Abstract: Objective To explore the role of P300 in impairment appraisal during psychiatric disorders caused by traumatic subarachnoid hemorrhage（TSAH）. Methods Sixteen patients who met the criteria for organic mental disorders （only caused by TSAH） according to the 10th version of the International Classification of Diseases （ICD-10） were included, along with seventeen healthy controls matched for gender, age, and educational level. P300 detection was conducted on the participants using a visual Oddball paradigm; meanwhile, assessments were made using scales such as the activity of daily living （ADL） scale and the social disability screening schedule （SDSS）. Results The P300 amplitudes at points Fz, Cz, CPz, and Pz in the TSAH group were significantly lower than those in the healthy control group （P<0.05）. The P300 latencies at points Cz, CPz, and Pz in the TSAH group were prolonged compared to the healthy control group （P<0.05）. There was a negative correlation between the amplitudes at points Fz, Cz, CPz, and Pz with the ADL scale and SDSS scores in the TSAH group (P<0.05). Additionally, there was a positive correlation between the P300 latencies at points Cz, CPz, and Pz with ADL scale scores and the P300 latency at point Pz with the SDSS scores in the TSAH group (P<0.05). Conclusion The amplitude of P300 can reflect the severity of mental disorders caused by TSAH, with lower P300 amplitudes indicating more severe conditions. P300 amplitude can serve as a reference indicator for psychiatric impairment appraisal during psychiatric disorders caused by TSAH.

Key words: forensic psychiatry, traumatic subarachnoid hemorrhage (TSAH), psychiatry impairment, event-related potential (ERP), P300

摘要： 目的 探索P300在外伤性蛛网膜下腔出血（traumatic subarachnoid hemorrhage，TSAH）所致精神障碍者伤残程度中的评估作用。方法 符合《ICD-10精神与行为障碍分类》中器质性精神障碍标准（损伤仅为蛛网膜下腔出血）的患者16名，匹配健康对照组17名。采用视觉Oddball范式对上述受试者进行P300检测；同时使用日常生活能力评定（activity of daily living，ADL）量表、社会功能缺陷筛选量表（social disability screening schedule，SDSS）进行评估。结果 蛛血组Fz、Cz、CPz和Pz点的P300波幅较健康对照组显著降低（P<0.05）。蛛血组Cz、CPz和Pz点的P300潜伏期较健康对照组延长（P<0.05）。蛛血组Fz、Cz、CPz和Pz点的P300波幅与ADL量表及SDSS评分呈负相关（P<0.05），蛛血组Cz、CPz和Pz点的P300潜伏期与ADL量表评分呈正相关（P<0.05），蛛血组Pz点的P300潜伏期与SDSS评分呈正相关（P<0.05）。结论 P300波幅降低可反映TSAH所致精神障碍的严重程度。P300可作为TSAH所致精神障碍伤残评定的重要参考指标。

关键词: 法医精神病学, 外伤性蛛网膜下腔出血, 精神伤残, 事件相关电位, P300