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目的探讨司法鉴定中颅脑外伤后精神障碍的表现特点及有关因素。方法收集2001年1月1日至2005年6月30日163例颅脑外伤后司法鉴定案例资料,采用卡方检验对精神障碍诊断、智力损害和人格改变等影响因素进行分析。结果本组病例中最多见的是神经症样综合症(42·3%);智能损害中,IQ<70组伤前文化程度低于IQ≥70组(P<0·05),前者脑外伤程度则明显重于后者(P<0·01);人格改变组脑外伤程度重于无人格改变组(P<0·01),额及/或颞叶损伤病例组人格改变发生率高于无额及/或颞叶损伤病例组(P<0·01)。结论重型颅脑损伤精神障碍多合并多种症状,且以智能损害最多见;轻型颅脑损伤后精神障碍以神经症样综合症最多见。鉴定过程中除考虑外伤程度外还应综合考虑伤前文化程度、脑损伤部位、个体素质、环境因素,并注重把握鉴定时机,以求鉴定结论更为公正客观。
Objective To explore the characteristics and related factors of mental disorders in forensic examination after traumatic brain injury. Methods The data of 163 cases of craniocerebral trauma from January 1, 2001 to June 30, 2005 were collected, and the influencing factors such as mental disorders diagnosis, mental impairment and personality change were analyzed by chi-square test. Results The most common symptom of this group was neurosis syndrome (42.3%). In intelligence impairment, IQ <70 group was lower than IQ group before education (P <0.05), the former had traumatic brain injury (P <0.01). The degree of brain injury in personality change group was higher than that in non-personality change group (P <0.01), and the incidence of personality change in frontal and / or temporal lobe injury group was higher than that No and / or temporal lobe injury cases (P <0.01). Conclusion There are many symptoms of severe craniocerebral injury with mental disorders, and the most common is mental damage. The most common neurotic syndrome is mental disorder after mild craniocerebral injury. In addition to considering the degree of trauma in the identification process should be considered pre-injury education, brain injury sites, individual qualifications, environmental factors, and pay attention to grasp the timing of identification in order to identify the conclusions more just and objective.