陳喬琪教授 台北馬偕紀念醫院精神科 台北醫學大學精神科

陳總統罹患重鬱症已經由台北榮民總醫院，邀集全國十位具有名望並受敬重的精神科教授，經過多次會診與精密儀器檢查予以確認。 「憂鬱」雖然是一般的口頭用語，但是重鬱症是一種大腦的疾病，不是心理疾病，沒有適當的治療不可能好起來，甚至會造成失智症。在台北榮民總醫院與行政院衛生署桃園醫院的核磁共振造影檢查，都顯示陳前總統的大腦皮質下出現許多異常的亮點。這種病理的變化表示，陳前總統的大腦曾經因為局部血管的血流量下降，導致腦血管周邊空間擴大或神經髓鞘的脫鞘現象。重鬱症會出現全身痛的感覺，免疫力功能下降，嚴重的時候會有生不如死的想法，因此重鬱症患者常有自殺行為，這是一般人很難想像的病痛。過去兩年，台北監獄對於陳前總統的罹病置之不理，導致重鬱症持續惡化以及大腦功能快速退化。 導致陳前總統罹患重鬱症的原因很多，其中複雜的訴訟案，無疑是很重要的致病因素之一。舉國務機要費為例，有罪與無罪的反覆判決，足以導致他多次崩潰。去年(2012 年)7 月再一次，最高法院撤銷國務機要費更一審無罪判決，對他衝擊很大，導致收縮血壓曾經飆高到200 以上，可能是導致大腦病變惡化的重要因素。用一般的法律常識判斷，可以瞭解陳前總統訴訟案件的複雜程度。但是也可以瞭解，因為相關法律的不完備，以及各級法院使用的各種判決手法，已經讓這位曾經是我國最聰明的法律系高材生，以及最優秀的律師，對於他自己的案件經過三年多奮鬥的結果，不僅完全無所適從，從而江郎才盡，已然心靈枯竭。對於聰慧的人，心靈枯竭之愁苦是惡疾，生不如死。 轉到台北榮民總醫院治療至今已三個月，但是情緒與認知功能改善有限，陳前總統目前完全無法思考、注意力不能集中、動作緩慢、有明顯被害妄想。他的自我功能非常脆弱，精神狀態非常不穩定，任何有關他將被送回北監的風吹草動訊息，都會導致他情緒崩潰，發怒，出現妄想情緒與嚴重恐懼感。 陳前總統已經沒有過問政治的能力、沒有組黨的可能、沒有逃跑的能力；他已經六十多歲，他沒有犯下反叛國家的重罪，他也不是具有反社會傾向的人，繼續關在監獄完全沒有意義。他是前總統，請放手罷!!讓他回家養病罷!!

2013-01-10

Former President Chen is already mentally exhausted. Please let go and let him go home to recover!

Author: Prof. Chiao-Chicy Chen Psychiatric Department, Taipei MaKay Memorial Hospital Psychiatric Department, Taipei Medical School After examining President Chen in June, 2012, I pointed out that he was suffering from Major Depressive Disorder (MDD), but Ministry of Justice denied it categorically. In September, 2012, through Magnetic Resonance Imaging (MRI) at Taoyuan Municipal Hospital, many unusual bright signals (hyperintensities) in the subcortical regions of President Chen’s brain were found. In fear of a stroke, President Chen was transferred to Taipei Veterans General Hospital (TVGH) for additional examinations. At the time, based on his pathological symptoms and the MRI images, the possibility of stroke was eliminated but it was confirmed that President Chen suffered from Major Depression Disorder (MDD). In order to ensure the credibility of this diagnosis, TVGH invited ten renowned medical professors in psychiatry to conduct joint diagnosis and further examinations with higher precision instruments. From this effort, it has been confirmed, without doubt, that President Chen suffers from MDD. "Depression" might be a phrase loosely used by common folks, but MDD is a brain disease, not just a manifestation of psychological conflict. Without proper treatments, one cannot recover from MDD and MDD can lead to dementia (loss of brain function). Through several Magnetic Resonance Imaging (MRI) examinations at Taoyuan Municipal Hospital and Taipei Veterans General Hospital, many unusual bright spots (hyperintensities) in the subcortical regions of President Chen’s brain were found. These pathological changes in the brain of President Chen indicate that there had been decreased local vascular blood flow, resulting in dilated perivascular spaces or neuron demyelination and contributing to the onset of his MDD. A person who suffers from MDD could feel severe pain over the whole body in addition to a weakened immune response. At the peak of the symptom, the patient could feel that living is a fate worse than death. As a result, many patients with MDD committed suicide. For most people, the suffering of MDD patients is beyond their comprehension. Over the past two years, the Executive Yuan, the Ministry of Justice and the Taipei Prison authority have failed to provide proper medical treatments for former President Chen, resulting in his MDD to worsen and his brain functions to deteriorate rapidly. There are many probable factors causing the MDD of President Chen, including the complexity of the litigation against him which is undoubtedly a very important pathogenic factor. For the Presidential Discretionary Fund case, for example, there are numerous flip-flops between guilty and innocence verdicts, enough to cause him to mentally crash many times over. In July last year (2012), once again, the High Court reversed the innocence verdict of the Presidential Discretionary Fund case, which was a great shock to him, resulting in his systolic blood pressure skyrocketing to more than 170 mmHg. This high blood pressure symptom could have been an important factor leading to his brain lesions. Without doubt, to anyone with a basic legal knowledge, all the charges against President Chen are highly complicated. However, one also has to recognize that, because of the incompleteness of the laws and the randomness of different verdicts by different courts at different levels, even President Chen, as one of the smartest law school students and the best attorneys in the country, after three years of fighting for his own innocence, is at a complete loss on how to proceed and is mentally and emotionally exhausted. To an intelligent person like him, this exhaustion is a vicious disease, making his living a fate worse than death. It has been three months since President Chen was transferred to Taipei Veterans General Hospital. However, his emotional and cognitive functions have shown little improvement. At this moment, he is unable to think and focus on any thought. His movement is slow and he is showing obvious symptoms of victim paranoia. His autonomic nerve function is very fragile and his mental state is very unstable. Any signal or rumor of returning him back to Taipei Prison can cause him extreme stress, anger, paranoia and great fear. President Chen is no longer capable of pursuing politics, forming a new party, or escaping out of the country. He is over 60-year-old. He did not commit treason and he is not anti-social. Continuing to imprison him in a prison carries no significance. He is a former democratically elected two-term president. It is time to let go and let him go home to recover from his illnesses. 2013-01-10 (Note：Thanks to Prof. Jay Tu to tranlate this article into English. - Taiwan eNews)