甘肃省293例肇事肇祸案件司法精神医学鉴定分析

目的了解甘肃省司法精神医学鉴定现状与特点,探讨精神病患者的涉案特征,为精神病患者肇事肇祸的预防和评估提供参考。方法对兰州市第三人民医院2013年3月-2016年2月的293份司法精神医学鉴定资料的人口统计学及犯罪学特征进行分析。结果 293份鉴定资料中,男性201例(68. 6%),女性92例(31. 4%),男女涉案比例为2. 18∶1;男性和女性的平均年龄分别为(36. 47±11. 63)岁和(35. 21±11. 38)岁;初中及以下受教育程度者209例(71. 3%);有精神障碍者283例(96. 6%),无精神障碍者10例(3. 4%);凶杀案113例,占刑事案件的47. 3%;完全责任能力者24例(8. 2%),限定责任能力者100例(34. 1%),无责任能力者169例(57. 7%)。结论甘肃省肇事肇祸精神病患者以中青年男性为主,多无业且受教育程度较低,刑事案件比例较高,以凶杀、伤害案件为主,作案时多伴幻觉、妄想等精神症状,多无责任能力。     

80年代与9O年代精神疾病司法鉴定案例比较分析

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.     

"民事行为能力"的概念及在鉴定实践中存在的问题探讨

民事司法精神病鉴定的核心,是对"民事行为能力"的评定.过去司法精神病鉴定所受理案件中,大多为刑事案件,对民事案件鉴定的经验和交流较少,因此对有关法律概念的理解不很一致,而且鉴定时也有采用刑事案件的鉴定模式去套用民事案件的鉴定.本文拟对有关问题进行讨论.     

醉酒犯罪司法精神病鉴定的再评定

酒精中毒导致的犯罪成为司法精神病学鉴定中的重要课题之一,现将我室司法精神病鉴定中与醉酒有关的刑事案例分析如下。１　对象与方法作者单位：１０００８３　北京医科大学精神卫生研究所１．１　对象　为我室司法精神病鉴定的刑事案件中诊断为醉酒者３０例,约占同期刑事鉴定案例的４％,均为男性。１．２　方法　根据Ｂｉｎｄｅｒ提出的分类标准,同时参照国内外有关分类标准和鉴定的有关案件对我室鉴定过的案例进行再评定与讨论。２　结果２．１　病理性醉酒　经再评定后仍诊断为病理性醉酒者１例（３．３％）。２．２　复杂性醉酒　再…     

1989-2008年司法精神病鉴定案例资料分析

目的分析1989～2008年司法精神病鉴定案例的特点及一般规律。方法采用自编调查表,对2301例法医精神病鉴定资料进行回顾性研究分析。结果,1．被鉴定人以男性（69．84％）,青壮年居多。其中以刑事责任能力鉴定为主,性自卫能力鉴定居次。2．刑事责任能力鉴定诊断以精神分裂症、情感障碍、器质性精神病、癔症性精神病为主：近10年,无精神病案例及人格障碍案例明显增加。犯罪类型以杀人、伤害案件为主;性防卫能力鉴定诊断精神发育迟滞及精神分裂症为主。因果关系鉴定诊断以脑外伤所致精神障碍及心因性精神障碍为主。民事行为能力诊断以精神分裂症为主。结论近20年鉴定案例以刑事案件的刑事能力及性防卫能力鉴定为主。疾病诊断以精神分裂症、智能障碍为主。近10年刑事责任能力鉴定中无精神病及人格障碍增多,完全责任能力明显呈上升趋势。     

外来打工者与本地涉案者司法鉴定案例的对照研究

目的 探讨外来打工者与本地区涉案者司法精神病学鉴定案例的特征及其异同点。方法 对我院鉴定的96例外来打工者与本地区的111例进行对照研究。结果 与对照组比较,研究组的年龄轻、未婚、文化低、农村、农民及无业人员占的比例高;案件类型研究组以盗窃抢劫居首位(40.6％),其次是凶杀伤害(22.9％),与对照组和有关报道不同;鉴定诊断研究组精神发育迟滞少见(5.2％),伪装精神病占的比例较高(8.3％),拘禁性精神障碍占的比例也较高(9.4％)。结论 两组司法精神病学鉴定的特点有所不同,打工者犯罪后诈病多见,应引起司法精神病学界的重视。     

