On August 31, Nanjing Brain Hospital’s judicial authentication office issued a judicial authentication opinion, which was: Wang Mou suffered from acute transient mental disorder at the time of the crime and had the ability to limit criminal responsibility. The development of the case here, I believe many friends wondered: [acute transient mental disorder] is what? Psychotic? Or psycho? Is it [crazy]? Is there really [acute transient mental disorder]? There is a real diagnosis of [acute transient mental disorder] in medicine, but it is more commonly seen in judicial authentication. According to the latest authoritative diagnostic criteria for mental disorders (DSM-5), acute transient mental disorder is defined as: a patient will suddenly change from completely free of psychotic symptoms to obviously abnormal psychotic state within 2 weeks or less; Abnormal thinking and behaviors such as hallucinations, delusions and nonsense occur, lasting as short as 1 day and as long as 1 month, and finally can fully recover to the pre-disease functional level. This group of patients did not take drugs, There are no physical or brain diseases that cause mental abnormalities, The diagnosis of mood disorder, schizoaffective disorder or schizophrenia cannot be used to explain the disease. The cause of this disease is still unknown. However, patients may have suffered from sudden [big events] such as the death of relatives, sudden loss of partners, work or marriage before their illness. Most of them are young adults, with more women than men. It is relatively rare for them to be over 50 years old and will not happen among children. What will people become when they are crazy? After suffering from [acute transient mental disorder], people will suddenly [go crazy] without warning, but [go crazy] has certain characteristics: 1. This [go crazy] symptom reaches its peak within a week; 2. There are many kinds of delusions, such as someone who wants to kill himself, he is a god, there is a mysterious force in control of his behavior, he is actually another sex, there are many ghosts floating around to destroy them… Patients will be very [play], very [serious], and the content of delusions is not fixed; 3. The patient fully accepts the delusional content and may also have strong emotions. 4. Accompanied by delusions and excitement, patients may make some behaviors that cannot be explained by common sense, such as shouting, talking and moving, and even destructive behaviors. 5. After [madness], patients sometimes lose their memory of the situation at that time and say that they feel that everything is not true at that time. 5. It will not [go crazy] within one month, and finally it can completely return to normal. Acute transient mental disorder, can it be okay? So, can people really return to normal completely after suffering from [acute transient mental disorder]? Some clinicians follow up these patients, After they were discharged from hospital, they continued to follow the changes of their condition. The results showed that 70 of the 98 patients diagnosed with [acute transient mental disorder] changed to [schizoid psychosis] at discharge (the symptoms of acute transient mental disorder were more stable and persistent but did not meet the diagnostic criteria for schizophrenia), and 48 of them later developed schizophrenia. Only 12 cases maintained the original diagnosis, the rest were changed to [hysterical psychosis] and [bipolar manic episode]. Therefore, the probability of being diagnosed [acute transient mental disorder] and then fully recovering is really not too high, but there are still some people who suddenly [go crazy] when they are what? In terms of psychiatric diagnosis, there are several kinds of [crazy] in the eyes of the public: 1. Psychiatric disorders: such as schizophrenia, schizoaffective disorders, acute transient psychotic disorders, etc. Their common characteristics are: there are typical psychotic symptoms, such as hallucinations, delusions, thinking disorders, etc.; 2. Mood disorders: For example, depression, bipolar disorder and depression are more widely known. Patients may live lazily and even commit suicide. Patients with bipolar disorder manic episode may have impulsive behavior of hurting people and destroying things. 3. Acute stress disorder: After being stimulated, the patient’s behavior may be abnormal and consciousness disorder often occurs (such as feeling unconscious, temporarily losing consciousness, etc.). Everyone must have read the story of Fan Jin’s middle lift. Knowing that the middle lift was true, Fan Jin, who was in his 50s, shouted “Alas! Okay! I got it! He fell and fell unconscious. When he woke up, He ran all the way, I don’t care if I fall all over mud. All the way to the market. Everyone can see clearly: The newly rich are crazy with joy. It is usually easy for us to judge that a person we normally come into contact with is [crazy]: this person may have exaggerated expression, talk to himself, describe himself as suddenly untidy, but he turns a blind eye to it, or his emotions may burst out and be out of control at all. In short, he is different from the person he knew before. Why is Fan Jin [crazy]? Obviously, he was stimulated. What will happen because of the stimulation, It mainly includes [acute transient mental disorder] and [acute stress disorder]. The so-called stimulation, It is called “stress event” in medicine, which refers to one or more things that stimulate most people in a certain cultural background and similar environment and will bring about emotional, cognitive and behavioral changes. After encountering stress events, not everyone will have emotional and behavioral changes, nor will they necessarily change immediately. Some people do not change obviously, At best, there will be some mood swings. Others, There may be some psychotic symptoms, Such as hallucinations, delusions, thinking becomes particularly scattered or dull. Compared with [acute stress disorder], People suffering from [acute transient mental disorder], [Crazy] It will be even more outrageous. Medical appraisal and legal adjudication mental disorder and criminal responsibility ability are two different concepts: mental disorder refers to: disorder or abnormality of mental activities such as perception, emotion and thinking caused by various reasons, resulting in obvious psychological pain or functional damage such as social adaptation of patients (Article 83 of the Mental Health Law); The capacity for criminal responsibility refers to: The ability to identify and control acts (article 18 of the Criminal Law). Whether the suspect has the ability to be criminally responsible or not, The right to appraise is still in the doctor, and the right to adjudicate is in the judge. Doctors or appraisers can only make medical judgments on mental disorders. Whether they affect the ability of criminal responsibility will finally be decided by legal workers through comprehensive [legal requirements]. The two are complementary and indispensable.
