The prevalence of mental disorders in Taiwanese prisons: a nationwide population-based study

Prevalence of skin diseases among elderly prisoners in Taiwan: an examination of skin health in prison

BACKGROUND

Although prisoner health is a topic of significant importance, it has received limited attention in epidemiological studies, likely due to challenges in obtaining data. Therefore, this study aimed to investigate the prevalence of skin diseases among elderly prisoners in Taiwan.

METHODS

We examined the presence of skin diseases in 2215 elderly prisoners based on the International Classification of Diseases, 9th revision Clinical Modification (ICD-9-CM). Additionally, the most common types of skin diseases among elderly prisoners in Taiwan were identified.

RESULTS

The prevalence of skin diseases among prisoners was estimated to be 55.03%. Elderly men prisoners exhibited a higher prevalence of skin diseases than the women prisoners. The most common skin diseases observed were as follows: contact dermatitis and other forms of eczema; pruritus and related conditions; cellulitis and abscesses; and urticaria.

CONCLUSION

Skin diseases were identified in more than half of the elderly prisoners. The overall quality of life of elderly prisoners can be improved by addressing their skin health, which would contribute to the fulfilment of their basic human rights.

CLINICAL TRIALS NUMBER

NA.

The impact of sleep disturbances on suicide risk among people living HIV: An eleven-year national cohort

OBJECTIVES

The suicide rate among individuals who experience sleep disturbances is five times higher than in the general population. Up to 70 % of people living with HIV (PLHIV) experience sleep disturbances. This study's purpose was to determine whether this population has higher rates of suicide compared to those without sleep disorders. Possible risk factors were also explored.

METHODS

A secondary analysis of nationwide data on all males and females over 15 years old with HIV living in Taiwan was conducted from January 1, 2005, to December 31, 2016. Sleep disturbances were identified through recorded diagnoses and medical treatments. Cox proportional hazard models and hazard ratios (HRs) and mediation analysis were employed to estimate the association between sleep disturbances and suicide risk during the follow-up period.

RESULTS

Of the 5680 PLHIV, 72 suicide events were reported. The suicide incidence rate among PLHIV suffering from sleep disturbances was 769 per 100,000 person-years. Sleep disturbances were associated with a significantly increased risk of suicide (AHR = 1.75, 95 % CI 1.02-3.02, p = 0.0429). A premium-based monthly salary of <24,000 (NT $) was also associated with an increased hazard of suicide (AHR = 4.14, 95 % CI 1.60-10.75, p = 0.0035). The pathway effect analysis using potential outcomes showed that depression did not mediate the effect of sleep disturbance on suicide.

CONCLUSIONS

Sleep disturbances were associated with higher suicide rates, even after adjusting for pre-existing depression. These findings suggest that paying attention to suicidal ideation among PLHIV suffering from sleep disturbances is necessary.

Prevalence of eye and adnexal disorders among elderly inmates in Taiwan prisons

BACKGROUND

Prisoner health is a topic of significant importance; however, it has received limited attention in epidemiological studies, likely because of challenges in obtaining relevant data. Specifically, research on ocular disorders among elderly prisoners is lacking. Thus, the aim of this study was to evaluate the prevalence of disorders of the eye and adnexa among elderly prisoners in Taiwan.

METHODS

We investigated the presence of eye and adnexal disorders in elderly prisoners in Taiwan using data from the Taiwan National Health Insurance Research Database. The ocular disorders were identified using the appropriate disease codes in the International Classification of Diseases, 9th revision Clinical Modification (codes 360-379). In addition, the most common types of eye and adnexal disorders among the prisoners were identified.

RESULTS

A total of 2215 elderly prisoners (age ≥ 65 years; 2073 men and 142 women) were examined. The prevalence of eye and adnexal disorders among the prisoners was 18.87%. The elderly female prisoners exhibited a higher prevalence of eye and adnexal disorders than the elderly male prisoners. The most common disorders were disorders of the conjunctiva, cataract, and disorders of the lacrimal system.

