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。     

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     

不同病期精神分裂症司法精神医学鉴定比较

目的：探讨不同病期精神分裂症患者的司法精神医学鉴定特点。方法：将147例精神分裂症划分为早期、发展期、缓解期和残留期进行比较。结果：以凶杀伤害为主的暴力型作案多见于早期与发展期，其作案动机以病理性为主。缓解期以现实动机为主，残留期以混合动机为主；早期与发展期无1例评定为完全责任能力，缓解期无1例评定为无责任能力，残留期以部分责任能力为主。结论：不同病期精神分裂症的司法精神医学鉴定存在一些不同特点，有助鉴定结论的评定。     

精神病患者凶杀行为特征及与责任能力相关性的研究

目的探讨精神病人凶杀行为特征及与责任能力的相关性。方法用自编凶杀行为特征调查表综合司法精神病鉴定中181例重型精神病病人和47例非精神病人凶杀案例的资料,采用SPSS13.0软件统计并进行凶杀行为特征的比较和责任能力与行为特征的相关分析。结果①两组在年龄构成、性别分布、婚姻状况及性格特征方面无显著性差异(P>0.05),在受教育程度和职业分布上差异有显著性(P(0.01);两组在作案诱因和先兆、预谋、方式、对象、动机、作案后的自我保护性、责任能力多方面有显著性差异(P(0.01)。②Logistic回归分析表明作案动机、隐蔽性、保护性、作案方式、诱因、病期和对象与责任能力的评定均呈显著性相关(B0.721~28.71;P0.000~0.027)。结论精神病人的凶杀行为特征与非精神病人有明显差异,其责任能力的评定依次与动机、隐蔽性、保护性、作案方式、诱因、病期和对象密切相关。     

早期精神分裂症刑事作案的责任能力相关因素分析

目的探寻在刑事作案中早期精神分裂症患者的特点及影响责任能力评定的相关因素。方法回顾性调查本中心司法鉴定室1991年至2000年间所作的本中心司法鉴定刑事案例资料，将早期精神分裂症患者与非早期精神分裂症患者和正常者进行分组比较，对家族史、案型、案前精神状况、作案诱因、作案动机、隐蔽性、作案对象、自我保护、鉴定诊断、症状特点、责任能力评定等相关因素用SPSS软件作统计分析。结果早期精神分裂症患者组在精神病家族史、文化程度、职业等方面与其他组相比有显著差异：自我保护、思维障碍、行为障碍等变量对三组被鉴定人具有差别效应。结论为提高在司法精神医学鉴定实践中对早期精神分裂症鉴定的准确性，应重视精神病家族史、作案动机、自我保护、思维障碍、行为障碍诸因素。     

司法精神病鉴定患者的脑电图分析

司法精神病鉴定患者的脑电图分析张广岐韩素凤为了探索脑电波变化与司法精神病鉴定患者的案由、作案动机、疾病诊断之间的关系，我们对１０７例司法精神病鉴定患者的脑电图资料分析于下。１．对象和方法：搜集１９９１年１月至１９９３年９月经司法鉴定确认精神疾病的案例...     

精神分裂症不同作案动机的责任能力分析

目的 通过对既往鉴定的114例精神分裂症刑事案件进行责任能力、疾病时期、动机类型、案件类型分类分析,探讨对不同作案动机中不同责任能力的理解,尤其是对现实动机中不同责任能力认定的认识。方法 依据“动机论”的定义,对1996～2001年涉及刑事案件鉴定结论为精神分裂症的114例进行再评定分类,采用百分比和卡方检验分析责任能力与四种不同作案动机类型、所处疾病时期、所涉案件类型及案件类型与疾病期的关系。结果 责任能力的认定与作案动机、与病人所处疾病时期之间有着显著相关性;不同的作案动机在不同的疾病时期明显不同,也存在相关性。结论 “动机论”是责任能力认定的一个良好参照指标,同时要综合病人疾病的严重程度、整体精神状态、所处疾病时期、境遇、社会功能等多方面因素。     

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。     

33例自杀前凶杀或伤害案的司法鉴定特点分析

目的探讨在自杀前凶杀或伤害他人案例的司法精神医学鉴定特点。方法对33例自杀前凶杀或伤害他人案例的司法鉴定资料进行回顾性分析。结果自杀前凶杀或伤害案例的诊断以精神分裂症、应激相关障碍为最多见,作案原因以精神病性症状影响或支配、扩大性自杀和报复性自杀为多见．不同作案原因的鉴定诊断及责任能力有所不同．不同鉴定诊断的作案原因与责任能力也存在区别。结论通过分析下同诊断、不同作案原因及它们之间的关系,并区分各自的责任能力特点．有助于提高司法精神医学鉴定的质量。     

