Chen Xiacan, Zhang Xueli, Wong Stephen C P, Yang Min, Kong Di, Hu Junmei
West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, China.
Key Laboratory of Evidence Science (China University of Political Science and Law), Ministry of Education, Beijing, China.
Crim Behav Ment Health. 2018 Apr;28(2):202-215. doi: 10.1002/cbm.2054. Epub 2017 Oct 19.
Little is known about the characteristics of people with and without schizophrenia who have been charged with homicide in China.
Our research question was what differences are there between alleged homicide offenders with and without psychosis?
All archival records of alleged homicide cases referred for assessment to the West China Forensic Central Medical Service during 1998-2006 were retrieved. The centre serves a large catchment area in the mainly rural province of Sichuan. A random 20% of cases with schizophrenia and all cases without psychosis were selected for comparison. Demographic, criminological and mental health data were extracted from the records, and violence was rated by using the Violence Risk Scale (Chinese version).
The two groups differed significantly in age, education, occupation, marital status and relationships to victim. The estimated risk of reoffending was higher in the schizophrenia group than the non-psychotic group, even after controlling for demographic differences. Despite many individuals reporting long histories of mental illness, about 40% of those with schizophrenia had never had any psychiatric treatment and less than 4% were in treatment at the time of the alleged homicide.
The tendency for homicidal people with schizophrenia to be older, less educated and more socially isolated than their non-psychotic peers is similar to experience in Western countries, but the apparently higher risk scale scores of the Chinese schizophrenia group and their greater tendency to attack strangers are different. The lack of reported previous engagement with mental health services by a clearly ill and risky group of people is a likely explanation. Similar rural problems compared with better served urban areas have been reported in the Chuvash Republic. The case for better rural mental health services seems strong. Copyright © 2017 John Wiley & Sons, Ltd.
在中国，关于被控杀人的精神分裂症患者与非精神分裂症患者的特征鲜为人知。
我们的研究问题是，有精神病和无精神病的被控杀人罪犯之间存在哪些差异？
检索了1998年至2006年间转介至华西法医中心进行评估的所有被控杀人案件的档案记录。该中心服务于四川省这个主要为农村地区的大片区域。随机抽取20%的精神分裂症患者案例和所有无精神病患者案例进行比较。从记录中提取人口统计学、犯罪学和心理健康数据，并使用暴力风险量表（中文版）对暴力行为进行评分。
两组在年龄、教育程度、职业、婚姻状况以及与受害者的关系方面存在显著差异。即使在控制了人口统计学差异之后，精神分裂症组再次犯罪的估计风险仍高于非精神病组。尽管许多人报告有长期精神疾病史，但约40%的精神分裂症患者从未接受过任何精神科治疗，在被控杀人时接受治疗的不到4%。
与非精神病同龄人相比，患有精神分裂症的杀人者年龄更大、受教育程度更低且社会隔离程度更高的趋势与西方国家的情况相似，但中国精神分裂症组明显更高的风险量表得分以及他们更倾向于攻击陌生人的情况有所不同。一个明显患病且有风险的群体此前未报告接受过心理健康服务，这可能是一个解释。楚瓦什共和国也报告了与服务较好的城市地区相比农村地区存在类似问题。改善农村心理健康服务的理由似乎很充分。版权所有© 2017约翰·威利父子有限公司。
