精神残疾评定标准

精神残疾评定 1、精神残疾的定义 精神残疾是指精神病人患病持续一年以上未痊愈，同时导致其对家庭、社会应尽职能出现一定程度的障碍。 精神残疾可由以下精神病引起: (1)精神分裂症; (2)情感性、反应性精神障碍; (3)脑器质性与躯体疾病所致的精神障碍; (4)精神活性物质所致的精神障碍; (5)儿童少年期精神障碍; (6)其他精神障碍。 2、精神残疾的分级 对于患有上述精神疾病持续一年以上未痊愈者，应用“精神残疾分级的操作性评估标准”评定精神残疾的等级: (1)重度(一级):五项评分中有三项或多于三项评为2分。 (2)中度(二级):五项评分中有一项或两项评为2分。 (3)轻度(三级):五项评分中有两项或多于两项评为1分。列表如下: 社会功能评定项目 正常或有轻度异常 确有功能缺陷 严重功能缺陷 个人生活自理能力 0分 1分 2分 家庭生活职能表现 0 1 2 对家人的关心和责任心 0 1 2 职业劳动能力 0 1 2 社交活动能力 0 1 2 《注》: 无精神残疾，五项总分为0或1分。 精 神 残 疾 的 检 查 方 法 采用“精神残疾分级的操作性评估标准”进行检查。各项评分，除去与知情人交谈，同时应结合对病人的观察和必要的交谈询问以确定五项的评分。 rAt present, we have formed a "three-three" Park. …… Industrial Park, according to ... ... The instructions of comrade, focus on development needs in the next decade, based on the original, and then extended the 6 square kilometers. Of the Park, to further improve the roads, power supply, communications, water supply and drainage and sewage pipe network and other infrastructure, to achieve full coverage of infrastructure and interconnection with the facilities and raise capacity. Each park to determine 1 leading industries, in particular stone Materials, cans, gloves, through guided, force and other measures to promote the "road company" Park, industrial agglomeration. Currently, to focus on building better ... ... Industrial Park, ... ... Wood Park as the starting area of the industrial park, planners need to take out plan, start construction as soon as possible, undertake in a timely manner ... ... Transfer of the wood industry. This opportunity slip by, so the timing must be tight. Second is to optimize government service. Low efficiency of government services, departments do not coordinate the views of businesses large, poor business environment, it is ... ... Short Board, decide to change. We will continue to deepen reform of the administrative examination and approval system, good digestion, implement the Government canceled, adjustment and devolution of administrative examination and approval matters, strengthen the existing supervision in matters of administrative power, has made it clear to cancel, are not allowed to keep or disguised approval. To do list list of administrative powers and responsibilities 指导语:(向知情人交谈) 以下五个问题，是对病人社会功能的评价。请您根据他(她)最近一个月的情况结合与病前的比较给予回答: 1、个人生活自理能力 本条件评定病人近一个月个人生活料理情况，比如是否按时休息、个人卫生习惯(比如洗脸、洗澡、理发、刮胡子)，梳妆打扮、衣着整洁、住处卫生、主动进餐、二便料理等情况。 0分-----与病前差不多，或偶有小问题。 1分-----确有功能缺陷。需要督促或协助，已经给他人增加了负担。 2分-----严重功能缺陷。绝大部分或全部生活料理需要由他人照管，给别人造成很大负担。 2、家庭生活职能表现 本条件评定病人近一个月内在家庭日常生活中，能否做到他(她)最起码应该做的事。比如与家人一起吃饭，分担部分家务劳动，与家人一起看电视，搞卫生，参与家庭事物讨论，修理家用物品，对家庭必要的经济支持等等。 0分-----与病前差不多，或仅有轻微异常。 1分-----确有功能缺陷。不履行义务，或每天在家中呆坐至少两小时。做什么事都很被动。 2分-----严重功能缺陷。几乎不参与家庭活动，不料理家务。 3、对家人的关心与责任心 本 条评定病人在近一个月内，对待配偶、父母、子女或同住亲属有无亲密感情与责任心，能否与他(她)们相互交往、交换意见，情感上或生活上的关心与支持。是否 关心孩子的抚养教育、关心家庭成员的进步与前途，关心家庭今后的发展与安排。对未婚病人还应了解他(她)们择偶的态度。 0分----与病前差不多，或仅有轻微异常。 1分----确有功能缺陷。夫妻间或与其他家庭成员很少交流与关心，对子女缺乏关怀。对家庭安排缺乏关心。 rAt present, we have formed a "three-three" Park. …… Industrial Park, according to ... ... The instructions of comrade, focus on development needs in the next decade, based on the original, and then extended the 6 square kilometers. Of the Park, to further improve the roads, power supply, communications, water supply and drainage and sewage pipe network and other infrastructure, to achieve full coverage of infrastructure and interconnection with the facilities and raise capacity. Each park to determine 1 leading industries, in particular stone Materials, cans, gloves, through guided, force and other measures to promote the "road company" Park, industrial agglomeration. Currently, to focus on building better ... ... Industrial