刑事案件精神病鉴定的诊断与既往精神病诊断的一致性

目的:探讨刑事案件中司法精神病鉴定的诊断(简称鉴定诊断)与既往精神病诊断(简称既往诊断)的一致性,从人口学特征、病史资料的角度分析相关影响因素。方法:本研究为期限两年的纵向研究,于2016年1月至2017年12月连续纳入既往有精神病诊断的刑事责任能力鉴定的案例173例,以两年观察期内鉴定诊断与既往诊断不一致作为结局事件,采用Cox回归模型的方法分析与诊断不一致相关的独立风险因素并计算各因素的风险比(HR)。结果:诊断一致组85例(49.1%),诊断不一致组88例(50.9%)。两组在吸毒、前科、刑事责任能力上的差异有统计学意义(P0.01)。鉴定诊断与既往诊断的一致性较差(Kappa=0.372,P0.001)。鉴定诊断以精神分裂症(25.4%)、精神活性物质所致精神障碍(24.9%)、人格障碍(22.5%)较多见。既往诊断以精神分裂症(52.0%)、心境障碍(22.5%)较多见。鉴定诊断与既往诊断的分布差异有统计学意义(Z=-3.325,P=0.001)。Cox回归分析显示,前科(HR=1.832,P=0.033)与吸毒史(HR=3.642,P0.001)是预测诊断不一致的主要因素。结论:刑事案件精神病鉴定的诊断与既往精神病诊断常不一致;前科、吸毒史等病史资料的补充是两种诊断产生差异的主要因素。     

性自我防卫能力评定的法律基础及其鉴定实践中的问题

自我防卫能力是我国最高人民法院、最高人民检察院、公安部、司法部和卫生部制定的《精神疾病司法鉴定暂行规定》(以下简称为暂行规定 )于 1989年颁布后正式提出的法定能力名称。由于适用于强奸案件的鉴定 ,司法鉴定人员常惯称为性自我防卫能力 (以下简称为性自卫能力 )。对于此名称的合理性及鉴定中涉及的具体问题 ,司法精神病学界颇有争议。一、名称的法律基础[1 3]在《暂行规定》颁布之前 ,对这类案例的法是能力名称的使用比较混乱 ,如责任能力、行为能力、性行为能力等。归纳这类案例有下列特点 :(1)案件性质 :刑事案件 ;(2 )鉴定对象 …     

司法精神病鉴定中不同结论的原因及对策探讨

近几年，随着我国法制建设的不断完善，重新进行司法精神病鉴定的案件日益增多，而鉴定结论(包括医学诊断结论、法定能力评定等)不同的状况也日益增多，目前已成为司法机关处理案件中的难题。为了正确认识及处理好不同鉴定结论问题，须深入探讨不同结论产生的原因和改进工作的对策，从而进一步提高我国司法精神病鉴定工作质量。     

司法精神医学鉴定无精神病171例分析

目的探索司法精神鉴定诊断为无精神病案例的特点。方法对171例司法精神医学鉴定中被诊断为“无精神病”的鉴定案例资料进行回顾性分析。结果无精神病案例占鉴定总数的26.80%,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。结论多因素综合分析有助于无精神病案例的司法鉴定。     

Reassessing the aftercare treatment of individuals found not guilty due to a mental disability in Hunan, China: supplemental study into the disposition of mentally ill offenders after forensic psychiatric assessment

OBJECTIVE: The purpose of the present paper was to examine the disposition of individuals in Hunan, China who are found not criminally responsible due to a mental disorder or defect. METHOD: Self-developed questionnaires were mailed to the family members of 240 patients who had received forensic psychiatric evaluations at the forensic psychiatric assessment center of Central South University, between 2001 and 2002. RESULTS: One hundred and seventy questionnaires were fully completed and returned by the patients' family members. According to the answers, 64.1% (109 patients) were found not criminally responsible due to a mental disorder or defect. In 87.6% of the cases, a judgement of guilty was in agreement with the psychiatrist's recommendation concerning criminal responsibility. A total of 61.8% of the patients found not guilty were discharged to their families and did not receive any further psychiatric treatment. CONCLUSION: In most cases, judicial decisions are consistent with a psychiatrist's opinion of criminal responsibility due to a mental disorder or defect. After such adjudication, further psychiatric treatment is often neglected due to the lack of resources and information. Hunan, China must make a continued investment into the availability and quality of outpatient mental health treatment for forensic patients after they have been discharged.     