现实动机作案与责任能力的关系

目的：探索司法精神医学鉴定中现实动机作案者与责任能力之间的关系。方法：分析78例现实动机作案者的责任能力。结果：除24例无精神病外，其余54种有各种精神障碍的作案者中有31例评定为限制责任能力，23例评定为完全责任能力，无1例能完全免除责任能力。结论：动机论适合于司法精神鉴定实践，现实动机作案者，不论其精神状态如何，均不能完全免除刑事责任。     

责任能力与作案特征、作案时精神症状的相关分析

目的:探讨责任能力与作案特征、作案时精神症状的相关性. 方法:通过使用精神疾病患者限定刑事责任能力评定量表及简明精神病评定量表(BPRS)等工具,对504例刑事案件鉴定案例的责任能力、作案特征及作案时精神症状进行相关分析. 结果:责任能力与BPRS中精神病性症状的相关性较大(0.5相似文献   

Criminal responsibility in sexual homicide perpetrators

OBJECTIVE: Evaluation of criteria for criminal responsibility, esp. in paraphilias and personality disorders. METHODS: We compared sexual murderers with diminished responsibility or not-guilty for reasons of insanity (n = 73) and those held fully responsible (n = 61) regarding psychiatric disorders, signs of severe paraphilias, level of personality structure (using Operationalized Psychodynamic Diagnostics) and offence related criteria. RESULTS: Sexual murderers found as diminished responsible or not-guilty, especially those detained in forensic psychiatric hospitals, showed more signs of a progressive sadistic development and lower levels of personality structure. Offence related criteria that are regarded as not supporting a diminished capacity plea (purposeful actions, long duration, complex, stepwise course of the offence) were found more frequent in those offenders that were detained in forensic hospitals. CONCLUSIONS: Signs for severity of paraphilias and personality disorders are useful in decisions about criminal responsibility. Criteria regarding purposeful course of action appear not to be adequate for the assessment of paraphilic sexual offenders.     

341例精神分裂症被鉴定人精神症状与社会危害行为的关系

目的探讨精神分裂症被鉴定人精神症状与社会危害行为的相关性。方法采用自制的调查表,通过查阅委托单位的鉴定委托送交材料和鉴定意见书的方式对湖南省341名无责任能力精神分裂症被鉴定人实施社会危害行为时存在的主要精神症状如幻觉、妄想、同时存在幻觉和妄想、思维逻辑障碍、行为紊乱等与其社会危害行为包括严重暴力社会危害行为、非严重暴力社会危害行为等信息进行登记,并进行关联性检验。结果①严重暴力社会危害行为组与非严重暴力社会危害行为组间不同精神症状构成比存在差异(χ2=16.259,P=0.003),精神症状与社会危害行为之间有关联(列联系数为0.213)。②精神分裂症被鉴定人实施严重暴力社会危害行为时以妄想症状出现的频数最多128例(45.7%);实施非严重暴力社会危害行为时以思维逻辑障碍出现的频数最多27例(44.3%)。③与严重暴力社会危害行为有关的妄想症状类型以被害妄想为主占106例(82.8%)、幻觉症状类型以命令性幻觉为主占13例(54.2%)、同时存在幻觉、妄想症状的以其它言语性幻听和被害妄想为主占76.6%。结论精神分裂症被鉴定人严重暴力社会危害行为可能主要与妄想有关,其非严重暴力社会危害行为可能主要与思维逻辑障碍有关。其中被害妄想、命令性幻听、同时存在其它言语性幻听和被害妄想的精神症状类型可能与精神分裂症被鉴定人严重暴力社会危害行为有关。     

