Kowalski Piotr, Skupień Elzbieta
Z Katedry i Zakładu Medycyny Sadowej Collegium Medicum UJ.
Arch Med Sadowej Kryminol. 2007 Jul-Sep;57(3):343-6.
As it follows from the expertise practice of the authors, broadly understood "depression syndrome" is the most common diagnosis occurring in sick-leave certificates provided for legal procedures to the court. This problem is encountered in penal, civil and insurance cases. At the same time, in a significant percentage of cases, the patient's self-presentation does not correspond with the provided diagnosis. A particular legal situation of a person stigmatized with such a diagnosis clearly indicates its pragmatic character. Hence, several questions emerge: (1) Why does such a particular diagnosis prevail? (2) Is there another disease entity in psychiatry, which has such a broadly reactive background? On the basis of a particular case the authors formulate the problem of the appropriately understood interest of the patient. Does the current protection against broadly understood legal consequences cause the patient to fixate on the defense mechanisms and -- in consequence -- degradation of his functioning?
根据作者的专业实践经验，广义上理解的“抑郁综合征”是法院法律程序病假证明中最常见的诊断。在刑事、民事和保险案件中都会遇到这个问题。同时，在相当大比例的病例中，患者的自我陈述与所提供的诊断不符。被这种诊断污名化的人的特殊法律状况清楚地表明了其务实的性质。因此，出现了几个问题：（1）为什么这种特殊的诊断如此普遍？（2）精神病学中是否存在另一种具有如此广泛反应背景的疾病实体？基于一个特定案例，作者提出了对患者适当理解的利益问题。当前对广义法律后果的保护是否会导致患者固着于防御机制，进而导致其功能退化？
