法医学杂志

法医学杂志 ›› 2017, Vol. 33 ›› Issue (2): 158-161.DOI: 10.3969/j.issn.1004-5619.2017.02.010

• 论著 • 上一篇    下一篇

颅脑损伤后器质性人格障碍的司法精神病学分析

李晨虎1，黄莉娜2，张明昌3，贺  盟3   

  1. （1. 上海市徐汇区精神卫生中心，上海 200232； 2. 上海市公安局物证鉴定中心 上海市现场物证重点实验室，上海 200083； 3. 复旦大学基础医学院法医学系，上海 200032）
  • 发布日期:2017-04-25 出版日期:2017-04-28
  • 通讯作者: 贺盟，男，硕士，主要从事司法精神病鉴定及法医病理学鉴定；E-mail：042101055@fudan.edu.cn
  • 作者简介:李晨虎（1974—），男，硕士，副主任医师，主要从事司法精神病鉴定及精神障碍的康复研究；E-mail：li_chenhu@163.com

Forensic Psychiatric Assessment for Organic Personality Disorders after Craniocerebral Trauma

LI CHEN-HU1, HUANG LI-NA2, ZHANG MING-CHANG3, HE MENG3   

  1. （1. Shanghai Xuhui Mental Health Center, Shanghai 200232, China; 2. Shanghai Key Laboratory of Crime Scene Evidence, Institute of Forensic Science, Shanghai Public Security Bureau, Shanghai 200083, China; 3. Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China）
  • Online:2017-04-25 Published:2017-04-28

摘要： 目的 探讨不同程度颅脑损伤后人格障碍的发生情况及其临床表现的差异性。 方法 运用《国际疾病分类（第10版）》对396例因交通事故所致颅脑损伤的患者进行诊断，同时对颅脑损伤程度分级，并用大五人格量表简化版进行评定。 结果 器质性人格障碍的发生率为34.6%，中度及重度颅脑损伤后人格障碍的发生率为34.9%和49.5%，明显高于轻度颅脑损伤的18.7%（P＜0.05）。轻度颅脑损伤后人格障碍者在神经质、外向性及顺同性上与无人格障碍者比较，差异均有统计学意义（P＜0.05）；中、重度颅脑损伤后人格障碍者在神经质、外向性、顺同性及严谨性上与无人格障碍者比较，差异均有统计学意义（P＜0.05）；中度颅脑损伤后人格障碍者的顺同性及严谨性分数明显低于轻度颅脑损伤人格障碍者，重度颅脑损伤者较轻度颅脑损伤者具有更低的外向性分数。 结论 颅脑损伤的严重程度与器质性人格障碍的发生密切相关，同时对后者的临床特征也会产生影响，对于法医精神病鉴定具有一定的提示和帮助。

关键词: 司法精神病学, 颅脑损伤, 人格障碍, 临床特征, 大五人格量表

Abstract: Objective To explore the occurrence and the differences of clinical manifestations of organic personality disorder with varying degrees of craniocerebral trauma. Methods According to the International Classification of Diseases-10, 396 subjects with craniocerebral trauma caused by traffic accidents were diagnosed, and the degrees of craniocerebral trauma were graded. The personality characteristics of all patients were evaluated using the simplified Neuroticism Extraversion Openness Five-Factor Inventory （NEO-FFI）. Results The occurrence rate of organic personality disorder was 34.6% while it was 34.9% and 49.5% in the patients with moderate and severe craniocerebral trauma, respectively, which significantly higher than that in the patients （18.7%） of mild craniocerebral trauma （P＜0.05）. Compared with the patients without personality disorder, the neuroticism, extraversion and agreeableness scores all showed significantly differences （P＜0.05） in the patients of mild craniocerebral trauma with personality disorder; the neuroticism, extraversion, agreeableness and conscientiousness scores showed significantly differences （P＜0.05） in the patients of moderate and severe craniocerebral trauma with personality disorder. The agreeableness and conscientiousness scores in the patients of moderate and severe craniocerebral trauma with personality disorder were significantly lower than that of mild craniocerebral trauma, and the patients of severe craniocerebral trauma had a lower score in extraversion than in the patients of mild craniocerebral trauma. Conclusion The severity of craniocerebral trauma is closely related to the incidence of organic personality disorder, and it also affects the clinical features of the latter, which provides a certain significance and help for forensic psychiatric assessment.

Key words: forensic psychiatry, craniocerebral trauma, personality disorders, clinical features, Neuroticism Extraversion Openness Five-Factor Inventory

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