刑事精神鑑定之失憶現象

Amnesia in Forensic Psychiatry

陳冠宇(Kuan-Yu Chen) ； 張書森(Shu-Sen Chang) ； 謝明憲(Ming-Hsien Hsieh) ； 林信男(Hsin-Nan Lin) ； 劉絮愷(Shi-Kai Liu)

《台灣精神醫學》 20卷3期 (2006/09) Pp. 182-191

https://doi.org/10.29478/TJP.200609.0003

摘要

目的：探索犯罪與失憶間關係，失憶的可能機制，及對責任能力判定之影響。方法：對台大醫院自民國70至91年刑事精神鑑定個案中有失憶現象者，進行精神鑑定資料之回溯分析，探討犯罪型態、精神科診斷、記憶缺失型態與鑑定結果的關係。結果：60名個案中大部分被診斷精神分裂症為主之嚴重精神病，及/或酒精藥物相關疾患，解離等精神官能疾患僅佔少數。半數為殺人等對身體的重大犯行（重大身犯）。犯行前是否飲酒，可區分出獨特犯罪型態。急性精神症狀發作及/或酒精藥物影響下犯行者，多半犯行前已出現失憶；輕型精神疾患者則多於犯行後開始失憶。部分失憶者較多，多數為選擇性忘記犯行。鑑定結果半數為心神喪失，但失憶皆非判定之主要理由。結論：失憶個案的精神科診斷相當多樣化。多數為重大身犯但大多犯行前即開始失憶，顯示非僅心理防衛機轉所能解釋。即使明顯於酒精中毒下犯行，並不能因此減除責任能力。判斷責任能力時，主要考慮為既存精神疾患的障礙嚴重度，而非出現失憶與否。

關鍵字

失憶現象 ； 解離 ； 精神鑑定 ； 責任能力

並列摘要

Objective: This study analyzed the manifestations and mechanisms of amnesia associated with crimes, and its influences over the psychiatric diagnosis based judgment of legal responsibility. Methods: Psychiatric files of criminals who received forensic evaluation at National Taiwan University Hospital from 1981 to 2002 were searched to identify cases of crime-associated amnesia. Manifestations of amnesia were recorded from medical records and analyzed to determine their associations with criminal patterns, psychiatric diagnoses and judgments about legal responsibility. Results: Sixty subjects with crime-associated amnesia were identified. Half of them had committed violent acts. The most frequent diagnoses were major psychoses or/and psychoactive substances-related disorders. Neurotic (including dissociation) conditions were found in only a minority of subjects. The amnesia tended to onset prior to the offences in subjects with acute psychotic disturbance or/and psychoactive substance use, while onset was more often after the crime in neurotic subjects, indicating possible psychogenic origins. The amnesias were often incomplete. Most subjects had selective amnesia of criminal acts. The legal procedures were not suspended by the claims of amnesia and legal responsibility was not determined solely based on the account of amnesia. Conclusions: Subjects with crime-associated amnesia had a variety of psychiatric conditions. Many subjects had violent physical offences with onset of amnesia occurring prior to the criminal acts, mitigating the traditional interpretation of amnesia as the result of psychogenic defense mechanisms. Although amnesia in subjects using psychoactive substances clearly indicated that offenses had been committed while intoxicated, they were not exempted from legal responsibility on that account alone. The psychiatric judgment of legal status relied on the severity of pre-existing psychiatric disturbance, rather than the presence of amnesia. (Full text in Chinese)

並列關鍵字

amnesia ； dissociation ； forensic examinations ； legal responsibility

參考文獻

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