Grünberger Josef, Wisnecky Thomas, Keckeis Katinka, Kaplan Sonja, Heilmann Jutta, Twardowsky Patricia, Stöhr Hans, Bösch Anna
Universitätsklinik für Psychiatrie und Psychotherapie, Medizinische Universität Wien, Wien, Austria.
Wien Med Wochenschr. 2012 Apr;162(7-8):176-81. doi: 10.1007/s10354-012-0063-6. Epub 2012 Mar 28.
Pupillometry is a non-invasive investigation based on the concept that pupillary reagibility depends on a number of specific sensory, mental and emotional variables. By means of the receptor test based on the topical application of the cholinergic antagonist tropicamide cognitive deficits can be evaluated. The present study focuses on the question whether the receptor test is able to differentiate criminally responsible mentally disordered offenders (§ 21/2 StGB) with different durations of confinement concerning the presence of a functional psychosyndrome, as defined by Grünberger.
Four groups of offenders with different durations of confinement (group A: confinement 0-2 years, n = 26, X = 33; group B: 2-5 years, n = 29, X = 34; group C: 5-10 years, n = 6, X = 36; group D: >10 years, n = 10, X = 43) were investigated by means of a computer-assisted TV pupillometer. After a baseline measurement 0.01% tropicamide was instilled into the eye. The second measurement was conducted 20 min after the first, the 3rd and 4th measurements in intervals of 20 min.
The groups with a longer duration of confinement showed a reduced activation and vigilance and increased fatigability as compared with the groups of shorter confinement. In the receptor test the group that had been imprisoned for 0-2 years showed more cognitive deficits than those imprisoned for ≥5 years.
Evaluation of activation, fatigability and vigilance indicates that the duration of confinement plays a role in the development of a functional psychosyndrome. The results of the receptor test, in which the group with a longer duration of confinement showed less pronounced cognitive deficits and no significant changes of the tropicamide effect over time, suggest that in this group a dose change might be required to make the cognitive deficits evident.
瞳孔测量法是一种基于瞳孔反应性取决于多种特定感觉、心理和情绪变量这一概念的非侵入性检查方法。通过基于局部应用胆碱能拮抗剂托吡卡胺的受体测试，可以评估认知缺陷。本研究聚焦于受体测试是否能够区分被关押不同时长的应负刑事责任的精神障碍罪犯（《德国刑法典》第21/2条）是否存在如格伦贝格尔所定义的功能性心理综合征。
使用计算机辅助电视瞳孔计对四组被关押时长不同的罪犯进行调查（A组：关押0至2年，n = 26，X = 33；B组：2至5年，n = 29，X = 34；C组：5至10年，n = 6，X = 36；D组：>10年，n = 10，X = 43）。在进行基线测量后，将0.01%的托吡卡胺滴入眼内。第一次测量后20分钟进行第二次测量，第三次和第四次测量间隔20分钟。
与被关押时长较短的组相比，被关押时长较长的组表现出激活和警觉性降低以及易疲劳性增加。在受体测试中，被关押0至2年的组比被关押≥5年的组表现出更多的认知缺陷。
对激活、易疲劳性和警觉性的评估表明，关押时长在功能性心理综合征的发展中起作用。受体测试结果显示，被关押时长较长的组认知缺陷不那么明显，且托吡卡胺效应随时间无显著变化，这表明在该组中可能需要改变剂量才能使认知缺陷显现出来。
