精神分裂症攻击行为的对照研究

为了探讨精神分裂症攻击行为的相关因素，对４３例有攻击行为的精神分裂症患者和８２例无攻击行为的精神分裂症患者进行了对照研究。结果显示：既往暴力史，ＥＰＱ—Ｎ分，ＢＰＲＳ的思维障碍、敌对猜疑和激活性三个因子，以及命令性幻听和被害妄想等精神症状是精神分裂症患者攻击行为的主要危险因素。提示这些危险因素对精神分裂症攻击行为具有预测价值     

伴有幻觉和妄想的Alzheimer病的临床特点

作者对比分析了７６例Ａｌｚｈｅｉｍｅｒ病中有幻觉和妄想症状以及无幻觉和妄想症状两组病人的起病年龄、认知功能、以及幻觉和妄想症状的出现率。结果显示：前者的起病年龄（６５±７岁）明显晚于后者（６１±６岁），认知功能障碍也轻于后者。幻觉和妄想症状则以幻听、被害妄想最多见。     

伴有幻觉和妄想的Alzheimer病的临床特点

作者对比分析了７６例Ａｌｚｈｅｉｍｅｒ病中有幻觉和妄想症状以及无幻觉和妄想症状两组病人的起病年龄、认知功能、以及幻觉和妄想症状的出现率。结果显示：前者的起病年龄（６５±７岁）明显晚于后者（６１±６岁），认知功能障碍也轻于后者。幻觉和妄想症状则以幻听、被害妄想最多见。     

旅途精神病暴力犯罪特征39例回顾性分析

对３９例旅途精神病暴力犯罪司法鉴定案例进行了分析，发现本组患者最常见的症状是被害妄想、情绪障碍和意识障碍。暴力攻击行为受被害妄想或幻觉直接支配，均指向陌生人。暴力行为的发生有一高峰期。患者受妄想和幻觉的影响。极易采取暴力对抗这种极端应激方式来缓解心理冲突的压力，亦是容易涉及法律问题的重要原因。     

不同年代首次住院精神分裂症患者症状学变化

目的:探讨不同年代首次住院精神分裂症患者症状学变化。方法:对1989年、1999年及2009年各128例首次住院的精神分裂症患者精神病性症状进行分析。结果:感知及情感障碍中各症状出现率各组间差异无统计学意义;思维障碍中被害妄想、夸大妄想、罪恶妄想、关系妄想、钟情妄想出现率差异有统计学意义(P0.05或P0.01);与1989年组比较,2009年组被害妄想、关系妄想出现率明显增高,罪恶妄想、钟情妄想出现率明显下降(P均0.05)。结论:随年代变迁,首次住院的精神分裂症患者思维障碍更多为被害妄想及关系妄想。     

62例旅途性精神病司法鉴定分析

目的探讨旅途性精神病犯罪行为的特点及原因。方法对62例旅途性精神病的卷宗及临床资料进行回顾性分析。结果被鉴定人均系边远地区的务工者,犯罪行为性质以暴力凶杀为主,作案特点多为突然发生,动机不明,无预谋,被害人多为同车旅客或一般路人,与被鉴定人素不相识。作案工具大多为随身携带的劳动工具或即景物件。被鉴定人作案当时均有不同程度的意识障碍、关系妄想、被害妄想和错幻觉。结论旅途性精神病多为暴力犯罪行为,这与其精神病理症状的特点有关,也与该群体所处社会地位有一定关联。     

精神分裂症精神病理学

本文用前瞻性方法收集86例精神分裂症的临床精神病理学资料。发现病例中感知障碍、思维障碍、情感障碍及一级症状的频率均超过半数。各种精神症状中唯一存在显著性性别差异的是冲动伤人,且大多数冲动伤人的发生与幻觉妄想有关。     

独生子女与第一胎非独生子女精神分裂症的临床特征比较

目的探讨独生子女与第一胎非独生子女精神分裂症患者的临床特征。方法对独生子女与第一胎非独生子女精神分裂症患者的临床特征进行比较。结果独生子女精神分裂症患者以关系妄想,被害妄想,被播散感,思维松弛、破裂及情感不协调,紧张冲动行为、焦虑抑郁及言语性幻听症状多见,并且BPRS因子分以焦虑抑郁、思维障碍及敌对性因子分较高。结论精神分裂症的症状受家庭环境的影响。     