54例颅脑创伤有关精神障碍的司法鉴定

目的 探讨精神损伤的司法鉴定。方法 对54例与颅脑创伤有关精神障碍司法鉴定进行分析,按精神损伤程度分重伤组与非重伤组统计,卡方检验。结果 54例中,颅脑创伤所致智能障碍38例(70.4％),遗忘综合征1例(1.8％),精神病7例(12.9％),反应性精神病3例(5.6％),诱发精神疾病5例(9.3％),均没有评定损伤或伤残等级。重伤组与非重伤组颅脑外伤等级的差异有显著性(x~2=18.54,P<0.01)。与颅脑创伤有关精神障碍的司法鉴定有增多的趋势。结论 颅脑创伤所致精神障碍的严重程度和颅脑外伤损伤程度有关,制定统一的精神损伤鉴定标准,进一步完善颅脑创伤所致精神障碍的司法鉴定刻不容缓。     

不同类型刑事案例的司法精神病资料比较

目的 探讨不同类型刑事案例的司法精神病鉴定特点,方法 将２９４例司法鉴定刑事案例分成智力型,暴力型与性攻击型三组进行社会人口学及司法精神病学资料比较,结果 智力型案例作案时多存在不同程度智能障碍,多诊断为精神发育迟滞,精神分裂症和无精神病,作案动机多为现实,多评定部分及完全责任能力,暴力型案例作案动机多为病理,不明或混难事 ,作案者多为农业劳动者,诊断多为精神分裂症,无责任能力为主;性攻击型案例作     

不同时期精神疾病司法鉴定案例比较

目的探讨我院不同时期所进行的精神疾病司法鉴定案例特点。方法对我院1987年-1996年司法鉴定的292例(A组)与1997年-2003年鉴定的1097例(B组)案例,按鉴定类型、疾病种类、犯罪类型等进行对照分析。结果责任能力、受审能力、申办户口等的例数显著增多,性防卫能力、服刑能力鉴定例数显著减少且评定标准趋严;在责任能力鉴定中,精神正常者、精神发育迟滞(MR)患者的比例显著增多,应激障碍者显著下降;MR和癫痫所致精神障碍的责任能力评定明显趋严。强奸犯罪的亦显著改变。结论应加强对司法精神病学,尤其是责任能力评定的研究,以便更加规范、客观。     

Review of psychiatric services to mentally disordered offenders around the Pacific Rim

This article was commissioned to collate and review forensic psychiatric services provided in a number of key Pacific Rim locations in the hope that it will assist in future dialogue about service development. The Board of the Pacific Rim College of Psychiatrists identified experts in forensic psychiatry from Australia, Canada, China, Hong Kong, Japan, Russia, Singapore, Taiwan, and the US. Each contributor provided an account of issues in their jurisdiction, including mental health services to mentally disordered offenders in prison, competence or fitness to stand trial, legal insanity as a defense at trial, diminished responsibility, and special forensic services available, including forensic hospitals and community forensic mental health services. Responses have been collated and are presented topic by topic and country by country within the body of this review. The availability of mental health screening and psychiatric in‐reach or forensic liaison services within prisons differed considerably between countries, as did provisioning of community forensic mental health and rehabilitation services. Diversion of mentally disordered offenders to forensic, state, or hybrid hospitals was common. Legal constructs of criminal responsibility (insanity defense) and fitness to stand trial (“disability”) are almost universally recognized, although variably used. Disparities between unmet needs and resourcing available were common themes. The legislative differences between contributing countries with respect to the mental health law and criminal law relating to mentally disordered offenders are relatively subtle. The major differences lie in operationalizing and resourcing forensic services.     

