Analysis of Post-Concussion Syndrome Disability Re-appraisal / 法医学杂志

OBJECTIVES@#To understand the current status of appraisal of post-concussion syndrome disability and the reasons for the changes in re-appraisal opinions.@*METHODS@#The cases that were judged as "post-concussion syndrome and ten-level disability" in the first appraisal and re-appraised for psychiatric impairment by the Academy of Forensic Science in 2019 were analyzed retrospectively.@*RESULTS@#There were 75 cases, including 58 cases with pre-hospital emergency medical records, among which 39 cases were clearly recorded to be without a history of coma; 74 cases had emergency medical records, among which 44 cases were recorded of having a history of coma; 43 cases had follow-up medical records, among which 24 cases had a history of psychiatric follow-up. The most complained symptoms of the appraisee in appraisal and examination include headache, dizziness, poor sleep at night, irritability, memory loss, fatigue and inattention. The main reasons for the re-appraisal application include doubts about the history of coma, doubts about the credibility of mental symptoms, post-concussion syndrome didn't meet the disability criteria, and objections to the original appraisal procedure or the original appraisal agency. The appraisal opinions of a total of 47 cases were changed. Seven of them did not meet the disability criteria, and the main reason was that there was no clear history of coma and no head injury was admitted; the coma history of the 40 other cases had to be confirmed by the court before they can be clearly identified as disabilities. The reason was that the records about the history of coma were inconsistent or there were alterations and additional information.@*CONCLUSIONS@#In the past, the conditions for appraisal of post-concussion syndrome disability were too lax and must be further standardized and strictly controlled.

Application of Mismatch Negative in Evaluation of Severity of Mental Disorders due to Traumatic Brain Injury / 法医学杂志

Objective To explore the applied value of mismatch negative （MMN） in evaluation of severity of mental disorders due to traumatic brain injury. Methods Thirty-five patients（case group） that conform to the diagnostic criteria of organic （traumatic brain injury） mental disorder in ICD-10 Classification of Mental and Behavioural Disorders criteria were selected. Twenty-four healthy subjects （normal control group） that matched the case group in terms of gender, age composition ratio and educational level were selected. All subjects were evaluated by Activity of Daily Living Scale （ADL） and Social Disability Screening Schedule （SDSS） and then examined by Event-Related Potential （ERP）. A statistical analysis of the data was made by SPSS 22.0 software. Results The 32 patients and 24 normal control subjects completed the study. The scores of ADL and SDSS were significantly higher in the case group than in the normal control group （P<0.05）. The latency of Fz, FCz, Cz and Pz in the case group was significantly longer than that in the normal control group （P<0.05）. In the case group, the latency of Fz, FCz, Cz and Pz was positively correlated with the scores of ADL and SDSS （P<0.05）. The equation can be well fitted with the scores of ADL and SDSS. The latency and amplitude of Fz, FCz, Cz and Pz were used as concomitant variables and whether or not the subjects had mental disorders due to traumatic brain injury as dependent variables. Conclusion The latency of MMN can be used as an indicator in potential evaluation of the severity of mental disorders due to traumatic brain injury, which means that the longer the latency of MMN is, the more severe mental disorders due to traumatic brain injury may be. The combined application of ADL, SDSS and MMN can be an objective indicator in preliminary judgment of mental disorders due to traumatic brain injury.

Personality Change due to Brain Trauma Caused by Traffic Accidents and Its Assessment of Psychiatric Impairment / 法医学杂志