分裂症中海马的损伤

在过去的十年中,有关精神分裂症的精神病理学讨论着重于阳性症状(妄想、幻觉及思维障碍)与阴性症状(不语、快感缺乏、情感淡漠、意志缺失和不合群)。然而,特别在一些长期住精神病院的分裂症患者中,有一组症状是很难归类为阳性或阴性症状的。这些症状通常被描述为“古怪行为”,包括烦渴、踱步、不停吸烟、怪异装饰、收藏、刻板行为及仪式性动作。与许多阳性或阴性症状不同,不少这些     

癫痫性精神分裂样精神病与精神分裂症的对照研究

本文对癫痫性精神分裂样精神病与精神分裂症各52例进行对照分析,结果发现癫痫性精神分裂样精神病患者精神症状出现于癫痫发作9.12年之后;与精神分裂症相比,其精神症状出现年龄较大,发病多无诱因,多为急性、亚急性起病,病前性格外向者较多,其癫痫家族史的比率较高,而其精神病家族史的比率较低,其幻听、思维粘滞、病理性赘述、易激惹的出现率较高,而感知综合障碍、破裂性思维、关系妄想、被害妄想、钟情妄想、情感淡漠、情感不协调、意志行为减退的出现率较低,其抗精神病药用量较低,而疗效与精神分裂症组无显著性差异。最后,对癫痫与精神分裂样精神病的关系进行了讨论。     

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。     

司法鉴定中精神分裂症患者与无精神病者暴力行为的对照研究

目的通过对精神分裂症患者和无精神病者鉴定资料的对照研究来探讨分裂症患者暴力行为的特殊性。方法按自制的统一表格详细收集有关被鉴定人的一般人口学资料、临床特点、犯罪特点、鉴定案由、法律能力评定等项目,探讨影响分裂症患者辨认能力、控制能力的因素。结果两组被鉴定人在职业、作案动机、预谋、自我保护和作案先兆等一些与案情有关的特点上存在显著差异。结论精神病理因素对精神分裂症患者辨认和控制能力有重要的影响。     

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.     

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   

精神分裂症患者暴力行为：—司法鉴定资料的对照研究

目的：通过对精神分裂症患者和非精神病肇事者鉴定资料的对照研究来探讨分裂症患者暴力行为的特殊性。方法：收集被鉴定人的临床、历史、案情资料等因子,在有病组和无病组间分别进行显著性检验;然后通过回归分析,分别考察分裂症病人辨认、控制和责任能力的因素,结果：两组被鉴定人一些与案情有关的特点上存在显著差异：其中文化程度、婚姻、职业、作案动机、预谋、自我保护和作案先兆等能够用于预测两组被鉴定人、结论：结论差异反映了精神病理因素对患者辨认和控制能力的影响,说明分裂症病人的暴力攻击是一种疾病状态。     

A questionnaire survey on judgment of criminal responsibility]

The authors conducted questionnaire surveys utilizing model cases with the aim of investigating the current views of psychiatrists regarding criminal responsibility judgments in forensic psychiatric evaluations. Six model cases-injury by a person with acute schizophrenia, indecent assault by a person with chronic schizophrenia, attempted murder by a woman with depression, arson by an alcohol abuser, burglary by an amphetamine abuser, rape and indecent assault by a person with personality disorder-were presented to 345 psychiatrists, who were asked about criminal responsibility and appropriate treatment for each of the cases. One hundred eighty-five of the psychiatrists responded. In the case of acute schizophrenia with hallucination and delusion, the case of severe depression, and the personality disorder case, there was a high level of agreement between the evaluations of criminal responsibility made by the different respondents, but in the case of chronic schizophrenia, the case of alcohol-induced psychotic disorder, and the case of amphetamine abuse, there were variations in the evaluation of criminal responsibility, with many respondents emphasizing the patient's symptoms and condition at the time of the offense, and relatively few emphasizing whether the disorder was endogenous. Regarding the form of treatment, many of the respondents recommended compulsory hospitalization for the case of acute schizophrenia with hallucination and delusion, while at the same time recommending treatment in a prison environment for the personality disorder case. In contrast, for the case of chronic schizophrenia and the case of alcohol-induced psychotic disorder, opinion was divided as to whether the subject should be handled with a medical or a judicial approach. Regarding treatment for the case of alcohol-induced psychotic disorder and the case of amphetamine abuse, there was a tendency to make a judgment based on the subject's condition at the point of psychiatric evaluation, which was not necessarily linked to the criminal responsibility.     

