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中国上海颅脑损伤后器质性人格障碍的法医精神病学分析

Forensic psychiatric analysis of organic personality disorders after craniocerebral injury in Shanghai, China.

作者信息

Li Beixu, Fang Youxin, Lin Junyi, Chen Xueyan, Li Chenhu, He Meng

机构信息

School of Policing Studies, Shanghai University of Political Science and Law, Shanghai, China.

Shanghai Fenglin Forensic Center, Shanghai, China.

出版信息

Front Psychiatry. 2022 Jul 29;13:944888. doi: 10.3389/fpsyt.2022.944888. eCollection 2022.

Abstract

OBJECTIVE

To explore the incidence rate and the differences of clinical manifestations of organic personality disorders with varying degrees of craniocerebral trauma.

MATERIALS AND METHODS

According to the International Classification of Diseases-10, 1,027 subjects with craniocerebral trauma caused by traffic accidents were reviewed, the degrees of craniocerebral trauma were graded and those with personality disorder after craniocerebral trauma were diagnosed. The personality characteristics of all patients were evaluated by using the simplified Neuroticism Extraversion Openness Five-Factor Inventory (NEO-FFI).

RESULTS

The incidence rate of organic personality disorder after all kinds of craniocerebral trauma was 33.1%, while it was 38.7 and 44.2% in the patients after moderate and severe craniocerebral trauma, respectively, which was significantly higher than that in the patients after mild craniocerebral trauma (18.0%) ( < 0.05). Compared with the patients without personality disorder, the neuroticism, extraversion and agreeableness scores all showed significantly differences ( < 0.05) in the patients with personality disorder after craniocerebral trauma; especially the conscientiousness scores showed significant differences ( < 0.05) in the patients with personality disorder after moderate and severe craniocerebral trauma. The agreeableness and conscientiousness scores in the patients with personality disorder after moderate and severe craniocerebral trauma were significantly lower than that after mild craniocerebral trauma, and the patients with personality disorder after severe craniocerebral trauma had lower scores in extraversion than that after mild craniocerebral trauma.

CONCLUSION

The severity and area of craniocerebral trauma is closely related to the incidence rate of organic personality disorder, and it also affects the clinical manifestations of the latter, which provides a certain significance and help for forensic psychiatric appraisal.

摘要

目的

探讨不同程度颅脑创伤所致器质性人格障碍的发生率及临床表现差异。

材料与方法

依据国际疾病分类第10版,对1027例因交通事故导致颅脑创伤的患者进行回顾性研究,对颅脑创伤程度进行分级,并诊断颅脑创伤后出现人格障碍的患者。采用简化的神经质-外向性-开放性五因素问卷(NEO-FFI)对所有患者的人格特征进行评估。

结果

各类颅脑创伤后器质性人格障碍的发生率为33.1%,中度和重度颅脑创伤患者的发生率分别为38.7%和44.2%,显著高于轻度颅脑创伤患者(18.0%)(P<0.05)。与无人格障碍的患者相比,颅脑创伤后有人格障碍的患者在神经质、外向性和宜人性得分上均有显著差异(P<0.05);尤其是中度和重度颅脑创伤后有人格障碍的患者在尽责性得分上有显著差异(P<0.05)。中度和重度颅脑创伤后有人格障碍的患者在宜人性和尽责性得分上显著低于轻度颅脑创伤后有此类障碍的患者,重度颅脑创伤后有人格障碍的患者在外向性得分上低于轻度颅脑创伤后有此类障碍的患者。

结论

颅脑创伤的严重程度和范围与器质性人格障碍的发生率密切相关,且影响其临床表现,这为法医精神病学鉴定提供了一定的意义和帮助。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5497/9374033/8536d995ace3/fpsyt-13-944888-g0001.jpg

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