Uhlenbrock Judith, Hinrichs Jens, Heuft Gereon
Klinik für Psychosomatik und Psychotherapie Universitätsklinikum Münster Domagkstraße 22 48149 Münster Deutschland Klinik für Psychosomatik und Psychotherapie, Universitätsklinikum Münster.
Z Psychosom Med Psychother. 2017 Sep;63(3):234-250. doi: 10.13109/zptm.2017.63.3.234.
A retrospective study of expert opinions of a psychosomatic-psychotherapeutic university hospital for public and private customers over a period of 12 years Objectives: Both the public and the legislative have developed an increasingly critical awareness for the fact that expert witnesses need to be independent. In contrast, to date there have been few studies concerning the quantity and the results of psychosomatic-psychotherapeutic expert opinions for public and private clients.
In a retrospective study design, 285 expert opinions of a psychosomatic-psychotherapeutic university hospital stemming from consecutive, unselected random sampling over a 12-year time period (1990-2011) were analyzed using a predefined list of criteria. Besides client data, the study also noted the type and the objectives of the expertise, the sociodemographic data of the subjects, the biographic data of the subjects, the size of records, the particular psychopathological findings including conflict and structural diagnostics via the Operationalized Psychodynamic Diagnostics (OPD-2, Research Group 2006), syndromic diagnostics according to ICD-10 (WHO) including the related Impairment Scale Score (ISS, Schepank 1995), and the Global Assessment of Functioning-Scale (GAF, Heuft 2016).
54% of the subjects were men. All subjects were 46 years old at the time of examination; on average symptomatology had existed for 7 years, which made assessment of causality difficult. Most assignments referred to the effects of diseases or accidents in private contexts, followed by pension reports. Among the expert opinions related to possible implications of acts of violence, 95% were women. In 43.2% (n = 123) of the cases, the assessment had occurred in the context of legal action. In 65 cases at least one party had requested a supplemental written report during further procedure. In 17.8% (n = 22) of the cases sought by the courts, the expert witness was requested by at least one party to present the assessment verbally.
It should be emphasized that OPD conflict and structural diagnostics appear indispensable also for assessing mental health prior to an external event (accident or assault). The use of the two severity ratings (ISS, GAF) is discussed. It is proposed that expert witnesses be requested to name all their clients fromthe last 5 years at the beginning or end of the expert opinion, so that their independence from possible conflicts of interest can be established.
对一家身心治疗大学医院为公众和私人客户提供的专家意见进行为期12年的回顾性研究。目的：公众和立法机构对专家证人需要独立这一事实的认识日益批判性增强。相比之下，迄今为止，关于身心治疗专家为公众和私人客户提供意见的数量和结果的研究很少。
采用回顾性研究设计，使用预先定义的标准清单，对一家身心治疗大学医院在12年期间（1990 - 2011年）通过连续、无选择随机抽样得出的285份专家意见进行分析。除客户数据外，该研究还记录了专业意见的类型和目的、受试者的社会人口统计学数据、受试者的传记数据、记录规模、特定的精神病理学发现，包括通过操作性精神动力学诊断（OPD - 2，研究组2006年）进行的冲突和结构诊断、根据国际疾病分类第10版（世界卫生组织）进行的综合征诊断，包括相关的损伤量表评分（ISS，谢潘克1995年）以及功能总体评定量表（GAF，霍夫特2016年）。
54%的受试者为男性。所有受试者在接受检查时均为46岁；平均症状已存在7年，这使得因果关系评估困难。大多数任务涉及私人背景下疾病或事故的影响，其次是养老金报告。在与暴力行为可能影响相关的专家意见中，95%为女性。在43.2%（n = 123）的案例中，评估是在法律诉讼背景下进行的。在65个案例中，至少有一方在进一步程序中要求提供补充书面报告。在法院寻求的17.8%（n = 22）的案例中，至少有一方要求专家证人口头陈述评估意见。
应强调的是，OPD冲突和结构诊断对于在外部事件（事故或袭击）之前评估心理健康似乎也是不可或缺的。讨论了两种严重程度评级（ISS，GAF）的使用。建议要求专家证人在专家意见的开头或结尾列出过去5年的所有客户，以便确定他们与可能的利益冲突的独立性。
