PDF(Pubmed)
Abstract：
Forensic evaluations of legal insanity include the experts\' assessment of symptoms present at the mental state examination (MSE) and the mental state at the time of offense (MSO). Delusions and hallucinations are most important. We explored how often symptoms were recorded in written forensic reports.
This exploratory, cross-sectional study included 500 reports of legal insanity written in 2009-2018 from cases of violent crimes in Norway. The first author read all reports and coded symptoms recorded from the experts\' assessments of the offenders. Two co-authors repeated this procedure for 50 randomly selected reports. Interrater reliability was calculated with Gwet\'s AC1. Generalized Linear Mixed Models with Wald tests for fixed effects and Risk Ratios as effect sizes were used for the statistical analyses.
Legal insanity was the main conclusion in 23.6% of the reports; 71.2% of these were diagnosed with schizophrenia while 22.9% had other psychotic disorders. Experts recorded few symptoms from MSO, but more from MSE, although MSO is important for insanity. We found a significant association between delusions and hallucinations recorded present in the MSO and legal insanity for defendants with other psychotic disorders, but no association for defendants with schizophrenia. The differences in symptom recordings between diagnoses were significant.
Few symptoms were recorded from the MSO. We found no association between presence of delusions or hallucinations and legal insanity for defendants with schizophrenia. This may indicate that a schizophrenia diagnosis is more important to the forensic conclusion than the symptoms recorded in the MSO.
This exploratory, cross-sectional study included 500 reports of legal insanity written in 2009-2018 from cases of violent crimes in Norway. The first author read all reports and coded symptoms recorded from the experts\' assessments of the offenders. Two co-authors repeated this procedure for 50 randomly selected reports. Interrater reliability was calculated with Gwet\'s AC1. Generalized Linear Mixed Models with Wald tests for fixed effects and Risk Ratios as effect sizes were used for the statistical analyses.
Legal insanity was the main conclusion in 23.6% of the reports; 71.2% of these were diagnosed with schizophrenia while 22.9% had other psychotic disorders. Experts recorded few symptoms from MSO, but more from MSE, although MSO is important for insanity. We found a significant association between delusions and hallucinations recorded present in the MSO and legal insanity for defendants with other psychotic disorders, but no association for defendants with schizophrenia. The differences in symptom recordings between diagnoses were significant.
Few symptoms were recorded from the MSO. We found no association between presence of delusions or hallucinations and legal insanity for defendants with schizophrenia. This may indicate that a schizophrenia diagnosis is more important to the forensic conclusion than the symptoms recorded in the MSO.
摘要：
背景：对法律精神错乱的法医评估包括专家对精神状态检查（MSE）和犯罪时（MSO）的精神状态的评估。妄想和幻觉是最重要的。我们探讨了在书面法医报告中记录症状的频率。
方法：这是探索性的，横断面研究包括2009-2018年挪威暴力犯罪案件中的500份法律精神错乱报告.第一作者阅读了专家对罪犯的评估中记录的所有报告和编码症状。两位共同作者对50份随机选择的报告重复了这一过程。用Gwet的AC1计算了评分者间的可靠性。使用具有固定效应和风险比的Wald检验的广义线性混合模型作为效应大小用于统计分析。
结果：法律精神错乱是23.6％的报告的主要结论；其中71.2％被诊断为精神分裂症，而22.9％患有其他精神病。专家记录到MSO的症状很少，但更多来自MSE，虽然MSO对精神错乱很重要。我们发现，MSO中记录的妄想和幻觉与其他精神病患者的法律精神错乱之间存在显着关联，但与精神分裂症的被告无关。诊断之间的症状记录差异显着。
结论：从MSO记录的症状很少。我们发现精神分裂症被告的妄想或幻觉与法律精神错乱之间没有关联。这可能表明精神分裂症的诊断对法医结论比MSO中记录的症状更为重要。
方法：这是探索性的，横断面研究包括2009-2018年挪威暴力犯罪案件中的500份法律精神错乱报告.第一作者阅读了专家对罪犯的评估中记录的所有报告和编码症状。两位共同作者对50份随机选择的报告重复了这一过程。用Gwet的AC1计算了评分者间的可靠性。使用具有固定效应和风险比的Wald检验的广义线性混合模型作为效应大小用于统计分析。
结果：法律精神错乱是23.6％的报告的主要结论；其中71.2％被诊断为精神分裂症，而22.9％患有其他精神病。专家记录到MSO的症状很少，但更多来自MSE，虽然MSO对精神错乱很重要。我们发现，MSO中记录的妄想和幻觉与其他精神病患者的法律精神错乱之间存在显着关联，但与精神分裂症的被告无关。诊断之间的症状记录差异显着。
结论：从MSO记录的症状很少。我们发现精神分裂症被告的妄想或幻觉与法律精神错乱之间没有关联。这可能表明精神分裂症的诊断对法医结论比MSO中记录的症状更为重要。
