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JAMA Neurol:神经变性疾病个体或经常发生犯罪行为

  1. 犯罪行为
  2. 神经变性疾病
  3. 阿尔兹海默氏症

来源:生物谷 2015-01-13 14:58

近日,一项发表于国际杂志JAMA Neurology上的研究论文中,来自瑞典隆德大学的研究人员通过研究揭示,尽管阿尔兹海默氏症患者(AD)犯罪的可能性最小,但一些神经变性疾病的个体却经常会有一些犯罪行为。

2015年1月13日 讯 /生物谷BIOON/ --近日,一项发表于国际杂志JAMA Neurology上的研究论文中,来自瑞典隆德大学的研究人员通过研究揭示,尽管阿尔兹海默氏症患者(AD)犯罪的可能性最小,但一些神经变性疾病的个体却经常会有一些犯罪行为。

神经变性疾病会引发大脑神经结构的功能异常,包括判断能力、执行机制、情绪过程、性行为、暴力及自我认知等,而大脑结构的异常往往会引发一些反社会和犯罪行为。这项研究中研究人员通过对1999年至2002年间2397名病人的医疗电子记录进行回顾性研究分析,揭示了痴呆症患者发生犯罪行为的频率和类型;这些病人中包括545名AD患者,171名行为变异的额颞痴呆症患者(bvFTD),89名原发性进行性失语症患者及30名亨廷顿氏症患者。

研究结果显示,2397名患者中有204名患者(8.5%)在疾病期间有犯罪行为出现的历史;在不同的诊断过程中,研究者发现在545名AD患者中有42名患者(7.7%)有犯罪行为表现,171名bvFTD患者中有64名患者(37.4%)有犯罪行为表现,而且在89名进行性失语症患者中有24名患者(27%)有犯罪行为表现,在30名亨廷顿氏症患者中有6名患者(20%)有犯罪行为表现。

在bvFTD患者组中常见的犯罪行为个体所占的比例最高,这些患者的行为主要表现为盗窃、性侵犯、侵害他人和公共场所随地小便等;而在AD患者中发生交通违章则较为常见,其通常和个体记忆缺失直接相关。所有在公共场所随地小便的患者均为男性,而且相比女性而言男性患者更易进行性侵犯。

最后研究者总结道,经常照顾中年或者老年人的个体需要密切关注这些个体的病情变化,并及时对患者的神经变性疾病状况进行诊断,以有效保护其不进行犯罪行为或减少其犯罪行为的发生率。(生物谷Bioon.com)

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Criminal Behavior in Frontotemporal Dementia and Alzheimer Disease

Madeleine Liljegren, MD1; Georges Naasan, MD2; Julia Temlett, MBBS3; David C. Perry, MD2; Katherine P. Rankin, PhD2; Jennifer Merrilees, PhD2; Lea T. Grinberg, MD, PhD2; William W. Seeley, MD2; Elisabet Englund, MD1; Bruce L Miller, MD2

Importance Neurodegenerative diseases can cause dysfunction of neural structures involved in judgment, executive function, emotional processing, sexual behavior, violence, and self-awareness. Such dysfunctions can lead to antisocial and criminal behavior that appears for the first time in the adult or middle-aged individual or even later in life. Objective To investigate the frequency and type of criminal behavior among patients with a diagnosed dementing disorder. Design, Setting, and Participants We conducted a retrospective medical record review of 2397 patients who were seen at the University of California, San Francisco, Memory and Aging Center between 1999 and 2012, including 545 patients with Alzheimer disease (AD), 171 patients with behavioral variant of frontotemporal dementia (bvFTD), 89 patients with semantic variant of primary progressive aphasia, and 30 patients with Huntington disease. Patient notes containing specific keywords denoting criminal behavior were reviewed. Data were stratified by criminal behavior type and diagnostic groups. Main Outcomes and Measures Frequencies of criminal behavior and χ2 statistics were calculated. Results Of the 2397 patients studied, 204 (8.5%) had a history of criminal behavior that emerged during their illness. Of the major diagnostic groups, 42 of 545 patients (7.7%) with AD, 64 of 171 patients (37.4%) with bvFTD, 24 of 89 patients (27.0%) with semantic variant of primary progressive aphasia, and 6 of 30 patients (20%) with Huntington disease exhibited criminal behavior. A total of 14% of patients with bvFTD were statistically significantly more likely to present with criminal behavior compared with 2% of patients with AD (P < .001) and 6.4% were statistically significantly more likely to exhibit violence compared with 2% of patients with AD (P = .003). Common manifestations of criminal behavior in the bvFTD group included theft, traffic violations, sexual advances, trespassing, and public urination in contrast with those in the AD group, who commonly committed traffic violations, often related to cognitive impairment. Conclusions and Relevance Criminal behavior is more common in patients with bvFTD and semantic variant of primary progressive aphasia than in those with AD and is more likely to be an early manifestation of the disorder. Judicial evaluations of criminality in the demented individual might require different criteria than the classic “insanity defense” used in the American legal system; these individuals should be treated differently by the law. The appearance of new-onset criminal behavior in an adult should elicit a search for frontal and anterior temporal brain disease and for dementing disorders.

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