应激事件与精神障碍评定因果关系110例案例分析

Causality analysis of 110 cases on evaluation of mental disorder and stress event

目的了解司法鉴定中应激事件与精神障碍的因果关系评定特点,为提高此类案件鉴定质量提供参考依据。方法采用一般资料登记表对符合纳入标准的110例被鉴定人进行资料收集,并进行统计分析。结果男女年龄（χ2=10.253,P=0.000）、婚姻（χ2=8.359,P=0.015）、职业（χ2=15.344,P=0.009）比较差异有统计学意义。男性18岁以下的比例（47.2%）高于女性（19.3%）（χ2=9.690,P=0.001）,18~40岁的比例（35.8%）低于女性（61.4%）（χ2=7.176,P=0.007）;男性未婚比例（54.7%）高于女性（28.1%）（χ2=8.067,P=0.004）,已婚比例（41.5%）低于女性（68.4%）（χ2=8.052,P=0.004）;男性农民比例（32.1%）低于女性（61.4%）（χ2=9.477,P=0.002）,学生比例（47.2%）高于女性（17.5%）（χ2=11.111,P=0.000）。男女体型（χ2=11.647,P=0.003）、伤前性格（χ2=16.377,P=0.000）比较差异有统计学意义。男性瘦弱者、内向者比例（37.8%,41.7%）高于女性（12.3%,14.8%）（χ2=9.608,P=0.001;χ2=8.130,P=0.004）。未成年与成年被鉴定人家属反应程度比较差异有统计学意义（χ2=13.030,P=0.000）。未成年被鉴定人家属反应强烈者比例（75.7%）高于成年被鉴定人（41.1%）。家属反应程度与被鉴定人的年龄有显著关联性（χ2=18.022,P=0.000）。家属反应程度与被鉴定人的社会功能受损情况也有关联性（χ2=7.103,P=0.029）。男性神经症症状群出现频度（47.2%）低于女性（71.9%）（χ2=7.015,P=0.008）。应激事件与法律关系评定有关联性（χ2=45.975,P=0.031）。鉴定诊断与法律关系评定显著关联（χ2=155.067,P=0.000）。结论性别、年龄、性格等因素影响个体对应激事件的反应,鉴定时应综合考虑各影响因素,规范诊断,合理进行法律关系评定。

Objective To understand the characteristics of cases of assessment about stressful events and mental disorder,in order to provide reference for enhancing the quality of identification of mental injury. Methods The prepared registration form of general information with the standards included in this study was used to identify 110 cases of people to gather information. Then the results were analyzed. Results The difference between male and female in age（ χ2= 10. 253,P =0. 000）,marital status（ χ2= 8. 359,P = 0. 015）,occupation（ χ2= 15. 344,P = 0. 009） was significant. Following the 18-yearold male who was identified（ 47. 2%） was more than women（ 19. 3%）（ χ2= 9. 690,P = 0. 001）,between 18 to 40-year-old male who was identified（ 35. 8%） was less than women（ 61. 4%）（ χ2= 7. 176,P = 0. 007）; the proportion of unmarried men（ 54. 7%） was significantly larger than women（ 28. 1%）（ χ2= 8. 067,P = 0. 004）,the proportion of married men（ 41. 5%）was significantly smaller than women（ 68. 4%）（ χ2= 8. 052,P = 0. 004）; the rate of male farmers（ 32. 1%） was less than women（ 61. 4%）（ χ2= 9. 477,P = 0. 002）,the proportion of students（ 47. 2%） was higher than women（ 17. 5%）（ χ2=11. 111,P = 0. 000）. Men and women in the size differences were significant（ χ2= 11. 647,P = 0. 003）,the character before injury of men and women in the differences were significant（ χ2= 16. 377,P = 0. 000）. The proportion of thin and inbound in male（ 37. 8%,41. 7%） was higher than that in women（ 12. 3%,14. 8%）（ χ2= 9. 608,P = 0. 001; χ2= 8. 130,P = 0. 004）.The extent of family member＇s reaction between juvenile and adult were significant（ χ2= 13. 030,P = 0. 000）. The reaction of juvenile＇s family member（ 75. 7%） were stronger than adult（ 41. 1%）. Family members＇ reactions had significant correlation with the age（ χ2= 18. 022,P = 0. 000）. Family members＇ reactions were relevant to the level of social function damage（ χ2=7. 103,P = 0. 029）. The frequency of symptoms in men（ 47. 2%） was significantly lower than that in women（ 71. 9%）（ χ2=7. 015,P = 0. 008）. The reasons for damage assessment and the legal relations were relevant（ χ2= 45. 975,P = 0. 031）. There was significant correlation between identification of diagnosis and assessment of legal relationships（ χ2= 155. 067,P = 0. 000）.Conclusion Gender,age,character and so on have influence on the one＇s reaction to stress events,the main factors,give specific diagnosis,get on reasonable assessment of the legal relationship should be considered in identification.