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[534例创伤性脑损伤所致精神障碍的法医精神病学案例]

[Forensic psychiatric cases of 534 mental disorders caused by traumatic brain injury].

作者信息

Li Ting, Li Guo-Rong, Jiang Hong-Xia, Tang Chen-Dong, Tang Jian-Liang

机构信息

Department of Forensic Medicine, Kangci Hospital of Jiaxing, Jiaxing 314500, China.

出版信息

Fa Yi Xue Za Zhi. 2013 Apr;29(2):116-9.

Abstract

OBJECTIVE

To analyze the types of mental disorders caused by traumatic brain injury and the optimal time for forensic psychiatric appraisal. To explore the relationship between the degree of traumatic brain injury, the time of appraisal and the grade of intellectual deficiency.

METHODS

Five hundred and thirty-four forensic psychiatric cases of mental disorders caused by traumatic brain injury were retrospectively analyzed.

RESULTS

In the types of mental disorders caused by traumatic brain injury, the most cases were diagnosed as organic mood disorders (51.1%), following organic neurosis-like syndrome (24.0%) and organic intellectual deficiency (18.0%). For the disability grades, the most cases were the level VIII and IX disability grades, 219 cases (41.0%) and 177 cases (33.1%), respectively. The degree of brain injury and the degree of intelligence defection according to WAIS-RC were higher in intellectual deficiency group compared with non-intellectual deficiency group (P < 0.05). The grade of disability correlated with the degree of brain injury, the result of WAIS-RC, the result of cerebral CT scanning, and the grade of brain electrical activity mapping (BEAM) abnormality (P < 0.05). Nevertheless, the degree of intellectual deficiency did not correlate with appraisal time and the degree of brain injury (P > 0.05).

CONCLUSION

The factors influencing intellectual deficiency are complex. The findings of objective examination including cerebral CT scanning, BEAM, WAIS-RC and others should be considered as important indexes for disability evaluation.

摘要

目的

分析创伤性脑损伤所致精神障碍的类型及法医精神病鉴定的最佳时机。探讨创伤性脑损伤程度、鉴定时间与智力缺损程度之间的关系。

方法

回顾性分析534例创伤性脑损伤所致精神障碍的法医精神病案例。

结果

在创伤性脑损伤所致精神障碍类型中,诊断最多的是器质性心境障碍(51.1%),其次是器质性神经症样综合征(24.0%)和器质性智力缺损(18.0%)。就伤残等级而言,最多的是八级和九级伤残等级,分别为219例(41.0%)和177例(33.1%)。与非智力缺损组相比,智力缺损组的脑损伤程度及根据韦氏成人智力量表修订版(WAIS-RC)得出的智力缺损程度更高(P<0.05)。伤残等级与脑损伤程度、WAIS-RC结果、脑CT扫描结果及脑电地形图(BEAM)异常等级相关(P<0.05)。然而,智力缺损程度与鉴定时间及脑损伤程度无关(P>0.05)。

结论

影响智力缺损的因素复杂。包括脑CT扫描、BEAM、WAIS-RC等在内的客观检查结果应被视为伤残评定的重要指标。

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