新兵精神疾病终极鉴定中“无精神病”的特征分析简

目的探索新兵精神疾病终极鉴定诊断为“无精神病”案例的特征。方法对2007-2012年间110例诊断为“无精神病”新兵的鉴定资料进行回顾性分析。结果“无精神病”案例占鉴定总数的29．4％，其中9．1％的案例二次鉴定最终确诊有各种精神疾病。造成“无精神病”的原因主要有入伍初期适应不良、心理测试结果异常、性格内向、情绪反应、精神症状假阳性和误诊。与全军新兵常模比较，“无精神病”案例症状自评量表（Symptom Checklist90，SCL-90）的躯体化、人际关系敏感、抑郁、焦虑、偏执等5个因子分均明显升高（P〈0．01或0．05）。结论终极鉴定为“无精神病”的新兵存在比普通新兵更为明显的异常心理症状，有必要在留队观察1～2月后重新集中进行二次鉴定。

Characteristic Analysis of Recruits Diagnosed without Psychosis in Psychiatric Medical Expertise

Objective To investigate the characteristics of the recruits diagnosed without psychosis in psychiatric medical expertise. Methods The clinical data of 110 recruits diagnosed without psychosis during 2007 and 2012 were retrospectively analyzed. Results The occurrence rate of ＂without psychosis＂ diagnosis in all diagnosed cases was 29. 4%, among whom 9.1 % were finally re-diagnosed with various psychosis. The main causes included maladjustment, abnormal psychological evaluation, introversion, emotional reaction, false positive mental symptoms and misdiagnosis. In Symptom Checklist 90 （SCL-90） test, the factorial scores including somatization, depression, anxiety and paranoid were significantly higher than the norm of Chinese recruits （P〈0. 01 or 0. 05）. Conclusion The recruits finally diagnosed without psychosis in psychiatric medical expertise have more abnormal psychological symptoms than the normal recruits. Re-diagnosis after enrolling for 1 to 2 months is necessary.