Analysis of Consistency Between Forensic Psychiatric Evaluation Diagnosis and Previous Clinical Psychiatric Diagnosis: A Retrospective Study

Mingchao Li,1,&ast; Yulin Cao,2,&ast; Xiaojun Wang,2,&ast; Lihua Li,3 Chunxi Wu,2 Xianyun Yi,4 Kechu Wang,5 Haibo Zheng,2 Yi Liu,2 Zijun Xiong,6 Jifen Gong,2 Qiuming Ji7 1Department of Psychiatry, Wuhan Mental Health Center, Wuhan City, People’s Republic of China; 2Department of Psychiatry, Wuhan Wudong Hospital, Wuhan City, People’s Republic of China; 3Department of Finance, Wuhan Wudong Hospital, Wuhan City, People’s Republic of China; 4Department of Anesthesiology, Wuhan Wudong Hospital, Wuhan City, People’s Republic of China; 5Department of Medical Records, Wuhan Wudong Hospital, Wuhan City, People’s Republic of China; 6Department of Laboratory, Wuhan Wudong Hospital, Wuhan City, People’s Republic of China; 7Department of Science, Wuhan Wudong Hospital, Wuhan City, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Qiuming Ji, Department of Science, Wuhan Wudong Hospital, No. 46 of Wudong Street, Qingshan District, Wuhan City, Hubei Province, 430084, People’s Republic of China, Email [email protected] Chunxi Wu, Department of Psychiatry, Wuhan Wudong Hospital, No. 46 of Wudong Street, Qingshan District, Wuhan City, Hubei Province, 430084, People’s Republic of China, Tel +862750528367, Fax +862786438247, Email [email protected]: Currently, there are situations where there is discordance between the identified diagnosis and the previous clinical diagnosis for psychiatric identification, causing extensive discussion. Therefore, the purpose of this study is to systematically analyze the consistency between forensic psychiatric identification diagnosis (referred to as identification diagnosis) and previous psychiatric diagnosis (referred to as previous diagnosis) in criminal cases.Methods: Using a retrospective study design, 78 criminal cases evaluated as having no mental illness by the Forensic Evaluation Department of Wuhan Mental Health Center in 2021– 2022 were selected as research subjects. Diagnostic agreement was evaluated using the kappa coefficient.Results: (1) Among 78 cases, 43 had a history of mental illness, with a prevalence rate of 55.13%; (2) The evaluation diagnosis was consistent with the previous diagnosis in 12 cases (27.91%) and inconsistent in 31 cases (72.09%), with Kappa=0.243 (P< 0.05), indicating poor consistency; (3) Schizophrenia (21 cases, 48.84%) and mood disorders (14 cases, 32.56%) were the most common in previous diagnoses; (4) Evaluation diagnoses were mainly no mental illness (38 cases, 48.72%) and physiological passion (8 cases, 10.26%).Conclusion: In criminal cases where the forensic evaluation diagnosis is no mental illness, the consistency between the evaluation diagnosis and the previous diagnosis is low, which is closely related to the differences in thinking patterns and assessment focus between forensic evaluation and clinical diagnosis. It is recommended to strengthen the standardized construction of forensic evaluation and improve the quality of evaluation.Keywords: criminal cases, forensic psychiatry, evaluation diagnosis, previous diagnosis, diagnostic consistency