我国司法精神病学现状的研究

目的 探讨中国司法精神病学研究现状及其发展方向。方法 对１９７６￣１９９５年１０种精神科专业杂志中有关司法精神病学的２３１篇文章进行分析,并将１９９１￣１９９５年的研究结果与１９７６￣１９９０年进行比较。结果 １９９１年后发表的文章（１３０篇,５６．３％）是１９９０年前发表文章（１０１篇,４３．７％）的１．２９倍。１９９１年后性犯罪案例（１２．２５％）和性自卫能力评定的比例（２６．２５％）较１９９     

司法精神病鉴定中限定刑事责任能力评定(附95例分析)

目的：对司法精神病鉴定中评定为限定刑事责任能力进行讨论。方法：对95例司法精神病鉴定中评为限定刑事责任能力案例进行分析。结果：限定刑事责任能力的评定在鉴定中可酌情应用。结论：限定责任能力大致可见于以下几种：①精神病性症状与作案无直接关系；②继发性人格障碍而非疾病直接导致；③轻、中度精神发育迟滞；④其他精神活动障碍。     

Older criminals: a descriptive study of psychiatrically examined offenders in Sweden

OBJECTIVE: We retrospectively examined psychiatric diagnoses of older offenders referred by court for psychiatric assessment in Sweden, and compared them with younger offenders. METHOD: In Sweden, structured court-ordered forensic psychiatric evaluations are undertaken by a forensic psychiatric team. Data on age, sex, citizenship, psychiatric diagnoses, offences, and legal insanity declarations were obtained for the years 1988-2000 (n = 7297). RESULTS: There were 210 forensic psychiatric evaluations in those aged 60 and over. 7% had a diagnosis of dementia, 32% psychotic illness, 8% depressive or anxiety disorder, 15% substance abuse or dependence, and 20% personality disorder. Older offenders were significantly less likely to be diagnosed with schizophrenia or a personality disorder, and more likely to have dementia or an affective psychosis compared to younger ones. Logistic regression analyses suggested that of the studied factors, the ones most typical of older offenders were a diagnosis of dementia and being charged with a sexual offence. CONCLUSION: There appear to be important differences in psychiatric morbidity between older offenders and younger ones who come into contact with forensic psychiatric services. This research may assist in the planning of forensic and therapeutic services for the increasing number of older adults passing through the criminal justice system.     

精神障碍者限定刑事责任能力的评定分级

目的：研究对限定责任能力进行分级的可行性。方法：根据责任能力受影响的程度将106例限定责任能力案例分为三组,对他们的作案特点和疾病严重程度进行比较分析。结果三组在作案特点和疾病严重程度上存在显著差异：小部分组多起意过程简单(92％)、作案前缺乏先兆(84％)及计划准备(84％),缺乏自我保护(64％),对作案行为的认识模糊,自知力、生活自理能力及工作学习能力受损严重;大部分组多正常起意(76．9％)、作案前有先兆(46．2％)及计划准备(76．9％),有自我保护(74．4％),对作案行为的认识较完整,有一定自知力,生活自理能力及工作学习能力受损轻;部分组则介于两者之间。结论限定责任能力可以被划分为三级。     

Psychiatric and psychological evidence in the Supreme Court of Iceland—2001 to 2007

Background: Little is known about expert psychiatric and psychological evidence in appeal cases. Aims: To review the frequency, nature and impact of expert psychiatric and psychological evidence in the Supreme Court in Iceland over a 7-year period where all appeals in Iceland are heard. Method: All cases listed on the Supreme Court's Website between 2001 and 2007 were identified. The judgements were carefully screened for relevant information. Details of the nature of the criminal offences for the sample were obtained from official records. Results: 3367 cases were identified. Psychiatric and psychological evidence was considered in 213 (6.3%) cases (2.7% and 4.2% for the two disciplines, respectively), with only 10% cases involving reports from both disciplines. Psychiatrists focused primarily on assessing violent offenders, diminished responsibility issues, restraining orders, and mental state examinations and diagnosis, whereas psychologists were more commonly involved in custody disputes and credibility assessments of victims of sexual offending. No oral expert evidence was heard in the Supreme Court. Psychiatric and psychological evidence was typically that previously presented in the District Courts. Conclusions: This is the first comprehensive study to investigate the contribution of forensic psychiatry and psychology in appeal cases. Psychiatrists and psychologists have complementary skills for the assessment of court referrals. Their evidence and recommendations in appeal cases in Iceland are accepted by the Supreme Court in the great majority (78%) of cases.