Forensic Psychiatry

法医精神病学
  • 文章类型: Letter
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  • 文章类型: Journal Article
    长期自杀,特定类型的杀人自杀事件,具有严重的社会后果,但仍然缺乏系统的研究。这项回顾性研究调查了中国中部地区51例涉及精神障碍的长期自杀病例,目的是更好地了解此类事件的危险因素并指导预防策略。从2015年到2022年的8年期间,从法医机构收集了案件,和人口特征,案例详细信息,并记录精神病数据.这51起事件涉及51名肇事者和79名受害者,更多的女性犯罪者(58.8%)和更多的女性受害者(54.4%)。肇事者的平均年龄为36.1岁,大多数已婚(88.2%)。几乎所有受害者都是肇事者的家人,像最多的孩子(64.6%),其次是配偶(24.1%)。最常见的杀人死亡方式是机械性窒息(38.0%),其次是尖锐装置(36.7%)和药物中毒(16.5%)。抑郁症(76.5%)是肇事者最常见的精神障碍诊断。该研究分析了长期自杀的独特特征,以丰富此类数据。这些发现有助于加强对潜在肇事者和受害者的筛查和识别,以防止此类案件发生。
    Extended suicide, a specific type of homicide-suicide event, has severe social consequences yet remains lacking systematic research. This retrospective study investigated 51 cases of extended suicide involving mental disorders in central China with aim of better understanding risk factors for such events and guiding prevention strategies. Over an 8-year period from 2015 to 2022, cases were collected from forensic institutions, and demographic characteristics, case details, and psychiatric data were recorded. The 51 incidents involved 51 perpetrators and 79 victims, with more female perpetrators (58.8%) and more female victims (54.4%). The average age of the perpetrators was 36.1, and most were married (88.2%). Almost all of the victims were family members of the perpetrator, like the most numerous children (64.6%), followed by spouses (24.1%). The most common homicide mode of death was mechanical asphyxia (38.0%), followed by sharp devices (36.7%) and drug poisoning (16.5%). Depressive disorders (76.5%) were the most common diagnosis of mental disorder for perpetrators. The study analyzed the unique characteristics of extended suicide to enrich such data. These findings help strengthen the screening and identification of potential perpetrators and victims to prevent such cases from occurring.
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  • Research on facial micro-expression analysis has been going on for decades. Micro-expression can reflect the true emotions of individuals, and it has important application value in assisting auxiliary diagnosis and disease monitoring of mental disorders. In recent years, the development of artificial intelligence and big data technology has made the automatic recognition of micro-expressions possible, which will make micro-expression analysis more convenient and more widely used. This paper reviews the development of facial micro-expression analysis and its application in forensic psychiatry, to look into further application prospects and development direction.
    面部微表情分析相关研究已经有数十年的发展历史,微表情能够反映个体的真实情绪,在精神障碍的辅助诊断、病情监测方面有重要应用价值。近年来,人工智能和大数据技术的发展使得微表情自动化识别成为可能,这将使得微表情分析更加便捷、应用范围更加广泛。本文回顾了面部微表情分析技术的发展和其在法医精神病学领域的应用现况,以展望该技术的应用前景和发展方向。.
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  • 文章类型: Journal Article
    神经丝轻链蛋白(NfL)是在脑脊液和血液中可测量的神经损伤的流体生物标志物。患有不同神经退行性疾病和轻度创伤性脑损伤的患者显示NfL水平升高。然而,到目前为止,在患有精神疾病的患者中尚未发现NfL水平升高。据我们所知,以前尚未在接受法医精神病学评估的人或在法医精神卫生服务机构接受治疗的人中研究血液中NfL的发生。据说,与其他精神病患者相比,这些患者的神经损伤风险更高。
    在这项试点研究中,我们调查了20名接受法医精神病评估的患者和20名法医精神病医院患者的血浆NfL水平.将NfL值与年龄和性别相匹配的健康个体的对照组进行比较。
    两个法医组中NfL升高的患病率较低,与对照组相比没有差异。然而,一些接受法医精神病学评估的人的价值略有升高。
    在更接近指数犯罪的调查组中观察到略微升高的值,当NfL水平升高可能会更普遍,由于从进攻时的急性条件。这就有理由进一步研究这个群体。
    UNASSIGNED: Neurofilament light chain protein (NfL) is a fluid biomarker of neural injury measurable in cerebrospinal fluid and blood. Patients with different neurodegenerative disorders and mild traumatic brain injury display elevated levels of NfL. However, so far, elevated levels of NfL have not been demonstrated in persons with psychiatric disorders. To our knowledge, the occurrence of NfL in the blood has not previously been studied in persons undergoing forensic psychiatric assessment or persons treated in forensic mental health services. Supposedly, these persons suffer from experiences and conditions with a higher risk of neural injury than other psychiatric patients.
