精神分裂症病人肇事因素分析

就鉴定案例中肇事精神分裂症病人与一般精神分裂症群体、其他肇事精神病人群体的资料进行比较,结果显示：精神分裂症群体的肇事率、凶杀率远高于其他精神病群体;肇事精神分裂症病人的诊治情况明显差于一般精神分裂症群体,且再婚率低,家庭支持系统不力等。提示：加强对精神分裂症病人的社会监管和治疗,是防止肇事行为发生,维护社会治安的积极措施。     

Differences in Handwritings of Schizophrenia Patients and Examination of the Change after Treatment

The aim of this study was to analyze the differences between the handwritings of schizophrenia patients and healthy subjects in addition to the changes that occurred in schizophrenia patients' handwriting in response to the treatment. The test subjects were 29 schizophrenia patients and 29 healthy individuals with the same age, gender, and dominant hand. The changes in the handwritings were examined according to 14 different parameters. On the day of admittance, the percentage of extra letters was 16.7%, and after 7–10 days of hospitalization, it rose to 33.3%. The percentage of skipped words decreased from 29.2% to 16.7% after 7–10 days of hospitalization, and to 10% after 3 weeks. The letters written by schizophrenia patients are significantly larger in height and width compared to the control group. The schizophrenia patients showed a higher incidence of crossed-out letters, adding extra words, missing punctuation as well as missing words.     

COMT基因与精神分裂症患者暴力攻击行为关联性的研究进展

精神分裂症患者的暴力攻击行为发生率高于一般人群,暴力攻击行为在某些方面具有显著的遗传倾向性,与精神分裂症患者暴力攻击行为研究最多的是儿茶酚氧位甲基转移酶（catechol-O-methyltrans-ferase , COMT ）基因。本文从COMT Val158Met 和COMT Ala72Ser 的SNP 多态性、COMT 基因单倍型、COMT基因启动子区DNA甲基化等方面对COMT基因变异与精神分裂症患者暴力攻击行为的相关性研究进行综述,并提出精神分裂症患者暴力攻击行为的遗传学研究方向。     

多巴胺受体基因遗传多态性与精神分裂症的关联及法医学意义

精神分裂症是一种常见的多因子参与的复杂疾病,司法精神病学鉴定中对精神分裂症的涉及甚多,但无有效的生物学鉴定指标。研究表明,多巴胺神经递质功能紊乱可能在精神分裂症的发生及其主要症状中发挥重要作用。本文综述了多巴胺受体的分类、基因结构以及近年来关于多巴胺受体基因遗传多态性与精神分裂症的关联研究及其法医学意义。     

‘Monsters don’t bother me anymore’ forensic mental health service users’ experiences of acceptance and commitment therapy for psychosis

Acceptance and Commitment Therapy for psychosis (ACTp) is an approach that aims to change the relationship an individual with psychosis has with difficult thoughts, emotions and experiences. It promotes the use of acceptance, defusion, mindfulness and focussing on valued outcomes as opposed to struggling with psychotic experiences. This service evaluation project explored service users’ experiences and meanings of ACTp within a medium secure mental health service. Thematic analysis was used to analyse interviews with 10 male service users. Four main themes emerged from the data: ‘Recovery’, ‘Insight’, ‘Developing Skills’ and ‘Accessibility’. Overall, service users viewed their experience of ACTp positively and identified encouraging therapeutic outcomes. These findings suggest that ACTp is an approach that should be considered a therapeutic option within forensic mental health contexts. These outcomes were compared with previous research findings. Limitations of the study, clinical implications and ideas for future research have been discussed.     