OBJECTIVE@#To explore the main performance of personality change in people with mild psychiatric impairments which due to the brain trauma caused by traffic accidents and its value in assessment of psychiatric impairment.@*METHODS@#The condition of personality change of patients with traumatic brain injury caused by traffic accident was evaluated by the Scale of Personality Change Post-traumatic Brain Injury (SPCPTBI). Furthermore, the correlation between the personality change and the degrees of traumatic brain injury and psychiatric impairment were explored. Results In 271 samples, 239 (88.2%) with personality changes. Among these 239 samples, 178 (65.7%), 46 (17.0%), 15 (5.5%) with mild, moderate and severe personality changes, respectively. The ratio based on the extent of personality changes to the degree of brain trauma was not significant (P > 0.05), but the total score difference between the groups was significant (P < 0.05). There was no statistical significance between the medium and high severity brain trauma groups. The higher degree of personality changes, the higher rank of mental disabilities. The total score difference of the scale of personality change among the different mild psychiatric impairment group was significant (P<0.05). The difference between other psychiatric impairment levels had statistical significance (P < 0.05) except level 7 and 8.@*CONCLUSION@#The occurrence of personality change due to traumatic brain injury caused by traffic accident was high. Correlations exist between the personality change and the degree of psychiatric impairment. Personality change due to brain trauma caused by traffic accident can be assessed effectively by means of SPCPTBI, and the correlation between the total score and the extent of traumatic brain injury can be found.

Progress on association between COMT gene and violence behavior in patients with schizophrenia / 法医学杂志

The prevalence of violence behavior in patients with schizophrenia is higher than that in common population. Data suggest that genetic factors may play a substantial role for the etiology of the behavior. Among the particular gene polymorphisms that have been considered to be involved in violence behavior, the catechol-O-methyltransferase (COMT) gene had been the focus of recent research. This article reviews the association research between COMT gene and violence behavior in patients with schizophrenia in several aspects: SNP polymorphism of COMT Val158Met and COMT Ala72Ser, haplotype of COMT gene and DNA methylation of promoter region of COMT gene. The genetic research direction is presented for patients with schizophrenia.

Function disorder assessment on patients with mild psychiatric impairment due to road traffic accidents / 法医学杂志

OBJECTIVE@#To explore the methods to assess the function disorder of patients with mild psychiatric impairment due to road traffic accidents.@*METHODS@#In contrast to that of the patient with physical impairment, the function disorder of the patient with mild psychiatric impairment was assessed by the standard assessment instruments, such as the Barthel index of ADL (BI), Functional Activities Questionnaire (FAQ), Social Disability Screening Schedule (SDSS), Activity of Daily Living Scale (ADL), Physical Self-maintenance Scale (PSMS), and Instrumental Activities of Daily Living Scale (IADL).@*RESULTS@#Except BI, the each total score of FAQ, SDSS, ADL, PSMS, and IADL correlated well with the rank of psychiatric impairment. The difference of each total score of rating scales among different physical impairment rank was not statistically significant. At the impairment rank of level 10, the difference of each total score of FAQ and ADL was not significant between the two groups; each total score of BI, SDSS, and IADL in psychiatric impairment was higher than that of physical impairment, while the total score of PSMS in psychiatric impairment was lower than that of physical impairment. At the level 9, except PSMS, the each total score of BI, FAQ, SDSS, IADL and ADL in psychiatric impairment was higher than that of physical impairment. At the level 8, except BI and PSMS, the each total score of FAQ, SDSS, IADL and ADL in psychiatric impairment was higher than that of physical impairment.@*CONCLUSION@#The different criteria for assessment of mild psychiatric and physical impairment may exist, and appropriate indexes for assessment between physical and psychiatric impairment need to be further elucidated.

Preliminary study on civil capacity rating scale for mental disabled patients / 法医学杂志

OBJECTIVE@#To create civil capacity rating scale for mentally disabled patients, and explore its feasibility during the forensic psychiatric expertise.@*METHODS@#The civil capacity-related items were determined after discussion and consultation. The civil capacity rating scale for mentally disabled patients was established and the manual was created according to the logistic sequence of the assessment. The rating scale was used during the civil assessment in four institutes.@*RESULTS@#There were 14 items in civil capacity rating scale for mentally disabled patients. Two hundred and two subjects were recruited and divided into three groups according to the experts' opinion on their civil capacities: full civil capacity, partial civil capacity and no civil capacity. The mean score of the three groups were 2.32 +/- 2.45, 11.62 +/- 4.01 and 25.02 +/- 3.90, respectively, and there was statistical differences among the groups. The Cronbach alpha of the rating scale was 0.9724, and during the split-reliability test, the two-splited part of the rating scale were highly correlated (r = 0.9729, P = 0.000). The Spearman correlative coefficient between each item and the score of the rating scale was from 0.643 to 0.882 (P = 0.000). There was good correlation between the conclusion according to the rating scale and the experts' opinion (kappa = 0.841, P = 0.000). When the discriminate analysis was used, 7 items were included into the discrimination equation, and 92.6% subjects were identified as the correct groups using the equation.@*CONCLUSION@#There is satisfied reliability and validity on civil capacity rating scale for mentally disabled patients. The rating scale can be used as effective tools to grade their civil capacity during the forensic expertise.

