84例凶杀案司法精神医学鉴定分析

目的探讨司法精神医学鉴定中精神病患者发生凶杀案的特征,为司法精神医学鉴定工作提供科学依据。方法对84例凶杀案司法精神医学鉴定资料进行回顾性分析。结果凶杀案占同期鉴定案例的22.1%,其中青壮年作案占82.14%,农民作案占82.14%。各类精神障碍患者占75%,其中疾病诊断分类排前三位的分别是精神分裂症、癫痫及癫痫伴发精神障碍、边缘智力或精神发育迟滞。凶杀案后果严重,受害者多为亲人与熟人,占94.69%。结论应加强精神卫生知识的宣教,促进精神卫生立法,防止精神病患者肇事,提高精神疾病防治的整体水平。     

60例凶杀案件司法精神医学鉴定结果分析

目的 了解凶杀案件司法精神医学鉴定中，当事精神疾病患病情况。方法 对我院司法精神医学鉴定中60例凶杀案件当事进行精神疾病患病情况分析。结果 60例凶杀案件当事各类精神疾病患病率达84％，其中以精神分裂症、情感性精神病、精神发育迟滞为多见。中青年精神病人作案占84％；农村病人作案占66％。结论 本资料中的凶杀行为与病情有关，对家庭、社会危害性极大。     

179例精神分裂症凶杀案司法精神医学鉴定分析

目的探讨司法精神医学鉴定案例中精神分裂症凶杀案例的鉴定状况。方法对179例精神分裂症凶杀案的司法精神病鉴定资料进行回顾性分析。结果精神分裂症凶杀行为多发生于青壮年及经济收入低的人群,男性显著多于女性,文化程度偏低。病程≤1a作案者居多．随着病程延长,发案率逐渐降低。作案方式及工具以刀具为主．对象以近亲属为主。26．3%为有完全责任能力．21．8%为限定责任能力．51．9%为无责任能力。结论积极对精神分裂症患者进行治疗和监护是预防暴力行为的有效途径。     

精神病刑事案件司法鉴定544例分析

目的分析司法精神病鉴定案例的特点,为精神病司法鉴定工作提供依据。方法对2005年-2011年我院受理的544例精神病司法鉴定案例资料进行回顾性分析。结果2007年和2009年鉴定的案例最少,2011年鉴定的案例最多;鉴定诊断的精神病中精神分裂症占44．85％,精神发育迟滞占19．30％;无刑事责任能力者占48．89％,限制或部分刑事责任能力者占25．53％。结论司法精神病鉴定案件中有精神病者居多,相关部门应加强精神卫生知识的普及工作和精神疾病的防治工作。     

67例凶杀案司法精神医学鉴定分析

目的 :探讨司法精神医学鉴定凶杀案例特点。方法 :对本院 1992～ 2 0 0 1年司法精神医学鉴定 6 7例凶杀案例资料进行回顾性研究。结果 :有各种精神疾病者占 85 .1% ,精神分裂症占 4 9.3% ,精神发育迟滞占 10 .4 % ,癫痫所致精神障碍占 9.0 % ,青壮年占 80 .6 % ,农民占 83.6 %。精神疾病者多在幻听、妄想 ,病理性冲动影响下作案。凶杀造成 6 3人死亡 ,4 0人受伤。有责任能力者占 2 2 .4 % ,限定责任能力者占 14 .9% ,无责任能力者占 6 2 .7%。结论 :精神分裂症 ,精神发育迟滞 ,癫痫所致精神障碍是重点防范的精神疾病 ,及时治疗各种精神疾病 ,加强对精神病人的管理 ,是防范凶杀行为的重要措施     

司法精神医学鉴定案例130例分析

目的：探讨司法精神医学鉴定案例的临床特征。方法对130例司法精神病鉴定资料进行回顾性分析。结果本组鉴定诊断排前3位的依次为精神分裂症（19．2％）、精神发育迟滞（15．4％）、颅脑外伤所致精神障碍（13．9％）;进行刑事责任能力评定者占70．8％,其中评定为完全责任能力占32．6％,限制责任能力占29．4％,无责任能力占38．0％。结论司法精神病鉴定案例中以刑事责任能力评定案例居多,鉴定诊断以精神分裂症为首位。     