The Psychopathological Profile of Cannibalism: A Review of Five Cases

In today's society, human cannibalism is extremely rare and represents an unthinkable act of violence. Scientific literature on the topic is sparse due to significant methodological problems, such as collecting enough data and generating unbiased analyses. The purpose of this article is to illustrate some psychodynamic aspects of cannibalism. After a review of the literature, we will present and compare five cannibalistic patients hospitalized in the Henri Colin secure unit (Villejuif, France). The patients described fall into two subgroups, suffering either from severe schizophrenia or from a mixed personality disorder with sadistic and psychopathic features associated with paraphilia. For the schizophrenia group, cannibalism is a self‐defense reaction to a perceived threat of destruction: survival depends on the annihilation or assimilation of the other. For the mixed personality disorder group, ego and narcissism are the central issue with a desire to overcome deep‐rooted frustrations by means of an extraordinary act.     

Religious Radicalization and Lone‐Actor Terrorism: A Matter for Psychiatry?

This article discusses the place of the psychiatric field in the ongoing phenomenon of religious radicalization. First, the article provides an overview of the existing literature on lone‐actor terrorists and the link with mental illness. Current research is focusing increasingly on lone‐actor terrorists. This is the most recent and rising development on the global terrorism scene. The literature is currently developing a more precise and informed definition of lone‐actor terrorism. The article then describes and discusses the case study of a mentally ill patient arrested following his assault on a military serviceman on the grounds of religious radicalization. The patient, diagnosed with schizophrenia, is taken as an example of the specific case of religious radicalization in patients with schizophrenia. Finally, the article discusses the curative and preventive roles that can be played by psychiatrists and other professionals who are in contact with these types of patients.     

精神分裂症者凶杀行为特征与其刑事责任能力相关性

目的探讨精神分裂症者凶杀行为特征及影响刑事责任能力评定的因素。方法自制调查表收集并比较经司法鉴定为具有凶杀行为的精神分裂症嫌疑人(n=110)与具有凶杀行为的无精神病者(n=70)的一般人口学资料、临床资料、作案行为特征、刑事责任能力等指标,并采用Logistic回归分析法探讨影响精神分裂症嫌疑人刑事责任能力的相关因素。结果精神分裂症组和无精神病组在年龄、性别、文化程度、婚姻状态方面差异无统计学意义(P0.05),两组在案发前思维障碍、情绪状态、社会功能等疾病相关因素方面差异均存在统计学意义(P0.05),并在攻击行为史、作案先兆、诱因、预谋、作案动机、作案对象、环境辨认、自我保护等一些与案情有关的特点上存在差异(均P0.05)。多因素Logistic回归分析显示,精神分裂症组的刑事责任能力与案发前思维障碍、情绪状态、社会功能、动机、预谋、自我保护性等因素有关(P0.05)。结论为提高对具有凶杀行为的精神分裂症嫌疑人刑事责任能力评定的准确性,应综合考虑相关精神病理因素及作案特征的影响。     

胆囊收缩素基因-45C/T多态性与精神分裂症的关联

目的 探讨精神分裂症人群胆囊收缩素(cholecystokinin,CCK)基因-45C/T位点遗传多态性及其法医学意义.方法采用双向等位基因特异性PCR方法对中国北方汉族群体207例精神分裂症患者(患者组)和202例健康个体(对照组)CCK基因-45C/T位点多态性进行检测.采用X<'2>检验对照组人群中基因型分布是...     

Partial Agonist Therapy in Schizophrenia: Relevance to Diminished Criminal Responsibility

Abstract: Pathological gambling (PG), classified in the DSM‐IV among impulse control disorders, is defined as inappropriate, persistent gaming for money with serious personal, family, and social consequences. Offenses are frequently committed to obtain money for gambling. Pathological gambling, a planned and structured behavioral disorder, has often been described as a complication of dopamine agonist treatment in patients with Parkinson’s disease. It has never been described in patients with schizophrenia receiving dopamine agonists. We present two patients with schizophrenia, previously treated with antipsychotic drugs without any suggestion of PG, who a short time after starting aripiprazole, a dopamine partial agonist, developed PG and criminal behavior, which totally resolved when aripiprazole was discontinued. Based on recent advances in research on PG and adverse drug reactions to dopamine agonists in Parkinson’s disease, we postulate a link between aripiprazole and PG in both our patients with schizophrenia and raise the question of criminal responsibility.