Advanced investigation of testamentary capacity of the mentally disordered / 法医学杂志

Testamentary capacity is one of the civil competences, it means that a natural person enjoys the capacity or qualification to establish testament and deal with his property. Recently, the cases of testamentary capacity assessment of the mentally disordered are increasing. This article firstly introduces the concepts of the testament as well as the testamentary capacity, and then summarizes the assessment standard of the testamentary capacity, by using the Banks v. Goodfellow case as a basis to make the standard criteria including: the understanding of the nature of a will and codicil, the knowledge of the general extent of one's assets, the knowledge of the natural object of one's bounty, the understanding of the impact of the distribution of the assets of the estate, and the absence of a delusion specifically affecting the distribution of the estate. The impact factors of the testamentary capacity, including dementia, mood disorder, schizophrenia, alcohol, drug, and undue influence, etc., are summarized. Lastly, the related assessment tools such as the Mini-Mental State Examination, the Clock-Drawing Test, and the Testament Definition Scale are introduced briefly.

Civil competence assessment of the mental disorders involved in contract dispute / 法医学杂志

OBJECTIVE@#To search the criteria for evaluating the civil competence of the mental disorders involved in contract dispute.@*METHODS@#Data on the interviewee's mental status and the forensic expertise were collected retrospectively. And 6 indexes were selected and graded: awareness of situation, factual understanding of issues, appreciation of likely consequences, rational manipulation of information, functioning in one's own environment and communication of choice. All of the data were analyzed by SPSS.@*RESULTS@#Fifty six cases were included and interviewee's civil competence was graded to three levels: full civil competence, diminished civil competence, and no civil competence. These cases included two types of contract: the real estate related contract (38 cases) and the labor related contract (14 cases). All of the 6 indexes were well correlated to the forensic expertise. The related coefficient was from 0.703 to 0.834, and the interrelated coefficient of the 6 items was also high, from 0.712 to 0.877.@*CONCLUSION@#It is feasible to divide the civil competence of the mental disorders into three grades. As the basis, these 6 indexes mentioned above are representative and can be applied in further standardized and quantified assessment of civil competence.

Assessment time on mental disability due to brain damage / 法医学杂志

OBJECTIVE@#To determine the best time for assessing mental disability due to brain damage.@*METHODS@#Ninety-three mental disabilities due to brain damage in traffic accidents were assessed and their follow-up studies were taken in different period after the brain injury: 3 months, 6 months, 9 months and 12 months. The patients' brain imaging, electroencephalogram (EEG) and detailed medical history were collected. Then to interview the patients' family members and to assess the patients' mental conditions with Wechsler Adult Intelligence Scale (WAIS), Social Disability Screening Schedule (SDSS), and Activity of Daily Living Scale (ADL). Diagnosis and disability assessments were based on all of the above information.@*RESULTS@#ADL and SDSS had good distinction between different levels of disability and different time. The overall sample demonstrated that there was no statistically significant difference between patients' ADL and SDSS averages in 9 and 12 months. For mild disability, there was no statistically significant difference between ADL and SDSS averages in 6, 9 and 12 months. For moderate disability, there was no statistically significant difference between ADL and SDSS in 9 and 12 months. And there was no statistically significant difference between ADL and SDSS averages in 6, 9 and 12 months for severe disability.@*CONCLUSION@#For mild disability, it is recommended to assess the mental disability 6 months after the injury, for moderate disability, it is 9 months. The statistics data recommended that the best assessment time for severe disability is 6 months after injury. However, our comprehensive analysis concludes that the suitable time is 9 months after injury.