Park, ... ... Wood Park as the starting area of the industrial park, planners need to take out plan, start construction as soon as possible, undertake in a timely manner ... ... Transfer of the wood industry. This opportunity slip by, so the timing must be tight. Second is to optimize government service. Low efficiency of government services, departments do not coordinate the views of businesses large, poor business environment, it is ... ... Short Board, decide to change. We will continue to deepen reform of the administrative examination and approval system, good digestion, implement the Government canceled, adjustment and devolution of administrative examination and approval matters, strengthen the existing supervision in matters of administrative power, has made it clear to cancel, are not allowed to keep or disguised approval. To do list list of administrative powers and responsibilities 2分-----严重功能缺陷。与家人经常争吵或在家不理任何人。对孩子完全不管。对家庭的将来一点也不考虑。未婚者对择偶态度不可理解。 4、职业劳动能力 本条评定近一个月病人病前掌握的职业技能(指在职人员)学习能力(指学生)或家务劳动(指病前无职业，已休学待业或离退休者)水平有否下降。是否按常规行事，按时上下班，按时校学习，家务劳动能否因精神病已受到影响。 0分-----无异常，或只有些小问题。 1分-----确有功能缺陷。不能按时上下班。职业工作已降低档次，学习成绩或家务劳动水平下降。也包括因精神病待业、病休及休学、病人可恢复工作或学习，尚待安排者。 2分-----严重功能缺陷。因精神病症状明显而不能工作与学习，不能料理家务。 5、社交活动能力 本条评定病人近一个月没与人们交往与参与社会活动的情况。包括:对同事、同学、亲友、邻居以及与生活工作等需要接触但不一定熟悉的人(如汽车售票员、商店售货员??)的接触与交往情况。主动走亲访友情况，主动逛商店、购物、去娱乐场所活动等情况。 0分-----与病前差不多，或仅有轻微异常。 1分-----不主动接触他人，不主动外出活动，但经过反复劝说与鼓励尚能接触与参与。 2分-----严重地社会性退缩，终日独处，拒不与人交往，拒绝参与任何社交活动，劝说无效。 rAt present, we have formed a "three-three" Park. …… Industrial Park, according to ... ... The instructions of comrade, focus on development needs in the next decade, based on the original, and then extended the 6 square kilometers. Of the Park, to further improve the roads, power supply, communications, water supply and drainage and sewage pipe network and other infrastructure, to achieve full coverage of infrastructure and interconnection with the facilities and raise capacity. Each park to determine 1 leading industries, in particular stone Materials, cans, gloves, through guided, force and other measures to promote the "road company" Park, industrial agglomeration. Currently, to focus on building better ... ... Industrial Park, ... ... Wood Park as the starting area of the industrial park, planners need to take out plan, start construction as soon as possible, undertake in a timely manner ... ... Transfer of the wood industry. This opportunity slip by, so the timing must be tight. Second is to optimize government service. Low efficiency of government services, departments do not coordinate the views of businesses large, poor business environment, it is ... ... Short Board, decide to change. We will continue to deepen reform of the administrative examination and approval system, good digestion, implement the Government canceled, adjustment and devolution of administrative examination and approval matters, strengthen the existing supervision in matters of administrative power, has made it clear to cancel, are not allowed to keep or disguised approval. To do list list of administrative powers and responsibilities 五、智力残疾标准 (一)智力残疾的定义 智力残疾，是指智力显著低于一般人水平，并伴有适应行为的障碍。此类残疾是由于神经系统结构、功能障碍，使个体活动和参与受到限制，需要环境提供全面、广泛、有限和间歇的支持。 智力残疾包括:在智力发育期间(18岁之前)，由于各种有害因素导致的精神发育不全或智力迟滞;或者智力发育成熟以后，由于各种有害因素导致智力损害或智力明显衰退。 (二)智力残疾的分级 分级标准 发展商(DQ) 智商(IQ) 适应性行为 WHO-DAS?分值 级别 (AB ) 0~6岁 7岁及以上 18岁以上 一级 ?25 ,20 极重度 ?116分 二级 26~39 20~34 重度 106~115分 三级 40~54 35~49 中度 96~105分 四级 55~75 50~69 轻度 52~95分 六、精神残疾标准 (一)精神残疾的定义 精神残疾，是指各类精神障碍持续一年以上未痊愈，由于存在认知、情感和行为障碍，以致影响其日常生活和社会参与。 (二)精神残疾的分级 18岁以上(含)的精神障碍患者根据《世界卫生组织残疾评定量表?》(WHO-DAS?)