精神发育迟滞司法鉴定78例报告

本文系我院1983～1992年间司法精神病鉴定案例692例中筛选出精神发育迟滞78例分析报告如下: 一般资料 1.作案组:42例,占鉴定案例的53.85％。其中男性38例、女性4例。     

精神障碍38例刑事责任能力司法鉴定资料分析

目的：探讨司法精神病鉴定中精神障碍责任能力的评定状况。方法对38例司法精神病责任能力鉴定资料进行回顾性分析。结果本组中鉴定诊断精神分裂症居首位（26．3％）、精神发育迟滞次之（21．1％）;责任能力评定完全刑事责任能力占36．8％,限制刑事责任能力占36．8％,无刑事责任能力占26．3％。结论精神疾病诊断与刑事责任能力之间无必然因果关系,应根据被鉴定人精神病理内容与案件事实之间是否存在因果关系评定刑事责任能力。     

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。     

司法精神医学鉴定为完全刑事责任能力55例资料分析

目的 探讨精神病司法鉴定完全刑事责任能力与精神疾病和案件侦破、司法判决的关系。方法 收集我院1996～2002年间55例鉴定为完全刑事责任能力案例进行统计分析。结果 被鉴定者的文化素质普遍较低，年龄多为青壮年。性格内向暴躁、残忍、多疑孤僻，送检单位公安机关居多，提出鉴定的亲属居多，鉴定无精神病者占38．18％。结论 在刑事案件中被鉴定人为逃避刑事责任经常伪装精神病，司法精神医学鉴定为司法公正提供了可靠的法律依据。     

Prognosis of acute encephalopathy

The prognosis in children with acute encephalopathy who were achieved rehabilitation in our rehabilitation center was presented. Main sequelae was motor disturbance 25%, mental deterioration 90%, higher cortical dysfunction 80% and epilepsy 70%. The patients were divided into 5 groups according to the clinical courses at the onset: cases with metabolic disorders, cases with cytokine storms, cases with status convultics, cases with severe refractory status epilepticus, and cases with the main symptom of decreased consciousness. Typical cases of each group were showed with their brain MRI and single photon emission cerebral tomography (SPECT). In cases with metabolic disorders and cytokine storms, the sequelae were generally severe. In cases with status convulticus, main sequelae was mental deterioration. In cases with severe refractory status epileptics, most contraversial problem was epilepsy. In cases with the main symptom of decreased consciousness, higher cortical dysfunction was the main problem.     

北京市丰台区流动人口精神卫生健康状况调查

目的探讨北京市丰台区流动人口精神卫生健康状况,为政府制定相应精神卫生政策和干预措施提供依据。方法随机抽取北京市丰台区三个乡的六个自然村中650名流动居住人口,采用问卷调查表及访谈相结合的方法进行调查分析。结果流动人口文化水平较低,精神卫生知识匮乏,对精神卫生知识了解者仅占12.3%。了解渠道单一,其中53.13%为电视、24.15%为报纸书籍宣传资料、17.33%为健康讲座社区宣传、97.04%希望获得法律法规的帮助、91.74%希望获得预防治疗康复知识、54.05%希望获得福利与保障政策、24.30%希望获得精神疾病诊疗机构情况。流动人口中存在着一定数量的精神疾病患者,在住院患者中所占比例呈逐年上升的趋势。结论流动人口对精神疾病知识了解极少,精神健康知识需求非常迫切;加强对流动人口的精神卫生健康教育,提高对精神疾病的认识,并将精神疾病患者纳入管理体系之中,是我们今后的重要任务之一。     

癫痫患者违法行为司法鉴定资料分析

目的 探讨癫痫患者违法案例特征,为司法鉴定提供依据.方法 对45例癫痫患者违法的司法鉴定资料进行回顾性分析.结果 癫痫患者违法者以男性(95.56%),未婚(60.00%),初中以下文化程度(91.11%),农民及无业者(88.89%),有阳性精神病家族史(88.89%)者居多.80.00%作案对象为家人和熟人,53.33%无刑事责任能力,77.78%无作案预谋,88.89%无犯罪记录,案件类型以凶杀(48.48%)、伤害(20.00%)为主.不同刑事责任能力者违法案件类型、作案动机、作案预谋、促发因素比较差异均有极显著性(P＜0.01).结论 癫痫患者违法以男性、未婚、初中以下文化程度、农民及无业者居多;多无刑事责任能力、无作案预谋、无犯罪记录;作案对象多为家人和熟人;案件类型以凶杀、伤害为主;刑事责任能力与促发因素、预谋、作案动机、案件类型显著相关.     

