Perr I N
University of Medicine and Dentistry, Robert Wood Johnson Medical School, Piscataway, New Jersey 08854.
Bull Am Acad Psychiatry Law. 1991;19(2):203-14.
The application of the concept of multiple personality disorder (MPD) is one of the most complex and controversial issues facing forensic psychiatrists. The case presented is one in which a diagnosis of multiple personality disorder is not only well documented, but was so diagnosed at least 10 years before the ultimate homicide. Nonetheless, consideration of the legal issues was difficult. Other cases, particularly the Bianchi case, reflect the clinical difficulties in diagnosis. Subsequent cases have reflected a judicial review of the issues and a trend to disallow the concept of MPD as a defense; the author suggests that forensic psychiatrists incorporate these opinions in their future judgments.
多重人格障碍(MPD)概念的应用是法医精神病学家面临的最复杂、最具争议的问题之一。本文所呈现的案例中,多重人格障碍的诊断不仅有充分的记录,而且在最终的杀人事件发生至少十年前就已确诊。尽管如此,对法律问题的考量仍很困难。其他案例,尤其是比安奇案,反映了诊断方面的临床困难。后续案例则体现了对这些问题的司法审查以及不允许将MPD概念作为抗辩理由的趋势;作者建议法医精神病学家在未来的判断中纳入这些观点。