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

Objective: 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.