Psychopathy and violent recidivism among young criminal offenders

OBJECTIVE: To investigate the predictive validity of psychopathic personality traits (assessed with the revised psychopathy checklist, PCL-R; Hare, 1991) for violent criminal recidivism among young offenders. METHOD: The relationship between PCL-R psychopathy and violent re-offending was studied in 98 young (M=18.40, range 15-20 years) violent and sex offenders subjected to forensic psychiatric evaluation in Sweden during 1988-95. Subjects were followed during detainment and for 24 months in the community to first reconviction for a violent offence. RESULTS: We found a modest but significant association between PCL-R scores and violent recidivism, almost exclusively accounted for by behavioural criteria. Among 13 possible confounders tested, conduct disorder before age 15 and a young age at first conviction eliminated the relationship between psychopathy and violent recidivism in pair-wise logistic regression models. CONCLUSION: PCL-R psychopathy may be a less valid predictor for violent criminal recidivism among severe youthful offenders than among adult offenders.     

Violent women,blame attribution,crime, and personality

BACKGROUND: The attribution of blame for criminal act has an impact, both on the way the offender must come to terms with the offence and on the risk of recidivism. Blame attribution has been found to be related to the type of crime and personality. AIMS: This study examined the relationship of blame attribution and feelings of guilt in violent female offenders, according to factors related to crime, background and personality. METHODS: The Gudjonsson Blame Attribution Inventory (BAI) and the Defense Style Questionnaire (DSQ) were administered to 58 violent female offenders. The Hare Psychopathy Checklist-Revised (PCL-R), Structured Clinical Interview II for DSM-IV (SCID II) and clinical interviews were used for assessment. RESULTS: Lower scores of guilt feelings were found in women than has been reported for men. The feelings of guilt were higher in homicide than in other violent crimes, but lower in the cases where women had committed prior violent crimes. No differences were found between psychiatric patients and prisoners. The duration of hospitalisation and incarceration did not result in differences in blame attribution and guilt, but when the victims survived, guilt feelings seemed to increase with the passing of the time. External attribution was related to motives of crime, but traumatic experiences did not have a crucial impact upon blame attribution. The attribution of blame and the amount of guilt feelings were found to be related to personality. Women scoring high on psychopathy reported less guilt than women with low scores. The corresponding result was not obtained in the group of women with antisocial personality disorder, who, however, showed an unexpectedly low use of external attribution. CONCLUSION: The results suggest that it might be difficult for women to cope with the violent offence and that the characteristics of psychopathy seems to have a crucial impact on the guilt feelings and consequently on coping with the crime in female offenders.     

Criminal and psychiatric histories of Finnish arsonists

We investigated psychiatric and demographic variables and lifetime criminality among arsonists referred for a pre-trial psychiatric assessment. The medical and criminal records of 282 arsonists were studied in order to compare first-time and repeat offenders with regard to diagnostic, demographic and biological variables. Alcohol dependence and antisocial personality disorder were common among recidivist offenders. This finding was especially prominent among offenders who committed violent crimes. Recidivist offenders commonly had a history of long-lasting enuresis during their childhood. They were younger at the time of their first offence, and were more often intoxicated with alcohol during the arson attempt. Among arsonists, lifetime criminal recidivism was primarily associated with alcohol dependence and antisocial personality disorder. Psychosis was a common diagnosis among subjects who had no record of recidivist criminal offences.     

Relating psychiatric disorders, offender and offence characteristics in a sample of adolescent sex offenders and non-sex offenders

Introduction Several studies have paid attention to the relationship between psychiatric disorders and adolescent offending but few have distinguished different types of offenders, especially within the category of youngsters who have committed sex offences. Aim To test for relationships between psychiatric disorder and specific offence category among young male offenders. Method Nationwide data were extracted from Dutch Forensic Psychiatric Services (FPD) files for five groups of offenders, as defined by their index offence: 308 violent sex offenders; 134 non‐violent sex‐offenders; 270 sex offenders against children; 3148 violent offenders and 1620 offenders charged with any crime other than interpersonal body contact crimes. They were compared on individual characteristics and psychiatric diagnoses according to DSM‐IV criteria. Having a diagnosis of a paraphilia alone was exclusively associated with sex offending, therefore all such youths were excluded from further analyses. The OVERALS technique was used to explore possible relationships between offence, psychiatric diagnoses, sociodemographic and individual characteristics among the remaining young men for whom all pertinent data were available (n = 1894). Results Sex offenders constituted a distinct group of juvenile delinquents. Developmental disorders were more common among non‐violent sex offenders and child molesters. Violent offences were more typical of delinquents from immigrant backgrounds. Conclusion Group differences in types of psychiatric diagnoses may reflect differences in aetiological factors for the various types of sexual and other delinquent behaviour, and this would be worthy of further study. Copyright © 2007 John Wiley & Sons, Ltd.