Civil competence assessment of the mental disorders involved in compensation of personal injury / 法医学杂志

OBJECTIVE@#To seek and ascertain indicators that can be used in the civil competence assessment of the mental disorders involved in compensation of personal injury.@*METHODS@#A retrospective study was made on the data related to the interviewee's mental status assessed by forensic experts during the period from 2003 to 2005 in Institute of Forensic Science, Ministry of Justice, P.R.China. The 6 indicators, including awareness of situation, factual understanding of issues, appreciation of likely consequences, rational manipulation of information, functioning in one's own environment, and communication of choice, were graded and statistically analyzed using SPSS 11.5 software.@*RESULTS@#The 6 indicators correlated well with the assessment of forensic experts ,with the related coefficient between 0.632 and 0.876, and the inter-related coefficient among the 6 indicators between 0.575 and 0.911.@*CONCLUSION@#The 6 indicators could be used for the civil competence assessment and may also be taken as the basis for further standardization and quantification of civil competence.

Influencing factors of psychopath's civil litigation / 法医学杂志

OBJECTIVE@#To explore the influencing factors of schizophrenic patient's capability in civil litigation, and to establish the base of quantitative study about execution of civil litigation.@*METHODS@#To study questionnaires completed from patients with and without civil litigation capabilities and to determine the influencing factors from medical and forensic aspects.@*RESULTS@#One hundred patients were admitted to the study and were divided into two groups based on capability in civil litigation. There were significant differences in psychiatric and legal aspects between the groups.@*CONCLUSION@#Capability of schizophrenic patients in perusing civil litigation had been impaired or even complete lost.

The assessment of criminal responsibility of schizophrenic rape offenders / 法医学杂志

OBJECTIVE@#To explore potential application of Diminished Criminal Responsibility Rating Scale (DCRRS) on rape offenders.@*METHODS@#The DCRRS was used retrospectively to study 77 cases of rape offenders. They were divided into three groups according to the degree of diminished criminal responsibility.@*RESULTS@#There were significant differences in rating scores among three groups (mild group 21.32+/-5.56, moderate group 25.92+/-5.19, and major group 29.54+/-4.62), and 16 of 18 items showed good correlation with the total scores of the scale (r=0.256 to 0.611), 7 factors were extracted by the factor analysis and their cumulative squared loadings was 75.784%.@*CONCLUSION@#The DCRRS is valid and reliable in a in assessment of criminal responsibility schizophrenic rape offenders.

The application of diminished criminal responsibility rating scale to schizophrenia offenders / 法医学杂志

OBJECTIVE@#To explore the feasibility of Diminished Criminal Responsibility Rating Scale(DCRRS) to schizophrenia offenders.@*METHODS@#The DCRRS were used respectively to 325 cases of schizophrenia offender which were divided into three groups according to the degree of criminal responsibility.@*RESULTS@#There were significant differences in rating score among three groups (mild group 21.16 +/- 4.17, moderate group 25.87 +/- 5.43, major group 29.35 +/- 4.60), and all items have good correlation with the total score of the scale. 6 factors were extracted by the factor analysis, and their cumulative squared loadings is 68.485%.@*CONCLUSION@#The diminished criminal responsibility in schizophrenia offenders could be divided into three grades.

