司法精神病学鉴定后的处理情况调查

目的 为了维护社会安全和依法保障精神病人的合法权益，需要正确处理精神病违法者。实际上，人们对司法精神病学鉴定后的处理情况知之甚少。因此，进行此项调查研究。方法 采用邮寄调查问卷的方式对四川省５２个县市的１８３例精神病违法者进行调查。结果 在处置精神病违法者的机关中，公安局占７３．０８％，法院占２６．７２％。有责任能力组中有２．２２％被无罪释放；无责任能力组中有２．１０％被判邢；部分责任能力组中有１     

司法精神病学鉴定后的处理情况调查

目的为了维护社会安全和依法保障精神病人的合法权益，需要正确处理精神病违法者。实际上，人们对司法精神病学鉴定后的处理情况知之甚少。因此，进行此项调查研究。方法采用邮寄调查问卷的方式对四川省52个县市的183例精神病违法者进行调查。结果在处置精神病违法者的机关中，公安局占73．08％，法院占26．72％。有责任能力组中有2．22％被无罪释放；无责任能力组中有2．10％被判刑；部分责任能力组中有13．95％被无罪释放。结论公安局是处理精神病违法者的主要机构。存在不适当处置情况，尤其对部分责任能力者的处理更复杂、更困难。     

Principles of the forensic psychiatric assessment of exhibitionism

Incompetence of the existing approach to forensic psychiatric assessment of exhibitionism as well as the necessity for conducting the analysis of direct manifestations of perverse behaviour are shown. Dissimilar clinical manifestations of this kind of paraphilias are presented and its fixed, compulsive and impulsive variants are described. The necessity for singling out differential forensic psychiatric criteria depending on psychopathologic characteristics of exhibitionism is stressed.     

HELP: an educational forensic psychiatric assessment program

This paper describes the establishment of an educational group, Health through Education in Law and Psychiatry (HELP), within an inpatient forensic psychiatric assessment service. Until recently HELP sessions have been provided twice weekly to suitable patients during their stay of some 30 days at the Metropolitan Toronto Forensic Service (METFORS). We first outline very briefly the function of METFORS, then describe the HELP project broadly, and finally discuss the rationale of the program in greater detail. Our point is that programs of this type form an added resource in assessment and in the early stages of treatment. We also argue that, along with the accepted clinical role in assessment, forensic psychiatrists and colleagues in related disciplines can serve a valuable role as teacher and therapist.     

Domestically and generally violent forensic psychiatric outpatients: personality traits and behavior

A group of 63 domestically violent patients and a group of 103 generally violent patients at a Dutch forensic psychiatric outpatient clinic are examined with regard to personality traits and problem behaviors to develop treatment programs for domestically violent patients. The domestically violent patients are more unstable from a psychological viewpoint but not more inclined to anger than the average Dutch male. They report less anxiety in situations in which criticism can be given but more anxiety in situations in which someone can be given a compliment. When comparing domestically violent patients with generally violent patients, domestically violent patients score lower on anger as disposition and on aggressive behavior than the generally violent patients do. However, both groups do not differ from each other in their score on the dimension of psychopathy.     

司法精神病学鉴定中癫痫所致精神障碍的研究现状

癫痫与精神障碍在我国均是常见的多发病．如不及时而恰当地治疗，可发展为慢性病，迁延数年，严重者造成残疾，甚至终生不愈，从而对患者的身心健康、工作、学习、婚姻以及社会功能等等造成巨大影响。因此二者不仅是医学问题而且是社会问题。据6城市调查协作组（1982）的流行病学调查数据显示癫痫发病率是37／10万。患病率4．4‰．据此推算我国至少有癫痫患者500万～600万。根据世界卫生组织（1999）的统计．非传染性疾病占全球疾病负担的比重日益增加．其中精神障碍占全球疾病总负担的10．5％（中低收入国家）和23．5％（高收入国家）。所以二者消耗的卫生经济资源是惊人的，引起了各国专家学者的重视。而随着研究的深入．发现两者间存在某种必然的联系．癫痫人群的精神分裂症患病率为3％～7％．而精神分裂症在普通人群的患病率为1％。对该联系的认识首先由Morel（1860）介绍，发现有些癫痫患者出现发作性精神症状。Lernpert等（1990）研究表明66％的癫痫病人有精神异常，其中最多的是抑郁症状。两者间究竟存在怎样的内在联系并彼此相互作用的呢？长期以来一直成为各国学者的研究热点之一。     

