精神疾病司法鉴定情况分析

Analysis for the forensic expertise of mental illness

目的调查20年间精神疾病司法鉴定案例的特点及发展变化趋势。方法对2001至2020年在司法鉴定中心进行精神疾病司法鉴定案例的人口学资料、案件类型、医学诊断及法律能力评定进行回顾性分析。结果20年间鉴定案例8302例,鉴定有效案例为8228例(有效率99.1%),刑事案件4596例(55.9%),民事案件1700例(20.7%),被害和性防卫能力案件1054例(12.8%),服刑能力780例(9.5%)。其中刑事案件中以故意杀人、故意伤害、盗窃案件居前三位;民事案件中以民事行为能力及交通事故案例位居前列,且呈逐年增加的趋势,尤以近5年明显增加。医学诊断的排序为:无精神病(28.2%),精神分裂症(19.2%),器质性精神障碍(16.2%),精神发育迟滞(15.6%),双相情感障碍(6.0%),抑郁障碍(5.7%)。在评定法律能力的案例中:刑事责任能力(62.3%)、性自我防卫能力(14.0%)、民事行为能力(12.1%)位于前三位。无刑事责任能力中,精神分裂症居首位(66.7%),无行为能力中器质性精神障碍最多(74.6%),无性自我防卫能力中精神发育迟滞占71.0%,无服刑能力中精神分裂症居多(62.3%)。多元Logistics回归分析显示男性(OR=7.462,P<0.001)、农民(OR=1.321,P=0.001)、个体(OR=1.873,P=0.018)、31~40岁(OR=1.281,P=0.016)、双相情感障碍(OR=1.580,P=0.005)是刑事鉴定案件的危险因素。结论目前刑事责任能力鉴定案件仍然是精神疾病司法鉴定工作的重点,民事案件中民事行为能力及交通事故鉴定案例明显上升,医学诊断无精神病的比例上升。

Objective To investigate the characteristics and development trends of forensic cases of mental illness in the past 20 years.Methods The demographic data,case types,medical diagnosis,and legal capabilities assessment of judicial appraisal of mental illness cases from 2001 to 2020 in Forensic Identification Center of our hospital were retrospectively analyzed.Results A total of 8,302 cases were identified in the past 20 years,with 8,228 effective cases(effective rate 99.1%),of which,there were 4,596(55.9%)criminal cases,and 1,700(20.7%)civil cases,1,054(12.8%)cases of victims,and 780 cases(9.5%)of serving sentences.Of the criminal cases,intentional homicide,intentional injury,and theft were among the top three.The civil capacity appraisal cases and traffic accident cases ranked in the top,with increasing year by year,especially in the past five years.The order of top five medical diagnoses was non-psychosis(28.2%),schizophrenia(19.2%),organic mental disorder(16.2%),mental retardation(15.6%),bipolar affective disorder(6.0%),depressive disorder(5.7%).Among the 7,089 cases of legal capacity assessment,criminal responsibility capacity(62.3%),sexual self-defense capacity(14.0%),and civil capacity(12.1%)were among the top three.The schizophrenia ranked first(66.7%)among the legal capacity rated as incapable of criminal responsibility,the organic mental disorder was the most in incapacity rating cases(74.6%),and the mental retardation accounted for 71.0%in the inability to self-defense and no sentence was served.Schizophrenia was the majority who were not capable of serving a sentence(62.3%).Multivariate Logistic regression analysis showed that males,farmers,individuals,31~40 years of age,bipolar disorder were the risk factors in criminal identification cases(P<0.01 or P<0.05).Conclusion At present,the identification of capacity for criminal responsibility is still the focus of judicial identification of mental illness.The identification of capacity for civil conduct and traffic accidents in civil cases in increased significantly,and the proportion of medical diagnosis without mental illness is increased.