Association between depression and G72 gene polymorphism / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the association between G72 gene polymorphisms and depression,and to probe the difference of G72 gene polymorphisms between depression with and without mixed family history.</p><p><b>METHODS</b>The polymorphisms of G72 gene (rs947267 and rs2181953) were detected by PCR technique in 100 depressive patients without mixed family history, 50 depressive patients with mixed family history and 86 normal controls.</p><p><b>RESULTS</b>(1) The frequencies of rs947267 genotypes and alleles in female depressive patients without mixed family history were significant different to the controls (P=0.017 and P=0.008), the OR scores were 0.300 (A/A, P=0.010), 0.456(A, P=0.008) and 2.195(C, P=0.008) respectively; but in male patients there were no significant differences to the controls (P>0.05). (2) The frequencies of rs2181953 genotypes and alleles in the depressive patients without mixed family history were not significantly different to the controls regardless of sex (P>0.05). (3) The frequencies of rs947267 and rs2181953 genotypes and alleles in the depressive patients with mixed family history were not significantly different to the controls regardless of sex (P>0.05).</p><p><b>CONCLUSION</b>The G72 gene polymorphism may be associated with female depressive patients without mixed family history,C allele of rs947267 may be the risk factor.</p>

Study of rating scale of mentally prisoner's competency to serve a sentence / 法医学杂志

OBJECTIVE@#To create an instrument to determine the mental prisoners' competency to serve a sentence, which is according with the Chinese legal system.@*METHODS@#Integrating the Chinese criminal jurisprudence and the authors' forensic psychiatric experience, the research team created an instrument which called Competency to serve a sentence Rating scale firstly, then used the instrument retrospectively, in the end the validity and reliability of the instrument were inspected and, through an diagnostic test, the feasibility of the instrument was evaluated.@*RESULTS@#Homogeneity reliability of the instrument is 0.8779, the correspondence of the conclusion between the instrument and the expertise is 0.909, except the positive likelihood ratio is 0.0683, the other diagnostic index are better.@*CONCLUSION@#The Competency to serve a sentence Rating Scale is feasible.

Study of affecting factors of mentally prisoner's competency to serve a sentence / 法医学杂志

OBJECTIVE@#Explore the affecting factors of mentally prisoner's competency to serve a sentence (CSS), establish the base of quantitative study of CSS.@*METHODS@#Firstly, the researchers compile a questionnaire named legal-psycho ability of competency to serve a sentence questionnaire, then the researchers scaling the object with RTHD, and ask all object complete the questionnaire. there a hypothesis, that the object who are cured in cured ward is incompetent to serve a sentence (ISS), and the other who are stay in rehabilitated ward is competent to serve a sentence (CSS).@*RESULTS@#There are 185 object admitted the study, the ISS group the CSS group have significance between psychiatric and legal aspects.@*CONCLUSION@#At the influence of psychiatric symptoms, the mentally prisoner's competency to serve a sentence had been impaired, and they should been transferred from prison to hospital.

A study of mental health issues in the objects of substance abstinence who got labor education and rehabilitation / 法医学杂志

OBJECTIVE@#To investigate the personality and mental health of the objects of substance (caffeine, cocaine, hallucinogens and so on) abstinence who got labor education and rehabilitation.@*METHODS@#258 male objects and 250 female objects of substance abstinence selected randomly from institutions of labor education and rehabilitation were assessed with MMPI and SCL-90.@*RESULTS@#MMPI tests indicated the personality abnormality in the objects. SCL-90 tests manifested the mental health abnormality of them compared with Chinese models, especially in the female objects.@*CONCLUSION@#More attention should be paid on the mental health of the objects of substance abstinence.

The creation of an instrument to determine competency to stand trial / 法医学杂志

OBJECTIVE@#To create an instrument to determine the mental disorder offenders' competency to stand trial, which is according with the Chinese legal system.@*METHODS@#Integrating the foreign instruments and the Chinese criminal jurisprudence, and combing the authors' forensic psychiatric experience, the research team created an instrument which was called Competency to stand trial Determining Instrument firstly, then used the instrument in practice, in the end the validity and reliability of the instrument were inspected, and through an diagnostic test, the feasibility of the instrument was evaluated.@*RESULTS@#Split-half and homogeneity reliability of the instrument is 0.9366 and 0.9213 respectively, the correspondence of the conclusion between the instrument and the expertise is 0.704. Except the sensitivity is 0.6097, all the other diagnostic index are over 0.80.@*CONCLUSION@#The Competency to stand trial Determining Instrument is feasible.