Griebnitz E, Mitterauer B, Kofler B
Institut für Forensische Psychiatrie, Universität Salzburg.
Versicherungsmedizin. 1993 Jun 1;45(3):74-9.
In the legal judgment of suicidal cases following brain trauma the emphasis is put on the causality between trauma and suicide on the one hand, and on the question of free determination of intent, on the other hand. These problems are investigated empirically in the present study and an explanatory model based on act theory is proposed. At first, an annual sample of suicides in the region of Salzburg is put through a multidimensional diagnosis (suicidal axis syndrome-Mitterauer 1981). The suicidal axis syndrome consists of the following three components: 1. Suicide attempts in the history 2. Diagnosis of exogenous or (and) endogenous brain dysfunction 3. Suicide-positive history. Of a total of 130 exactly interpretable suicide cases there were 16 cases with a brain trauma followed by an organic brain syndrome in the history. Of these, 11 had announced their suicidal attempts previously and 4 presented with a suicide-positive family history. Although the assessment of suicide in the family history is difficult due to insufficient information, the suicidal axis syndrome was definitely confirmed in 4 suicide cases. We attempt to show that at least in those cases with a suicidal axis syndrome, the free determination of intent is to be negated at the moment of suicide, and that due to the existing chronic brain syndrome a causality between trauma and suicide seems to be given in a neuropsychiatric sense.
在脑外伤后自杀案件的法律判定中，一方面重点在于创伤与自杀之间的因果关系，另一方面在于意图自由决定的问题。本研究对这些问题进行了实证调查，并提出了一个基于行为理论的解释模型。首先，对萨尔茨堡地区每年的自杀样本进行多维度诊断（自杀轴综合征——米特瑙尔，1981年）。自杀轴综合征由以下三个部分组成：1. 既往有自杀未遂史；2. 诊断为外源性或（和）内源性脑功能障碍；3. 有自杀倾向的家族史。在总共130例可准确解释的自杀案例中，有16例既往有脑外伤并伴有器质性脑综合征。其中，11例曾提前宣布过自杀企图，4例有自杀倾向的家族史。尽管由于信息不足，家族史中自杀倾向的评估存在困难，但在4例自杀案例中，自杀轴综合征得到了明确证实。我们试图表明，至少在那些患有自杀轴综合征的案例中，在自杀瞬间意图的自由决定是不存在的，并且由于存在慢性脑综合征，从神经精神病学角度来看，创伤与自杀之间似乎存在因果关系。