    UNASSIGNED: In this pilot study, we investigated plasma levels of NfL in 20 persons undergoing forensic psychiatric assessment and 20 patients at a forensic psychiatric hospital. NfL values were compared with control groups of healthy individuals matched for age and sex.
    UNASSIGNED: The prevalence of increased NfL in both forensic groups was low and did not differ compared with the controls. However, some persons undergoing forensic psychiatric assessment showed slightly elevated values.
    UNASSIGNED: The slightly elevated values were observed in the group investigated closer in time to the index crime, when elevated NfL levels could be expected to be more prevalent due to acute conditions from the time of the offense. This gives reason to look further into this group.
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  • 文章类型: Journal Article
    Traditional polygraph techniques mostly rely on the changes of an individual\'s physiological indicators, such as electrodermal activity, heart rate, breath, eye movement and function of neural signals and other indicators. They are easily affected by individual physical conditions, counter-tests, external environment and other aspects, and it is difficult to conduct large-scale screening tests based on the traditional polygraph techniques. The application of keystroke dynamics to polygraph can overcome the shortcomings of the traditional polygraph techniques to a large extend, increase the reliability of polygraph results and promote the validity of legal evidence of polygraph results in forensic practice. This paper introduces keystroke dynamics and its application in deception research. Compared with the traditional polygraph techniques, keystroke dynamics can be used with a relatively wider application range, not only for deception research but also for identity identification, network screening and other large-scale tests. At the same time, the development direction of keystroke dynamics in the field of polygraph is prospected.
    传统的测谎技术大多依赖个体的生理指标,如皮肤电、心率、呼吸、眼动和神经信号功能等指标的变化,容易受个体身体条件、反测试以及外部环境等方面的影响,并且很难进行大面积的筛查测试。将击键动力学应用于测谎可以很大程度上克服传统测谎技术的不足,增加测谎结果的可靠性,促进测谎结论在司法鉴定实践中的法定证据效力。本文介绍了击键动力学及其在欺骗研究中的应用,和传统测谎技术相比,击键动力学除了可以进行欺骗行为研究外,还可用于身份识别、网络筛查等大面积的测试,应用范围相对更广。同时,本文还对击键动力学在测谎领域的发展方向进行了展望。.
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  • 文章类型: Journal Article
    The clinical symptoms and signs of methamphetamine-associated psychosis (MAP) and schizophrenia are highly similar, but the situation is completely different when MAP and schizophrenia patients need to be assessed for criminal responsibility after they comitted a harmful behavior. Therefore, the distinction between the two psychoses is very important in forensic psychiatry. At present, the identification of these two psychoses is mainly dependent on the corresponding criteria such as the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the Chinese Classification of Mental Disorders Version 3 (CCMD-3). It\'s challenging to diagnose and distinguish between the two in practical cases due to their similar clinical symptoms and the lack of effective objective indexes. Different from the limitations of single omics, integrative omics intergrates data from multiple dimensions and has been extensively studied in the field of schizophrenia and has achieved some preliminary results. In view of the correlation between MAP and schizophrenia and the potential application value of integrative omics, this paper proposes an integrative omics strategy for MAP pathogenesis and forensic identification, aiming to improve the further understanding of the relationship between the two psychoses and the corresponding pathogenesis. It also provides references for the future exploration of integrative omics in forensic precise identification and effective monitoring and early warning methods.
    甲基苯丙胺所致精神障碍(methamphetamine-associated psychosis,MAP)和精神分裂症的临床症状及体征十分相似,但MAP和精神分裂症患者在发生危害行为后需评定刑事责任时的情况却完全不同,因而两者的甄别在法医精神病学鉴定中十分重要。目前对于两者的鉴别主要依据《精神障碍诊断与统计手册(第五版)》《中国精神障碍分类与诊断标准(第三版)》等诊断标准,但由于两者高度相似的临床表现和客观指标的缺乏,给法医学鉴识实践工作带来了很大的困难和挑战。不同于单一组学的局限性,整合组学将多个维度的数据整合起来,已在精神分裂症领域开展了广泛研究并初步取得一些应用成果。鉴于MAP和精神分裂症的关联性和整合组学的潜在的应用价值,本文提出以整合组学的策略进行MAP发病机制及法医学鉴识的研究思路,旨在完善对MAP与精神分裂症之间的关系及相应发病机制的进一步理解,也为未来整合组学在法医学精准鉴识及有效监测预警方法的探索提供借鉴与参考。.
