[Personality Change due to Brain Trauma Caused by Traffic Accidents and Its Assessment of Psychiatric Impairment].

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.

The comparison of disposal attitudes towards forensic psychiatric patients among police officers, psychiatrists and community members in China.

OBJECTIVE: To understand disposal attitudes towards forensic psychiatric patients among police officers, psychiatrists and community members in China. METHOD: 118 community members, 121 psychiatrists and 105 police officers completed a questionnaire regarding disposal attitudes towards forensic psychiatric patients. RESULT: Surveyed respondents (87.4%) believed patients with mental disorders experienced discrimination, and 97.4% were in favor of providing livelihood security for them. Police officers (89.5%) agreed that patients with mental illness were more violent than the general population, which was significantly higher than 74.4% of psychiatrists (X(2) = 14.29, P = 0.000). Among three groups, the most preferred disposal option for those found not guilty by reason of insanity (NGRI) was to treat them in the custody of a forensic psychiatric hospital, such as an Ankang Hospital (86.9%). The respondents agreed (96.8%) that an independent review board should be established for disposing decisions for forensic psychiatric patients. The percentage who agreed that police officers, prosecutors, and judges should be included in the review board was significantly higher among police officers than among community members (x(2) = 6.60, P = 0.01; x(2) = 9.74, P = 0.002; x(2) = 7.38, P = 0.007). When asked, "who has the legal right to determine whether offenders with mental disorders should bear criminal responsibility", forensic psychiatrists and judges were the top two responders (79.5% and 63.4%, respectively). CONCLUSION: This study suggested that the majority of those surveyed, especially police officers, held that patients with mental illness were violent and should receive violence risk assessments. Although psychiatrists paid more attention to the rights of patients, they also lacked legal knowledge, similar to community members and police officers. Therefore, it is necessary to inform the public regarding mental health, and to provide legal knowledge.

[Applicability of capacity of sexual self-defense assessment scale in psychiatric patients without mental retardation].

OBJECTIVE: To explore the applicability of Capacity of Sexual Self-defense Assessment Scale (CSSAS) in psychiatric patients without mental retardation. METHODS: Eighty-seven cases required for assessment of the capacity of sexual self-defense were collected and evaluated by trained professionals according to CSSAS, and the results were compared to the experts' opinions. RESULTS: The scores of three grades of capacity of sexual self-defense (none, limited and whole) were 5.97 +/- 5.83, 32.22 +/- 10.15 and 61.60 +/- 13.02, respectively, which were statistically significant among them (P < 0.01). The correlation coefficients between items and total score were 0.59 to 0.91, the Cronbach's alpha value was 0.96, the spilt half Cronbach's alpha value were 0.94 and 0.91, respectively, and the relation coefficient between them was 0.94. According to the original cut off scores, the Kappa value between scale results and experts' opinions was 0.32 (P < 0.01). By redefining the cut off scores, the Kappa value was improved to 0.84 (P < 0.01). Two factors were extracted by means of the factor analysis. The explanation rates of variance were 46.15% and 28.93%, respectively. The accuracy of retrospective cumulative square was 94.30%. CONCLUSION: The CSSAS could be applied in the psychiatric expertise of the capacity of sexual self-defense in psychiatric patients without mental retardation; however, the cut off scores and the factor weight should be redefined.

[Progress in standard assessment on competency to stand trial of mentally disordered offenders].

Competency to stand trial relates directly to legal rights of the appraised individual as well as whether criminal procedure can be carried out smoothly. Foreign scholars have conducted a large number of theoretical researches, and developed a series of standardized evaluation tools. However, the assessment on competency to stand trial has mainly focused on medical criteria in China for a long time, and most cases were judged by forensic psychiatrists' experience. Recently, Chinese scholars have started the initial research on standardized evaluation. This paper reviews the notion of competency to stand trial, the evaluation criteria, and the assessment tools domestically and abroad. The main focus is on foreign assessment tools, which included three categories. First category includes checklist, self-report questionnaires and sentence-completion tasks. Second category is the interview-based instruments without criterion-based scoring. Last category is the interview-based instruments with criterion-based scoring. This literature may be helpful for further research and standardization on assessment tools of competency to stand trial of mentally disordered offenders.

[Civil competence assessment of the mental disorders involved in contract dispute].

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.

[Civil competence assessment of the mental disorders involved in compensation of personal injury].

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.

[Assessment time on mental disability due to brain damage].

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.

[The assessment of criminal responsibility of schizophrenic rape offenders].

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.

[Identification of limited capacity for duties in schizophrenia: review of 31 cases].

OBJECTIVE: To study general rule existed in identification of limited capacity for duties in schizophrenia and put forward some recommendations to the related issues. METHODS: The data of 31 cases were analyzed based on essential items in identification of limited capacity for duties in Schizophrenia in order to obtain the contribution rate of major variables. RESULTS: It showed that the contribution rate of from variable 1 to variable 6 was 18.785%, 15.549%, 14.023%, 10.347%, 9.437% and 7.923% respectively, in which the variable 1 reflecting patient's recognition of dangerous act was the most important of all variables. CONCLUSION: The limited capacity for duties in Schizophrenia could be divided into three grades.