摘要
目的分析精神疾病患者死亡的法医学特征,为司法鉴定和临床关怀提供实践指导。方法收集上海市公安局虹口分局2013—2016年受理的精神疾病患者死亡案例,通过系统的案情调查、尸表检验,对所有死者的死亡原因、死亡方式及与相关因素进行统计学分析。结果 2013—2016年间共有134例精神疾病患者死亡。男女比例为1∶1.23,平均年龄为(54.9±17.6)岁。89人(66.4%)精神病史超过3年,106人(79.1%)生前服用精神药物。抑郁症最常见(94例),其次为精神分裂症(35例)和焦虑症(5例)。死亡方式分别为自杀(117例)、猝死(16例)和意外(1例)。自杀案件以高坠最常见(79例,58.9%)。猝死案例较自杀案例具有更长的精神病史和用药史,多发生于住宅内。结论应重视精神疾病患者的精神和心理状况,同时注重预防和治疗其他躯体疾病。
Objective To analyze the forensic characteristics of deaths in patients with mentally disordered and to provide instructions for forensic evaluation and clinical care. Methods All fatal cases were collected from Hongkou Branch of Shanghai Public Security Bureau from2013 to 2016.The causes of death,manners of death and their relationship with other factors were statistically analyzed based on systemic case investigation. Results There were a total of 134 fatal cases with mental disorders.The male female ratio was 1∶1.23 and the mean age at death was(54.9±17.6)years old.In all patients 89 cases(66.4%)had a clinical course of mental illness over 3 years,and 106 cases(79.1%)had a regular prescription of medications prior to deaths.Depression was the most common entity(94 cases),followed by schizophrenia(35 cases)and anxiety(5 cases).According to the manner of death,117 cases(87.3%)were suicidal,16 cases(11.9%)were sudden unexpected deaths,and 1 case(0.7%)was accidental death.Fall was the most frequent manner in the suicidal cases(79 cases,58.9%).Compared with suicides,cases that died suddenly and unexpectedly had a significantly longer course of mental disorder and medication use,and were more likely occurred inside their residences.Conclusions The psychological status of patients with mentally disordered should be intensively monitored,and their physical health should also be taken care of.
引文
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