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  • 文章类型: Journal Article
    OBJECTIVE: To understand the legal application and case deposition of assessment opinions of sexual self-defense capability, and to explore the necessity of legal correspondence in the sexual defense capability assessment.
    METHODS: According to the self-made questionnaire, the cases of sexual self-defense capability assessment completed by the Academy of Forensic Science from January 1, 2012 to December 31, 2018 were statistically analyzed through telephone interviews and referrals.
    RESULTS: Among the 69 cases, 3 cases (4.3%) had complete sexual self-defense capability, 30 cases (43.5%) had weakened sexual self-defense capability, 32 cases (46.2%) had no sexual self-defense capability, and 4 cases (5.8%) were not suitable for assessment. Among the 30 cases with weakened sexual self-defense ability, 15 cases were filed and investigated by public security authorities for rape and 15 cases were not. The inconsistent rate of disposition was 1∶1. Among the 15 rape cases filed and investigated by the public security authorities, 10 cases were arrested and prosecuted by the procuratorate and sentenced to fixed-term imprisonment by the court, while the other 5 cases were not arrested and prosecuted by the procuratorate, with an inconsistent rate of disposition being 2∶1.
    CONCLUSIONS: The legal application of the assessment opinion on the weakening of sexual self-defense capability is inconsistent, and the judicial disposition is confusing. It is imperative to unify and correspond the classification of sexual self-defense capability with the legal requirements.
    目的: 了解性自我防卫能力鉴定意见的法律适用及案件处置情况,探析性自我防卫能力评定法律契合的必要性。方法: 根据自制调查表,通过电话回访调查及查阅案例裁判信息,统计司法鉴定科学研究院于2012年1月1日—2018年12月31日鉴定完成的性自我防卫能力评定案件的处理情况。结果: 69例案例中,完全性自我防卫能力3例(4.3%),性防卫能力削弱30例(43.5%),无性自我防卫能力32例(46.2%),不宜评定4例(5.8%)。30例被评定为性自我防卫能力削弱者中,15例被公安机关以强奸罪立案侦查,15例未被公安机关以强奸罪立案侦查,处理不一致比例为1∶1;被公安机关以强奸罪立案侦查的案件中,10例由检察院批捕起诉,被法院判处有期徒刑,其余5例未被检察院批捕起诉,处理不一致比例达2∶1。结论: 性自我防卫能力削弱鉴定意见法律适用不一致,司法处置混乱,性自我防卫能力等级划分与法律要求进行统一、契合势在必行。.
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  • 文章类型: Journal Article
    背景:目前国内还缺乏对法医精神卫生院患者情况的全面研究。本研究旨在调查社会人口统计学,临床,湖南省法医精神病医院精神病患者的犯罪相关特征。
    方法:本研究于2018年11月1日至2019年1月30日进行。社会人口数据,临床,并收集患者的犯罪相关特征。简明精神病学评定量表(BPRS),修正的公开攻击量表(MOAS),和临床总体印象严重程度(CGI-S)量表用于测量他们的精神状况。
    结果:共有461名参与者参加了这项研究。其中,男性占86.3%,未婚占56.8%,平均年龄44.7±10.1岁,平均受教育年限为7.51±3.3年。在他们目前的进攻之前,共有345名患者(74.8%)因精神疾病寻求医疗帮助。虽然这些患者中有303(87.8%)服用了抗精神病药,254(73.6%)未能定期服用。在所有的住院病人中,90.5%被诊断为精神分裂症;385人(83.5%)从事杀人犯罪,54.0%的受害者是他们的家人。在凶杀案中,亲属更有可能是女性患者的受害者。在法医医院的平均住院时间为8.02±4.74年,超过80.0%的患者住院时间超过5年。
    结论:据我们所知,这是首次调查在中国法医精神病医院接受强制治疗的法医患者的概况。这些结果增加了有关法医患者特征的世界文献,并有助于确定该人群的常见治疗和与风险相关的需求。
    There is still a lack of comprehensive research on the profile of patients in forensic mental health hospitals in China. This study aims to investigate the socio-demographic, clinical, and offense-related characteristics of mentally ill offenders in the Hunan Provincial Forensic Psychiatric Hospital in China.