分数和下述的适应行为表现，18岁以下者依据下述的适应行为的表现，把精神残疾划分为四级: 精神残疾一级: WHO-DAS?值?116分，适应行为严重障碍;生活完全不能自理，忽视自己的生理、心理的基本要求。不与人交往，无法从事工作，不能学习新事物。需要环境提供全面、广泛的支持，生活长期、全部需他人监护。 精神残疾二级: WHO-DAS?值在106~115分之间，适应行为重度障碍;生活大部分不能自理，基本不与人交往，只与照顾者简单交往，能理解照顾者的简单指令，有一定学习能力。监护下能从事简单劳动。能表达自己的基本需求，偶尔被动参与社交活动;需要环境提供广泛的支持，大部分生活仍需他人照料。 rAt present, we have formed a "three-three" Park. …… Industrial Park, according to ... ... The instructions of comrade, focus on development needs in the next decade, based on the original, and then extended the 6 square kilometers. Of the Park, to further improve the roads, power supply, communications, water supply and drainage and sewage pipe network and other infrastructure, to achieve full coverage of infrastructure and interconnection with the facilities and raise capacity. Each park to determine 1 leading industries, in particular stone Materials, cans, gloves, through guided, force and other measures to promote the "road company" Park, industrial agglomeration. Currently, to focus on building better ... ... Industrial Park, ... ... Wood Park as the starting area of the industrial park, planners need to take out plan, start construction as soon as possible, undertake in a timely manner ... ... Transfer of the wood industry. This opportunity slip by, so the timing must be tight. Second is to optimize government service. Low efficiency of government services, departments do not coordinate the views of businesses large, poor business environment, it is ... ... Short Board, decide to change. We will continue to deepen reform of the administrative examination and approval system, good digestion, implement the Government canceled, adjustment and devolution of administrative examination and approval matters, strengthen the existing supervision in matters of administrative power, has made it clear to cancel, are not allowed to keep or disguised approval. To do list list of administrative powers and responsibilities 精神残疾三级: WHO-DAS?值在96~105分之间，适应行为中度障碍;生活上不能完全自理，可以与人进行简单交流，能表达自己的情感。能独立从事简单劳动，能学习新事物，但学习能力明显比一般人差。被动参与社交活动，偶尔能主动参与社交活动;需要环境提供部分的支持，即所需要的支持服务是经常性的、短时间的需求，部分生活需由他人照料。 精神残疾四级: WHO-DAS?值在52~95分之间，适应行为轻度障碍;生活上基本自理，但自理能力比一般人差，有时忽略个人卫生。能与人交往，能表达自己的情感，体会他人情感的能力较差，能从事一般的工作，学习新事物的能力比一般人稍差;偶尔需要环境提供支持，一般情况下生活不需要由他人照料。 七、多重残疾 存在两种或两种以上残疾为多重残疾。多重残疾应指出其残疾的类别。多重残疾分级按所属残疾中最重类别残疾分级标准进行分级。 精神残疾评定量表 国家心理咨询师 吴剑 2013年4月1日 世界卫生组织残疾评定量表第2版WHO-DAS-2，是世界卫生组织开发，经全球多中心测试的跨文化，跨领域标准化评定工具。其维度根据国际功能，残疾和健康分类ICF，活动和参与方面的限制为框架，用于全面评价各类残疾病人的家庭和社会功能状况。2000年进入中国。精神残疾是指各类精神障碍持续1年以上未痊愈，由于患者的认知，情感和行为障碍，影响其日常生活和社会参与功能，表现为家庭角色能力降低，社交，求职技能的缺乏或者减退等，从而导致患者不能完成应有的家庭和社会角色功能。无论从概念，成因，还是具体表现上说，与其他类型人躯体，语言，听力残疾都是有本质区别的。WHO-DAS-2在国外被证明具有稳定的心理测量特性和跨领域的可适用性，可以用在各类残疾功能评定。 使用工具是国际疾病与相关健康问题分类第十版ICD-10，诊断标准，属于精神残疾评定病种范围。排除标准是?60岁，明显躯体功能障碍，智力缺陷的。WHO-DAS-2的评定36条，包括理解与交流，身体移动，自我照顾，与他人相处，生活活动，社会参与。分没有困难-极重度困难5级。 WHO-DAS-2，经过19个国家21个中心测试信效度良好。处社会参与外，其他都是正相关。 世界卫生组织残疾评定量表第2版 指导语:此检查是关于人们由于健康原因而出现的困难。所指的健康原因包括:疾病、短期存在或长久持续的其他健康问题，损伤、精神或情感问题，以及酒药问题。请你考虑在最近30天内，你象往常一样从事以下各项活动时遇到了多大困难。请在5个选项选择最合适的一个。1=无;2=轻度;3=中度;4=重度;5=极重度/不能。 领域1(理解与交流)在最近,,天内，你在以下活动中存在多大困难, ,,(,集中做事,,分钟; ,,(,记住做重要的事; ,,(,在日常生活中分析并找到解决问题的办法; ,,(,学习新事物(如学习去一个新地方); rAt present, we have formed a "three-three" Park. …… Industrial Park, according to ... ... The instructions of comrade, focus on development needs in the next decade, based on the original, and then extended the 6 square kilometers. Of the Park, to further improve the roads, power supply, communications, water supply and drainage and sewage pipe network and other infrastructure, to achieve full coverage of infrastructure and interconnection with the facilities and raise capacity. Each park to determine 1 