Jeu d’argent problématique et responsabilité pénale

ObjectivesIn total, 14% to 30 % of individuals with gambling disorder engage in illegal acts to finance such behavior. This clinical situation could be explained by higher gambling severity, associated substance use disorder, antisocial personality disorder and economic factors (debts, financial problems). The present work focuses, more broadly, on criminal responsibility of problematic gamblers.MethodsWe will discuss this question through different typical situations that medical experts of criminal responsibility may have to face. We will address each of the following cases: 1) isolated problematic gambling; 2) problematic gambling associated with antisocial personality disorder; 3) problematic gambling associated with a manic episode; 4) problematic gambling associated with substance use disorders; and 5) problematic gambling associated wiht dopamine agonist treatment.ResultsIsolated problematic gambling, (not associated with any psychiatric or addictive disorder): it seems consensual that individuals committing infractions in this case are criminally responsible. However, impeded ability to action control and possible sentence attenuation could be discussed in case of severe gambling disorder. Problematic gambling associated with antisocial personality disorder: if the penal offence reports solely to personality disorder, criminal responsibility would be attributed. However, if illegal or violent acting is directly linked to co-cocurrent delusional symptoms, it could be a cause of criminal non-responsibility. Problematic gambling associated with manic episode: manic episode related offence could lead to negation of criminal responsibility, while a hypomanic episode may provide grounds for sentence reduction. Problematic gambling associated with substance use disorders: in France, addiction is not considered to remove nor to impede a person's ability to understand or control his actions and is excluded from criminal non-responsibility causes. However, substance induced delusional or confusional episodes could abolish a subject's discernment or his ability to control his actions yielding to penal non-responsibility. Problematic gambling associated with dopamine agonist treatment: Criminal responsibility for dopamine agonist induced gambling related illegal acts is still controversial. Nevertheless, people committing an infraction linked to associated dementia or dopamine agonist induced mania should be considered as criminally non-responsible.ConclusionsSome clinical dimensions such as craving intensity, compulsivity, disorder's severity, volitional control might be forensic targets to assess criminal responsibility.     

Incipient offending among schizophrenia patients after first contact to the psychiatric hospital system.

The study examines how age, sex and substance use disorder are associated with the risk of committing a criminal offence. The study explicitly examines the risk after the first contact to the psychiatric hospital system and after the diagnosis of schizophrenia for those with no previous criminal record; the association between previous non-violent criminality and later violent criminality is also analysed. The study sample comprised 4619 individuals ever diagnosed with schizophrenia. All solved offences were accessible. Data were analysed using Cox's regression. Schizophrenic men had twice the risk of schizophrenic women of committing both violent and non-violent offences. A registered substance use disorder increased the risk 1.9- to 3.7-fold, depending on the starting point for the analyses, while increasing age on first contact or when diagnosed with schizophrenia diminished the risk. Previous non-violent criminality increased the risk for later violent criminality 2.5- to 2.7-fold, depending on the starting point for the analyses. The results suggest that the psychiatric treatment system can play an active role in preventing criminality among individuals with schizophrenia. The preventive measures should be based on a thorough assessment including criminal history at intake and alertness toward young psychotic men with substance use disorders and especially if they also have a criminal history.     

Rethinking criminal responsibility: practical application of operational diagnosis and gnostic into expert testimony]

There had been argument concerning the difference between the agnostic approach and the gnostic approach to the psychiatric perspective of criminal responsibility until the landmark ruling by the 3rd court of the Japanese Supreme Court in 1984. The decision upheld the gnostic approach and affirmed that the defendant's criminal responsibility should be based on such factors as psychopathology, motive, modus operandi, situation surrounding the crime, and pre-morbid personality, as long as the offense was not directly motivated by the delusion or hallucination. The gnostic explanation includes so many various factors that the psychiatric testimony cannot easily be objective, while agnostic experts can find a conclusion about criminal responsibility only by psychiatric diagnosis. To establish a standard, the authors summarized the means of determination of criminal responsibility. The authors also discussed various topics related to criminal responsibility including Asperger's syndrome, illicit drug intoxication, and prescribed drug intoxication.     

Psychiatric testimony and the "reasonable person" standard

The aim of this article is to explore the boundaries of psychiatric testimony in criminal cases. In a series of vignettes, the author describes applications of psychiatric testimony in nontraditional areas. These are criminal cases in which the defendant-who was not mentally ill-acted in response to a situation that would tend to trigger violence in many persons: protection of self or others. In scenarios involving self-defense, duress, and passion/provocation, the dynamics involve interpersonal situations that give rise to behavior that may be entirely foreign to the defendant but that could not have been avoided. The law looks at these matters through a "reasonable person" standard: what the ordinary citizen would have done. In principle, there is often no need for expert testimony, because judges and jurors are presumed able to assess reasonableness, justification, or provocation. The trier of fact, however, could use a psychiatric explanation to assess culpability. The author discusses the cases in terms of application and admissibility.