    This study was conducted from November 1, 2018, to January 30, 2019. The data of socio-demographic, clinical, and offense-related characteristics of the patients were collected. The Brief Psychiatric Rating Scale (BPRS), the Modified Overt Aggression Scale (MOAS), and the Clinical Global Impression-Severity (CGI-S) scale were used to measure their psychiatric conditions.
    A total of 461 participants were enrolled in this study. Among them, 86.3% were males and 56.8% were unmarried; the average age of them was 44.7 ± 10.1 years, and the mean years of education were 7.51 ± 3.3 years. Before their current offense, a total of 345 patients (74.8%) had sought medical help for their mental illnesses. While 303 (87.8%) of these patients were prescribed antipsychotics, 254 (73.6%) failed to take them regularly. Of all the inpatients, 90.5% were diagnosed with schizophrenia; 385 (83.5%) engaged in homicidal offenses, with 54.0% of the victims being their family members. In homicide cases, the relatives were more likely to be victims of female patients. The mean length of stay in the forensic hospital was 8.02 ± 4.74 years, and over 80.0% of the patients had been hospitalized for over 5 years.
    To our knowledge, this is the first study investigating the profile of forensic patients receiving compulsory treatments in a forensic psychiatric hospital in China. These results add to the world literature on the characteristics of forensic patients and can help identify common treatment and risk-related needs of this population.
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  • 文章类型: Journal Article
    背景:在中国,警察部门通常在精神障碍患者犯罪后启动刑事责任评估。然而,法律没有明确规定要求评估的具体条件。关于精神障碍患者的流行病学特征和刑事责任评估的研究很少。本研究旨在分析单中心队列中精神障碍患者刑事责任评估的特征并确定影响因素。
    方法:在法医学中心接受刑事责任评估的案件,上海华东政法大学(CFS,2010年至2020年之间的ECUPL)进行了回顾性审查。刑事责任被归类为刑事不负责任,减轻刑事责任,并承担全部刑事责任。然后对各组之间的差异进行统计学分析。
    结果:在研究期间,437名患者,包括361名男性(82.61%)被转介进行刑事责任评估。他们的年龄从15岁到91岁不等。经过评估,不负责任的案件数量,减轻刑事责任,负全部刑事责任196人(44.85%),181(41.42%),和60(13.73%),分别。卡方检验和名义回归分析表明,刑事责任评估的影响因素包括公共场所犯罪(OR=14.734;95%CI:1.463-148.424)。受害人居住地的犯罪(OR=10.852;95%CI:1.068-110.214),犯罪嫌疑人的住所(OR=9.542;95%CI:1.046-87.092),F1X的法医精神病学诊断(OR=0.014,0.011;95CI:0.001-0.261,0-0.5),F2X(OR=5.75;95CI:1.315-23.145),F4X(OR=0.077;95CI:0.016-0.38,)和F6X(OR=0.112,0.075;95%CI:0.022-0.558,0.006-0.959),财产犯罪对象(OR=9.989;95%CI:1.305-76.455),盗窃案件(OR=0.09,0.087;95%CI:0.013-0.648,0.012-0.654),和危害公共安全的案件(OR=0.152,0.205;95%CI:0.034-0.678,0.045-0.931)。
    结论:公共场所犯罪,嫌疑人的住所和受害者的住所,F1X的法医精神病学诊断,F2X,F4X和F6X,财产的犯罪对象,盗窃和危害公共安全的案件类型是刑事责任评估的影响因素。因此,在这种情况下,应特别注意精神障碍患者,以避免对刑事责任评估的偏见。
    In China, police departments usually initiate assessment of criminal responsibility after patients with mental disorders commit crimes. However, the specific conditions demanding assessment are not clearly stipulated by law. Few studies have been conducted on the epidemiological characteristics and assessment of criminal responsibility in patients with mental disorders. This study aimed to analyze the features and identify influencing factors for assessment of criminal responsibility for patients with mental disorders in a single-center cohort.
    Cases undergoing criminal responsibility assessment at the Center of Forensic Science, East China University of Political Science and Law in Shanghai (CFS, ECUPL) between 2010 and 2020 were retrospectively reviewed. Criminal responsibility was categorized as criminal irresponsibility, diminished criminal responsibility, and full criminal responsibility. Differences among the groups were then statistically analyzed.