leading industries, in particular stone Materials, cans, gloves, through guided, force and other measures to promote the "road company" Park, industrial agglomeration. Currently, to focus on building better ... ... Industrial Park, ... ... Wood Park as the starting area of the industrial park, planners need to take out plan, start construction as soon as possible, undertake in a timely manner ... ... Transfer of the wood industry. This opportunity slip by, so the timing must be tight. Second is to optimize government service. Low efficiency of government services, departments do not coordinate the views of businesses large, poor business environment, it is ... ... Short Board, decide to change. We will continue to deepen reform of the administrative examination and approval system, good digestion, implement the Government canceled, adjustment and devolution of administrative examination and approval matters, strengthen the existing supervision in matters of administrative power, has made it clear to cancel, are not allowed to keep or disguised approval. To do list list of administrative powers and responsibilities ,,(,大体上了解人们说什么; ,,(,发起并继续一次谈话; 领域,(身体移动)在最近,,天内，你在以下活动中存在多大困难, ,,(,长时间站立(如,,分钟); ,,(,从座位上站起; ,,(,在家里来回移动; ,,(,走出家门; ,,(长距离行走(如,公里); 领域,(自我照料)在最近,,天内，你在以下活动中存在多大困难, ,,(,洗澡; ,,(,穿衣; ,,(,进食; ,,(,自己生活数日; 领域,,(与他人相处)在最近,,天内，你在以下活动中存在多大困难,只快乐由于 健康问题(疾病或疾患，损伤，精神或情感问题，以及酒药问题)所致的困难。 ,,(,与陌生人相处; ,,(,保持友谊; ,,(,与关系密切的人相处; ,,(,结交新朋友; ,,(,性活动; 领域,(生活活动)在最近,,天内，你在以下活动中存在多大困难, ,,(,承担家庭责任; ,,(,很好地完成你重要的家务劳动; ,,(,干完你需要做的所有家务劳动; ,,(,按照需要，尽快完成家务劳动; (工作或学习)如果你有一工作或是一名学生，请继续回答,,(,,,,(,，否则 跳到领域, ,,(,你的日常工作; ,,(,很好地完成你最重要的工作任务; ,,(,完成你需要的所有工作; ,,(,按照需要尽快完成你的工作; 领域,(社会参与)在回答近,,天你的社会参与情况，以及健康问题(躯体方面，精 神和情感方面，以及酒药相关问题)对你和你的家庭的影响。 ,,(,你周围环境的阻碍和限制，使你产生多大困难, ,,(,其他人的态度和行为对你有尊严地生活造成多大困难, ,,(,你同其他人一样参加社区活动(如节日活动，宗教活动或其他活动)时，存在 多大困难, ,,(,因为你的健康问题，你的家庭遇到多大困难, ,,(,你在自己的健康或疾病结局上花费多少时间, ,,(,你的健康问题对情绪的影响有多大, ,,(,你和你的家庭在你的健康问题上的经济花费有多少, ,,(,你自己在放松和休闲上遇到多大困难, rAt present, we have formed a "three-three" Park. …… Industrial Park, according to ... ... The instructions of comrade, focus on development needs in the next decade, based on the original, and then extended the 6 square kilometers. Of the Park, to further improve the roads, power supply, communications, water supply and drainage and sewage pipe network and other infrastructure, to achieve full coverage of infrastructure and interconnection with the facilities and raise capacity. Each park to determine 1 leading industries, in particular stone Materials, cans, gloves, through guided, force and other measures to promote the "road company" Park, industrial agglomeration. Currently, to focus on building better ... ... Industrial Park, ... ... Wood Park as the starting area of the industrial park, planners need to take out plan, start construction as soon as possible, undertake in a timely manner ... ... Transfer of the wood industry. This opportunity slip by, so the timing must be tight. Second is to optimize government service. Low efficiency of government services, departments do not coordinate the views of businesses large, poor business environment, it is ... ... Short Board, decide to change. We will continue to deepen reform of the administrative examination and approval system, good digestion, implement the Government canceled, adjustment and devolution of administrative examination and approval matters, strengthen the existing supervision in matters of administrative power, has made it clear to cancel, are not allowed to keep or disguised approval. To do list list of administrative powers and responsibilities