ABSTRACT
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Subject(s)
Humans , Male , Female , Preventive Psychiatry/methods , Preventive Psychiatry/trends , Psychiatry/methods , Psychiatry/organization & administration , Psychiatry/standards , Accident Prevention/methods , Accidents, Traffic/legislation & jurisprudence , Accidents, Traffic/prevention & control , Accidents, Traffic/statistics & numerical dataABSTRACT
The aim of this study is to determine how personality disorders (PDs) are viewed in relation to criminal responsibility (CR) within the jurisprudence of the Spanish Supreme Court. All sentences with PD from 2000 to 2006 were included. The most frequently occurring PDs are cluster B and nonspecific disorders, alongside another Axis I disorder. The Spanish Supreme Court admitted appeals on 50%, and sentencing criteria were changed in 25% of the cases. The most frequent outcome was in the first instance a minor reduction in CR and second full CR being upheld. The borderline PD and the comorbidity between a PD and an Axis I disorder are the variables associated with the decrease in CR. The assessment of CR in PD should be undertaken using the diagnosis as a base taking into account other elements, such as the type of PD, its seriousness, comorbidity, and relationship with the criminal behavior on trial.
Subject(s)
Crime/legislation & jurisprudence , Forensic Psychiatry , Mentally Ill Persons/legislation & jurisprudence , Humans , Mental Competency/legislation & jurisprudence , Personality Disorders/psychology , Regression Analysis , Retrospective Studies , SpainABSTRACT
BACKGROUND AND OBJECTIVE: Whiplash injury (WI) is commonly evaluated in medico-legal practice. With the aim of knowing the determining factors of WI's medico-legal prognosis, a prospective and observational study was carried out. PATIENTS AND METHOD: One hundred and twenty consecutive patients who were clinically observed and evaluated in the Medico-Legal Clinic of Barcelona were studied. Socio-demographic, clinical, radiographic and evolutive factors were analyzed. RESULTS: We included 120 patients with a mean age of 35.6 (14) years (range, 4-74), with a homogeneous male/female distribution. An earlier cervical pathology was detected in 10% of patients; none of them had previous psychiatric pathology. 95% corresponded to road-traffic accident cases and there were 5 aggression cases. Over 50% of cases involved a rear-end collision. All patients had neck pain, almost 25% had headache and 13% had paresthesia. According to the Whiplash Association Disorders clinical classification, distribution in grades (G) was: G I 51%, G II 32% and G III 17%. Patients reported recovery within a mean time of 71.6 (46) days (range, 4-244), with 51,2 (45) no working days (range, 0-180 days). The 52% of the patients rest with complains. According to the recovery time, the following medico-legal prognostic factors were identified: age (p < 0.001), being female (p = 0.001), clinical grade (p < 0.001) and abnormal cervical MRI exploration (p < 0.001). Patients with previous cervical pathology reported more complaints (p = 0.001). CONCLUSIONS: In our study, WI affected young people of both sex mainly during rear-end collision. Worst medico-legal prognostic factors were age, being females, severity of initial clinical symptoms, previous cervical pathology and abnormal cervical MRI/CT.
Subject(s)
Forensic Medicine/statistics & numerical data , Liability, Legal , Whiplash Injuries , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Spain , Whiplash Injuries/epidemiology , Whiplash Injuries/physiopathologyABSTRACT
FUNDAMENTO Y OBJETIVO: El síndrome del latigazo cervical (SLC) es una de las lesiones valoradas con más frecuencia en la práctica médico-forense diaria. Con el objetivo de conocer los factores que contribuyen al pronóstico médico-legal, se ha realizado un estudio observacional y prospectivo. PACIENTES Y MÉTODO: Se evaluó pericialmente a 120 pacientes consecutivos con SLC en la clínica médico-forense de Barcelona. Se registraron variables sociodemográficas, clínicas, radiológicas, evolutivas y periciales. RESULTADOS: La edad media (DE) fue de 35,6 (14) años (límites: 4-74) con una distribución homogénea en sexo, un 10 por ciento tenía antecedentes de enfermedad cervical previa y ninguno presentaba antecedentes psiquiátricos. En un 95 por ciento se trataba de accidentes de tráfico y en 5 casos fueron agresiones. En algo más de la mitad la colisión fue dorsal, todos los pacientes tenían cervicalgia, casi una cuarta parte cefalea y un 13 por ciento parestesias. El 51 por ciento de los pacientes tenían un grado clínico I de la clasificación de la Whiplash Association Disorders, un 32 por ciento el grado II y un 17 por ciento el grado III. El número medio de días de curación de las lesiones fue de 71,6 (46) días (límites: 4-244) y el número medio de días impeditivos, de 51,2 (45) (límites: 0-180). En el 52 por ciento de los pacientes quedaron secuelas. Como factores relevantes en el pronóstico médicolegal, en relación con los días de curación, hemos encontrado la edad (p < 0,001), el sexo femenino (p = 0,001), el grado clínico (p < 0,001) y tener una exploración neurorradiológica cervical alterada (p < 0,001). Los sujetos con antecedentes de enfermedad cervical previa tenían más secuelas (p = 0,001). CONCLUSIONES: En nuestro medio la población que presenta un SLC es joven, con igualdad de sexos y en la mayoría de las ocasiones se trata de un accidente de tráfico con colisión trasera. Como factores de peor pronóstico médico-legal hemos encontrado la edad, el sexo femenino, un mayor grado clínico inicial, la existencia de enfermedad cervical previa y el hecho de tener una resonancia magnética o TC cervical anormal (AU)