    In the study period, 437 patients including 361 males (82.61%) were referred for criminal responsibility assessment. Their ages ranged from 15 years to 91 years. After assessment, the number of cases with criminal irresponsibility, diminished criminal responsibility, and full criminal responsibility were 196 (44.85%), 181 (41.42%), and 60 (13.73%), respectively. The Chi-square test and nominal regression analysis showed that influencing factors for assessment of criminal responsibility comprised crime in public places (OR = 14.734; 95% CI: 1.463-148.424), crime in victim\'s residence (OR = 10.852; 95% CI: 1.068-110.214), crime in suspect\'s residence (OR = 9.542; 95% CI: 1.046-87.092), forensic psychiatric diagnosis of F1X (OR = 0.014,0.011; 95%CI:0.001-0.261,0-0.5), F2X (OR = 5.75; 95%CI:1.315-23.145), F4X (OR = 0.077; 95%CI:0.016-0.38,) and F6X (OR = 0.112,0.075; 95% CI: 0.022-0.558,0.006-0.959), criminal object of property (OR = 9.989; 95% CI: 1.305-76.455), cases of theft (OR = 0.09, 0.087; 95% CI: 0.013-0.648,0.012-0.654), and cases of endangering public security (OR = 0.152, 0.205; 95% CI: 0.034-0.678, 0.045-0.931).
    Crime in public places, suspect\'s residence and victim\'s residence, forensic psychiatric diagnosis of F1X, F2X, F4X and F6X, criminal object of property, case types of theft and endangering public security were influencing factors in assessment of criminal responsibility. Therefore, special attention should be paid to patients with mental disorders under such circumstances in order to avoid bias on assessment of criminal responsibility.
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  • 文章类型: Journal Article
    探讨不同程度颅脑外伤后器质性人格障碍的发生率及临床表现差异。
    根据《国际疾病分类-10》,对1,027名因交通事故引起的颅脑外伤的受试者进行了审查,对颅脑外伤的程度进行分级,并诊断为颅脑外伤后的人格障碍者。采用简化的神经质外向性开放五因素量表(NEO-FFI)对所有患者的个性特征进行评价。
    各种颅脑外伤后器质性人格障碍的发生率为33.1%,而中度和重度颅脑外伤后的患者为38.7%和44.2%,分别,轻度颅脑外伤患者的比例(18.0%),差异有统计学意义(P<0.05)。与无人格障碍患者相比,神经质,颅脑外伤后人格障碍患者的外向性和同意性评分均有统计学差异(P<0.05);尤其是中重度颅脑外伤后人格障碍患者的自觉性评分有统计学差异(P<0.05)。中度和重度颅脑外伤后人格障碍患者的同意和认真程度评分明显低于轻度颅脑外伤后,重度颅脑外伤后人格障碍患者的外向性评分低于轻度颅脑外伤后。
    颅脑外伤的严重程度和面积与器质性人格障碍的发生率密切相关,它也会影响后者的临床表现,为法医精神病鉴定提供了一定的意义和帮助。
    UNASSIGNED: To explore the incidence rate and the differences of clinical manifestations of organic personality disorders with varying degrees of craniocerebral trauma.
    UNASSIGNED: According to the International Classification of Diseases-10, 1,027 subjects with craniocerebral trauma caused by traffic accidents were reviewed, the degrees of craniocerebral trauma were graded and those with personality disorder after craniocerebral trauma were diagnosed. The personality characteristics of all patients were evaluated by using the simplified Neuroticism Extraversion Openness Five-Factor Inventory (NEO-FFI).
    UNASSIGNED: The incidence rate of organic personality disorder after all kinds of craniocerebral trauma was 33.1%, while it was 38.7 and 44.2% in the patients after moderate and severe craniocerebral trauma, respectively, which was significantly higher than that in the patients after mild craniocerebral trauma (18.0%) (P < 0.05). Compared with the patients without personality disorder, the neuroticism, extraversion and agreeableness scores all showed significantly differences (P < 0.05) in the patients with personality disorder after craniocerebral trauma; especially the conscientiousness scores showed significant differences (P < 0.05) in the patients with personality disorder after moderate and severe craniocerebral trauma. The agreeableness and conscientiousness scores in the patients with personality disorder after moderate and severe craniocerebral trauma were significantly lower than that after mild craniocerebral trauma, and the patients with personality disorder after severe craniocerebral trauma had lower scores in extraversion than that after mild craniocerebral trauma.
    UNASSIGNED: The severity and area of craniocerebral trauma is closely related to the incidence rate of organic personality disorder, and it also affects the clinical manifestations of the latter, which provides a certain significance and help for forensic psychiatric appraisal.
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