Abstract:

Objective To discuss the diagnosis of mental disorder due to drug in forensic psychiatric appraisal. Methods 60 cases related to drug（49 definite cases， 9 suspicious cases and 2 comorbidity cases） from 2006 to 2011 were reviewed. Results Methamphetamine， heroin and MDMA were the widely used drugs in these cases， often in a combinative way. The histories of drug abuse before psychiatric symptoms were varied， and usually the longer the history of drug abuse， the longer the duration of symptoms after drug abstinence. In a few cases， symptoms lasted for more than 12 months. Most cases presented as psychotic symptoms and emotional disorders， making them difficult to be distinguished from schizophrenia. Examination evidence was common in these cases. Insufficient objective evidence of drug abuse and unsureness of the course lead to uncertainty in suspicious cases. Conclusion Objective evidence of drug abuse should be the foundation of definite diagnosis. Some cases with long course may be the result of organic impairment of brain caused by chronic drug abuse.

Key words: forensic psychiatry, psychoactive substance, drug of abuse, diagnosis

摘要：

目的 探讨司法精神病鉴定中吸毒所致精神障碍的诊断。方法 收集2006-2011年鉴定中遇及的确诊案例、可疑案例、共病案例共60例，采用自编调查表对相关信息归类、分析。结果 冰毒、海洛因、摇头丸是使用最广泛的毒品，常为混用；吸毒至出现症状时间不一，吸毒史越长的，停吸后症状持续时间有越长的趋势，少数病程超过12月；精神症状常为精神病性症状及情绪异常，易与分裂症等误诊；实验室检查结果得到普遍使用；可疑案例未能确诊的原因主要是吸毒的客观证据不足和对病程标准把握的疑惑。结论 确诊应有吸毒的客观证据，病程较长考虑长期吸毒造成脑的器质性损害。

关键词: 司法精神病学, 精神活性物质, 毒品, 诊断