社会功能评价在精神发育迟滞患者性侵害案中的应用

目的探讨社会功能水平在精神发育迟滞患者性自我防卫能力评定中的作用。方法对性侵害案中125例符合CCMD-3精神发育迟滞诊断标准的性受害者采用自编法医精神病学鉴定案例登记表收集一般资料,使用韦氏智力测试量表(WAIS-RC)、成人智残评定量表和功能大体量表(GAF)进行评定。结果不同等级的性自我防卫能力的患者在职业、婚姻、文化程度、性知识及生育史等方面有显著差异。成人智残评定量表、大体功能评定量表(GAF)、智商(IQ)和鉴定诊断的一致性(Kappa值)分为0.710、0.661、0.494,三者和性自我防卫能力的一致率分为0.538、0.472、0.316。结论不能仅用智商来确定精神发育迟滞患者的性自我防卫能力的水平,应充分重视社会功能在性自我防卫能力评定中的作用。

Evaluation on social function in cases involving sexual assault of patients with mental retardation

Objective To explore social function in assessment of self-defense capability of patients with mental retardation against sexual assault.Methods The data of 125 sexual assault victims with mental retardation were collected according to our forensic psychiatry assessment criteria.Mental retardation was rated with WAIS-RC,GAF,and the rating scale of the intelligence disability.Results There were significant differences in occupation,marital status,education,knowledge about sex,and history of pregnancy among the patients with different levels of self-defense capability.The kappa values of the rating scale score of the intelligence disability,GAF,and IQ were 0.710,0.661,and 0.494;the kappa values of that and self-defense capability were 0.538,0.472,and 0.316 respectively.Conclusion The level of social function is very important in the assessment of self-defense capability in patients with mental retardation.