| Background:Background:on May 1,2013,the landmark mental health law was officially implemented,providing legal protection for the legitimate rights and interests of mental patients.In 2016,the Ministry of justice promulgated the revised general principles of judicial expertise procedures,which strengthened the connection mechanism between the management of judicial expertise and the use of judicial expertise,and standardized the procedures of judicial expertise entrustment,acceptance,implementation,opinion issuance and cross examination in court.The grading of the degree of disability caused by human injury,which was implemented on January 1,2017,not only replaces the assessment of the disability of the injured in road traffic accidents(GB18667-2002)in 2002,but also promotes the unification of the identification of human disability and the application of compensation law.Since 2011,the Ministry of justice has successively promulgated and implemented a number of technical specifications,such as the standard of forensic psychiatric examination for mental disorders,the guide to the assessment of criminal responsibility for mental disorders and so on,which makes forensic psychiatric identification have national standards,and provides quality assurance for the scientization,standardization and standardization of forensic psychiatric identification.Due to the revision and implementation of these laws and regulations and the application of identification guidelines,in the practice of forensic psychiatric identification,there will be some changes in the types of entrusted identification capacity,the assessment of legal capacity,the assessment of disability level,medical diagnosis and so on.Therefore,it is of great theoretical and practical significance to compare the forensic psychiatric identification cases before and after the implementation of mental health law and related guidelines,and to explore the changes of forensic psychiatric identification matters,case characteristics and expert opinions,so as to standardize and improve the quality of forensic psychiatric identification in the next step.Objective:To compare and analyze the current situation and characteristics of forensic psychiatric expertise cases in the past 10 years before and after the implementation of relevant regulations and guidelines,and to seek the general rules and development trend of forensic psychiatric expertise,so as to explore the impact of the implementation of relevant regulations and guidelines on forensic psychiatric expertise,and to further understand the changing rules of forensic psychiatric expertise,To improve the accuracy and quality of identification.Methods:A retrospective case-control study was conducted.A total of 1507 cases were identified by the Institute of forensic psychiatry of Shandong Ankang Hospital from January 1,2009 to December 30,2009and from January 1,2009 to December 30,2019.The identified cases from January 1,2009 to December 30,2009 were set as 2009 group(395cases),From January 1 to December 30,2019,the identified cases were set as the 2019 group(1112 cases).The self-made questionnaire(including general demographic characteristics,case types,cause of case,diagnosis and legal ability)was used to collect data.The two groups of cases were compared between groups and within groups,and the status and characteristics of the two groups of cases were comprehensively analyzed.Spss20.0 software was used for data entry and statistical analysis(~—x±s)T-test was used.The continuous variables in accordance with non normal distribution were represented by median(lower quartile,upper quartile)[M(QL,Qu)],and the classified variables were represented by rate(%)and constituent ratiχ2 inspection;Spss20.0software was used to analyze the single factor with significant difference by logistic regression.The difference was statistically significant(P<0.05).Result:1.General demographic characteristics of 2009 and 2019 appraisal groups:there were significant differences in age,marriage,place of birth,residence and occupation between the two groups(P<0.05).2.Clinical features2.1 There were significant differences in the use of psychoactive substances between the two groups.In 2019,the number of alcohol users in the identification group was significantly more than that in 2009,while the number of drug users was less than that in 2009(10.60 vs 8.40,3.00vs 0.70,P<0.05),χ2=13.288,P=0.01)。2.2 There was significant difference in family history between the two groups.Compared with the appraisal group in 2009,the incidence of family history of psychosis was lower in the appraisal group in 2019(12.30 vs 19.10,P<0.05),χ2=59.029,P=0.000)。3.The distribution characteristics of forensic psychiatric cases in the two groups3.1 In terms of the nature of cases,the proportion of civil cases(traffic accident cases)in 2019 was significantly higher than that in 2009(29.70 vs 5.10,P<0.05),χ2=67.132,P=0.000),while the proportion of criminal cases decreased significantly(25.30 vs 8,χ2=67.132,P=0.000)。3.2 Expert diagnosis:the number of cases of mental disorders caused by brain trauma in 2019 increased significantly compared with that in2009(5.80 vs 31.50),while the number of cases of schizophrenia,affective disorder and non psychosis decreased significantly compared with that in 2009(31.10 vs 16.50,17.50 vs 12.90,11.90 vs 10.30,P<0.05),χ2=186.937,P=0.000)。3.3 Client:in 2019,the proportion of court filed for appraisal increased significantly compared with that in 2009(41.20 vs 12.20),and the proportion of public security and prison applied for appraisal decreased compared with that in 2009(70.60 vs 57.80,15.70 vs 0.50,χ2=230.297,P=0.000)。3.4 Entrusted matters:the proportion of sexual self-defense cases,civil capacity cases and mental disability cases increased in 2019compared with that in 2009,in which the increase of mental disability cases was more obvious(9.60 vs 10.40,3.50 vs 9.50,5.60 vs 30.50),and the proportion of criminal cases and prison capacity cases decreased compared with that in 2009(55.70 vs 45.00,17.00 vs 0.40,χ2=322.266,P=0.000)。3.5 Entrusting territory and entrusting party’s ownership:the proportion of entrusting party outside Jining City increased compared with that in 2009(82.50 vs 72.70,P<0.05),χ2=17.447,P=0.000)。4.Characteristics of two groups of criminal cases:4.1 Identification diagnosis:the top medical diagnosis of the two groups were schizophrenia,affective disorder,mental retardation and no psychosis,with significant difference between the two groups(35.50 vs25.20,21.80 vs 26.20,8.60 vs 10.00,15.90 vs 20.40,P<0.05),χ2=21.330,P=0.031)。4.2 Assessment of criminal responsibility ability:the proportion of cases assessed as full responsibility ability is significantly higher than that of the 2019 group,while the proportion of cases assessed as limited and no responsibility ability is significantly lower than that of the 2019 group(33.20 vs 68.00,33.60 vs 19.00,33.20 vs 13.00,33.20 vs 68.00,33.60 vs19.00,33.20 vs 13.00,respectively),χ2=78.699,P=0.000)。5.Characteristics of two groups of civil cases:5.1 The composition of civil cases in the two groups:there is a significant difference in the composition of civil cases between the two groups,and the proportion of divorce and contract cases in the two groups is significantly lower than that in the 2009 group(30.80 vs 4.80,15.40 vs 5.70,P<0.05),χ2=11.575,P=0.006)。5.2 Judgment of civil capacity:there was no significant difference in judgment of civil capacity between the two groups(P>0.05).6.Characteristics of mental disability cases in the two groups:Disability Rating:the disability rating of the 2019 group was higher than that of the 2009 group,and there was a significant difference between the two groups[6.50(5.00,8.00)vs 9.00(8.00,10.00)](P=0.000).7.Two groups of sexual self-defense ability appraisal case characteristics:two groups in the legal judgment of asexual self-defense ability accounted for more than 80%,there was no difference in the appraisal diagnosis(P>0.05).In conclusion:With the continuous improvement of laws and regulations and the implementation of relevant guidelines:1.The proportion of civil cases,mental disability assessment cases,and sexual self-defense capacity assessment cases has increased significantly,while the proportion of criminal cases has decreased significantly;2.The proportion of appraisal applications submitted by the court has increased,indicating that the review and assessment of cases have become more stringent;3.The increase of appraisal cases outside Jining City indicates that appraisal institutions are widely recognized and the accuracy of appraisal has been improved;4.The proportion of full criminal responsibility in the constitution of criminal cases has increased. |
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