Predictors and outcomes of outpatient mental health care: a 4-year prospective study of elderly Medicare patients with substance use disorders

BACKGROUND: Many elderly inpatients have substance use disorders; recent treatment guidelines suggest that they should receive regular outpatient mental health care after discharge from hospital. OBJECTIVE: The prevalence, predictors, and outcomes of outpatient mental health care obtained by elderly Medicare patients with substance use disorders were examined. RESEARCH DESIGN: A longitudinal prospective follow-up was performed. SUBJECTS: Data from Medicare Provider Analysis and Review Record and Part B Medicare Annual Data were used to identify elderly inpatients with substance use disorders (n = 4,961) and determine their outpatient mental health care 4 years following hospital discharge. RESULTS: Only 12% to 17% of surviving elderly substance abuse patients received outpatient mental health care in each of 4 years after discharge. Cumulatively over 4 years, approximately 18% of surviving patients obtained diagnostic/evaluative mental health services, 22% obtained psychotherapy, and 9% received medication management. Of patients who obtained outpatient mental health care, 57% made 10 or fewer outpatient mental health visits over the entire 4 years. Younger, non-black, and female patients were more likely to obtain mental health outpatient care, as were patients with prior substance-related hospitalizations, dual diagnoses, and fewer medical conditions. Prompt outpatient mental health care was predictively associated with higher likelihood of mental health readmissions and, among patients with drug disorders, lower mortality. CONCLUSION: Very few elderly Medicare substance abuse patients obtain outpatient mental health care, perhaps because of health or economic barriers.     

Emergency Department Use by Young Adults With Chronic Illness Before and During the COVID-19 Pandemic

IntroductionThere was a significant decrease in emergency department encounters during the COVID-19 pandemic. Our large urban emergency department observed decreased encounters and admissions by youths with chronic health conditions. This study aimed to compare the frequency of emergency department encounters for certain young adults before the pandemic and during the COVID-19 pandemic.MethodsA retrospective cohort study using medical records of patients ages 20 to 26 years from October 2018 to September 2019 and February 2020 to February 2021. Files set for inclusion were those with a primary diagnosis of human immunodeficiency virus, diabetes mellitus, epilepsy, cerebral palsy, sickle cell disease, asthma, and certain psychiatric disorders for potentially preventable health events.ResultsWe included 1203 total encounters (853 before the pandemic and 350 during the pandemic), with the total number of subjects included in the study 568 (293 before the pandemic to 239 during the pandemic). During the pandemic, young adults with mental health conditions (53.1%) accounted for most encounters. Encounters requiring hospital admissions increased from 27.4% to 52.5% during the pandemic, primarily among patients with diabetes (41.8% vs 61.1%) and mental health conditions (50% vs 73.3%).DiscussionThe number of young adults with certain chronic health conditions decreased during COVID-19, with encounters for subjects with mental health conditions increasing significantly. The proportion of admissions increased during the pandemic with increases for subjects with mental health disorders and diabetes. The number of frequent users decreased during COVID-19. Future research is needed to understand better the causes for these disparities in young adults with chronic conditions who use the emergency department as a source of care.     

小儿脑瘫常见并发症的临床分析

目的：对脑瘫患儿常见并发症的发生率进行分析，为临床的早期治疗和预防提供资料。方法：脑瘫患儿108例,神经学检查评价脑瘫类型以及并发症诊断，并进行头部MRI检查、视听诱发电位检测及脑电图检测。结果：①108例中不同类型脑瘫并发症81例（75%），其中摄食困难、智力低下、语言障碍等并发症占多数。②混合型脑瘫的并发症发生率最高（90%）。③头部MRI异常率75.9%，以脑室周围白质软化症最多（45.1%）。结论：小儿脑瘫并发症严重影响患儿营养物质的摄取和体格发育，增加其融入社会的难度。早期注重婴幼儿摄食技能的发育监测，干预和改善其智能水平，促进语言发育，积极控制癫痫发作，可以降低并发症的发生率。