司法精神病学鉴定中癫痫所致精神障碍的研究现状

癫痫与精神障碍在我国均是常见的多发病,如不及时而恰当地治疗,可发展为慢性病,迁延数年,严重者造成残疾,甚至终生不愈,从而对患者的身心健康、工作、学习、婚姻以及社会功能等等造成巨大影响,因此二者不仅是医学问题而且是社会问题。据6城市调查协作组(1982)的流行病学调查数据显示癫痫发病率是37/10万,患病率4.4‰,据此推算我国至少有癫痫患者500万～600万。根据世界卫生组织(1999)的统计,非传染性疾病占全球疾病负担的比重日益增加,其中精神障碍占全球疾病总负担的10.5%(中低收入国家)和23.5%(高收入国家)。所以二者消耗的卫生经济资源是…     

Substance use disorders in forensic psychiatric patients

There is a lack of detailed information on the role of substance use disorders (SUD) as a substantial factor in offences and treatment in forensic psychiatric patients. The aim of this study was to get a better understanding of these specifics. Clinical records of 193 male patients admitted to a Dutch forensic psychiatric hospital were scrutinized on anamnestic, diagnostic and risk assessment data. One of the central findings was that the prevalence of SUDs was high. Patients with an SUD had a more extensive criminal history, unstable and deviant lifestyle and higher risk of violent behavior than patients without a substance use disorder. No differences were found in duration of treatment, aggressive incidents and leave. Another important finding was that a distinction could be made between patients with substance use as a primary criminogenic risk factor and patients with substance use as a secondary risk factor. Although substance use is identified as a general risk factor, this study supports the idea of sub categorization of patients with an SUD and emphasizes the need for a different treatment approach. Further study is needed to identify specific treatment approaches, based on more differentiated profiles of these patients.     

The presence of counsel at forensic psychiatric examinations

In virtually all situations involving forensic psychiatric assessments, the patient is represented by counsel. But does this fact entitle the lawyer to be present at the clinical evaluation? In a series of New York cases spanning a generation, judges have allowed presence of counsel at the psychiatric examination. The most common reason given for such a conclusion is to assure better cross-examination of the expert witness. Psychiatric evaluations mandated by law necessitate several guidelines different from those of the usual doctor/patient relationship. While we may have to accept the presence of attorneys in our consulting rooms, they should be observers only. To allow active intervention would distort the clinical process.     

The precarious practice of forensic psychiatric risk assessments

The development of forensic psychiatric risk assessments is discussed from a clinical point of view using the example of Sweden. A central task in forensic psychiatry has traditionally been to identify dangerous, mentally disordered subjects considered to be prone to commit violent acts. Over time, “dangerousness” has been reworded into “risk”. Nevertheless, such assessments have generally been based on the psychiatric factors characterising the individual patient, while group interaction, situational factors, or social and cultural circumstances, such as the availability of alcohol and drugs, have been largely overlooked. That risk assessments have a focused on people with a diagnosis of “mental disorder” and been used as grounds for coercive measures and integrity violations has somehow been accepted as a matter of course in the public and political debate. Even the basic question whether offenders with a mental disorder are really more prone to criminal recidivism than other offenders seems to have been treated light-handedly and dealt with merely by epidemiological comparisons between groups of persons with broad ranges of psychosocial vulnerability and the general population. Legal texts, instructions and guidelines from the authorities in charge are often vague and general, while actors in the judicial system seem to put their trust in psychiatric opinions. The exchange of professional opinions, general public expectations, and judicial decision processes poses a huge risk for misunderstandings based on divergent expectations and uses of terminology.     

医疗差错法医学鉴定

在诊疗护理工作中,由于行为人失职行为或技术过失,发生了一般性错误,给病员造成一定痛苦,延长了治疗时间,但无不良后果称为医疗差错.本文拟就医疗差错法医学鉴定进行探析.医疗差错虽然不构成医疗事故,但客观上存在着医疗单位工作人员在工作中的不足、差错或失误.     

