[Analysis of the Reasons for the Inconsistent Opinions on the Mental Disability Assessments]

To analyze the factors contributing to inconsistent opinions on assessments of mental disability degrees caused by traumatic brain injury (TBI).

A retrospective analysis was conducted on 50 cases of re-assessment of mental disability caused by TBI at Forensic Medicine Center of Sun Yat-sen University from 2018 to 2019. General demographic information of the assessed individuals, TBI conditions, and initial and re-assessment opinions were collected. Descriptive statistics, Spearman correlation analysis and generalized estimating equations were used to analyze the differences in mental disorder diagnosis and disability degrees between initial and re-assessment. The reasons for inconsistent opinions were analyzed.

The inconsistency rate for two mental disability assessment opinions was 70.0% (including only mental disorder diagnosis were inconsistent, only disability degrees were inconsistent and both inconsistent). The responses to questioning, memory, intelligence, emotional activities, volitional behavior activities, and self-awareness during the assessment were correlated with the location of the cerebral malacia foci caused by TBI. There were significant differences between the two assessments in the degree of impairment to some mental symptoms and the living ability.

The reasons for the inconsistent opinions on the two assessments may be: (1) depending on different brain imaging information (including changes in brain imaging information in the recent three months, and the location of cerebral malacia foci); (2) examiners have different understandings of the degree of damage caused by mental disorders; (3) examiner's assessment of the degree of impairment in living ability varies.