精神发育迟滞占84．72％,精神分裂症占12．5％,躁狂症占2．78％;性自卫能力丧失占81．94％,性自卫能力削弱13．89％,性自卫能力存在占4．17％。多数发生在受害人或犯罪嫌疑人家中,案发地以乡村居多（80．56％）。结论女性精神病患者被强奸与其性自卫能力丧失或削弱有关,为切实维护女性精神病患者的合法权益,应建立预防机制,加强监护,并长期进行生活能力培训及性防卫能力的培训。     

Unique sexual assault examiner program utilizing mid-level providers

Background: We implemented a unique sexual assault examiner (SAE) program utilizing Emergency Department (ED)-based mid-level providers. Sexual assault forensic evidence collection processes and training are not uniform in all EDs, with varying models in place. Methods: Our study evaluated the quality of SAE evidentiary collection in standardized evidence kits (Kits), compared to Kits from other EDs without the SAE program. We prospectively studied Kits from November 2004–October 2005. All Kits were evaluated for quantity (numbers of slides, envelopes, swabs), and quality (compliance with forensic standards) of evidence. Results: Although SAE Kits had similar total numbers of pieces of evidence, they had higher quality as measured by a greater number of compliant envelopes (5.44 vs. 1.44, p < 0.001) and a greater number of compliant slides (6.4 vs. 4.5, p < 0.001). SAE Kits had two measures with higher quality forensic evidence than non-SAE Kits. Conclusion: An integrated program of SAE-trained mid-level providers collect sexual assault Kits with a higher quality of forensic evidence than non-SAE providers.     

Emergency department management of the sexual assault victim

The optimal management of the sexual assault victim involves a multidisciplinary effort on the part of all legal, police, medical, and support personnel who interface in the emergency department. History, general physical examination, and pelvic examination are performed methodically, keeping in mind that the primary goal is to tend to the patient's medical needs. The gathering of evidence proceeds simultaneously with the physical examination. Evidence to be obtained and techniques are reviewed. Treatment entails attention to physical injuries, potential venereal disease and pregnancy, and psychiatric intervention. Management of the male rape victim or child victim of sexual abuse requires special attention to the peculiarities of those problems.     

Gynecological health impact of sexual assault

We examined the relationship between sexual assault and gynecological health symptoms (e.g., pelvic pain, painful intercourse) in a sample of predominately African American female veterans. Those who had been sexually victimized experienced significantly more frequent gynecological health symptoms than those who had not been assaulted. Multiple forced penetrations, assault by an intimate partner, having weapons used, physical injury, belief that the victim's life was in danger during the assault, and serving in the military at the time of assault increased the likelihood of reporting particular gynecological health symptoms. Screening women in health care settings for a history of violence can link women to resources and treatment for assault-related health symptoms.     

Listening to mental health workers' experiences: factors influencing their work with women who disclose sexual assault

Women are overrepresented within mental health service-use statistics, and a disproportionate number of them have experienced sexual assault. While mental health workers are often the first point of contact between these women and the mental health system, within the research to date, women have often reported a negative experience of disclosing sexual assault to these workers. This article presents findings from an exploratory Australian study. The aim of the study was to explore factors that influenced how mental health Crisis Assessment and Treatment Service (CATS) workers respond to women who disclose sexual assault in crisis service settings. Fifteen CATS workers were surveyed and the predominantly qualitative data were then analysed using thematic analysis. This article presents two key findings: (i) the majority of participants had not experienced adequate sexual assault training, and seven of the 15 did not feel well equipped to respond to a disclosure of sexual assault; and (ii) they rarely consulted or referred women to specialist sexual assault services, despite recognizing the significant impact of sexual assault on mental health functioning. Recommendations are made for training and increased communication between mental health and sexual assault service systems to ensure better outcomes for women.