Recent life events and subjective well-being of personality disordered forensic outpatients

PurposeThe majority of patients treated at forensic psychiatric outpatient facilities suffer from personality disorders, especially Cluster B disorders. Life events have been shown to influence subjective well-being, severity of psychopathology and delinquent behaviour of patients with different personality disorders. However, the influence of life events on subjective well-being of patients suffering from Cluster B personality disorders has rarely been studied. Following General Strain Theory and the dynamic equilibrium model, we hypothesised that negative life events would negatively influence subjective well-being, and that subjective well-being would change when an instability of life events occurs.MethodsFifty-six adult male forensic psychiatric outpatients were interviewed on their subjective well-being and filled out a self-report life event questionnaire, at three time-points, with an interval of three months. Life events were categorized along two dimensions: positive / negative and controllable / uncontrollable.ResultsPatients had a stable pattern of positive, negative controllable and uncontrollable life events. Positive controllable events did not have a stable pattern. Results indicated that only negative controllable events correlated negatively with subjective well-being. Furthermore, positive and positive controllable events correlated with a positive change in subjective well-being and uncontrollable events correlated negatively with this change.ConclusionsForensic psychiatric outpatients seem to experience a relatively stable ‘load’ of stressful life events, that does not influence change in subjective well-being. We did not find unequivocal support for General Strain Theory. In line with the dynamic equilibrium model, forensic outpatients seemed less used to positive controllable life events, which influenced positive change in subjective well-being. In outpatient forensic treatment, attempts to limit negative life events together with enhancing behaviour which results in positive events should be targeted. This might result in better lives for patients and in reduced criminal behaviour.     

司法鉴定若干理论问题研究(1)(1998年北京大学法学硕士研究生论文)

序　　言ｗｉｇｍｏｒｅ于 194 0年指出 ,在美国意见证据规则把诉讼变成合法化的赌博 ,在这方面其弊端超过其他诉讼法规则。Ｌ .Ｈａｎｄ法官在 193 2年的判决中说 ,没有一条法律规则被人滥用超过本 (意见证据 )规则。① 这意味着 ,司法鉴定及其制度是诉讼中认识最混乱、积弊最深、问题最多的领域之一 ,应当受到充分重视。司法鉴定在诉讼中具有不可替代的作用 ,是现代诉讼制度的技术基础 ,在现实的诉讼中发挥着越来越重要的作用 ,而司法鉴定结论失真却是诉讼中的一个常见问题 ,是导致错案的一个重要原因。对于鉴定结论失真 ,司法上必须排除…     

司法鉴定若干理论问题研究(1)（1998年北京大学法学硕士研究生论文）

序言 wigmore 于1940年指出,在美国意见证据规则把诉讼变成合法化的赌博,在这方面其弊端超过其他诉讼法规则。L．Hand 法官在1932年的判决中说,没有一条法律规则被人滥用超过本（意见证据）规则。这意味着,司法鉴定及其制度是诉讼中认识最混乱、积弊最深、问题最多的领域之一,应当受到充分重视。     

电子数据司法鉴定工具可靠性评估研究

探讨建立对电子数据司法鉴定工具进行科学性及可靠性的评估方法。在已有的国内外取证工具评测方法的基础上,借鉴国家强制认证认可和可靠性工程等因素,对电子数据司法鉴定工具可靠性评估体系中的工具基本认可和定性评估二阶段进行详细分析,为保证司法鉴定实践的科学性和准确性提供理论依据。     

Risk of homicidal behavior among discharged forensic psychiatric patients

We studied the risk of homicidal behavior among 281 released male forensic psychiatric patients during the 14-year period 1978–1991. Released patients were about 300 times more likely to commit a homicide than the general male population during the first year outside hospital, and the corresponding risk was 53-fold during a mean follow-up period of 7.8 years. The odds ratio for committing a homicide among all Finnish schizophrenics during the 12-year period 1980–1991 was 9.7, which indicates that previous criminality associated with schizophrenia also increases the risk of homicidal behavior remarkably when compared with schizophrenia per se. We believe that this kind of epidemiological approach is a useful method of identifying and classifying factors associated with very high risk of homicidal behavior and preventing homicidal behavior among high-risk populations.     

司法精神病鉴定证据价值论

司法精神病鉴定作为科学的认识活动,由于其本身的固有属性及诸多因素之影响,其鉴定结论在很大程度上具有不确定性.因此,要求法官在采信鉴定结论之前,必须结合司法精神病鉴定的特点、司法精神病鉴定结论的证据属性,分析、判断其证据价值.并通过对相关制度的完善,充分发挥庭审质证之功能,帮助法官提升对司法精神病鏊定结论形成内心确信的准确性.