CONCLUSIONS

A considerable proportion of elderly prisoners have disorders of the eye and adnexa. The overall quality of life of elderly prisoners can be improved by addressing their visual health, which contributes to the fulfillment of their basic human rights.

Gender differences in oral health among prisoners: a cross-sectional study from Taiwan

BACKGROUND

The prevalence of oral diseases among Taiwanese prisoners has rarely been investigated. This study aimed to estimate the gender-specific prevalence of oral disease in a sample of Taiwanese prisoners.

METHODS

We included 83,048 participants from the National Health Insurance (NHI) Program. Outcomes were measured using the clinical version of the International Classification of Diseases, Ninth Revision (ICD-9-CM). For prevalence, we provide absolute values and percentages. We also performed a χ2 test to assess sex and age group differences in the percentage of disease in the oral cavity, salivary glands, and jaw.

RESULTS

The prevalence rate of oral diseases was 25.90%, which was higher than that of the general population. The prevalence of oral diseases in female prisoners was higher than that in male prisoners (p < 0.001), and the prevalence of oral diseases in prisoners aged ≤ 40 was higher than that of prisoners aged > 40. Among all cases of diagnosed oral diseases, the top three diseases were dental hard tissue diseases (13.28%), other cellulitis and abscesses (9.79%), and pruritus and related conditions (2.88%), respectively. The prevalence of various oral diseases in female prisoners was significantly higher than that in male prisoners.

CONCLUSION

Oral disease is common among Taiwanese prisoners. Female prisoners had a higher prevalence of oral, salivary gland, and jaw diseases than male prisoners. Therefore, early prevention and appropriate treatment are required and also a need for gender-specific oral disease products given the differences in the prevalence of oral disease among male and female prisoners.

Prevalence of skin diseases in Taiwan prisons: a population-based study

BACKGROUND

The prevalence of skin diseases among prisoners in Taiwan has rarely been investigated. This study aimed to estimate the prevalence of skin diseases by sex in a sample of prisoners in Taiwan.

METHODS

We included 83,048 participants from the National Health Insurance Program. The outcomes were measured using the clinical version of the International Classification of Diseases, Ninth Revision. For prevalence, we presented absolute values as well as percentages. We also conducted an X² test to assess sex differences and age group differences in the percentages of skin and subcutaneous tissue diseases.

RESULTS

The prevalence of skin diseases was 42.25%, higher than that in the general population. The prevalence of skin diseases among male prisoners was higher than that among female prisoners (p < 0.001), and the prevalence of skin diseases among prisoners who were ≤ 40 was higher than that among prisoners who were > 40. Among all cases diagnosed with skin disease, the top three diseases were contact dermatitis and other types of eczema, cellulitis and abscess, pruritus, and related conditions. Male prisoners had a significantly higher prevalence of all types of skin diseases than female prisoners.

CONCLUSIONS

Skin diseases are common in prisoners in Taiwan. Therefore, early prevention and appropriate treatment are needed. Male-specific skin products are also needed, given the differences in the prevalence of skin diseases among male and female prisoners.

Prevalence and correlates of depressive symptoms among prisoners in Kaliti Federal Prison in Ethiopia: a facility based cross-sectional study

OBJECTIVE

This study intended to examine the prevalence and correlates of depressive symptoms among inmates in Kaliti Prison Centre, Addis Ababa, Ethiopia.

METHODS

A facility-based cross-sectional study was conducted among 694 randomly selected inmates in Kaliti Federal Prison in Ethiopia. The depressive symptom was examined using the Patient Health Questionnaire (PHQ-9). A binary logistic regression model was fitted to identify correlates of depressive symptoms. A p value <0.05 was considered to declare statistical significance, and an adjusted OR (AOR) with the corresponding 95% CI was computed to determine the strength of association. Data were analysed using SPSS V.20.

RESULT

The prevalence of depressive symptoms among prisoners in the current study was 56.6% (95% CI 53.2 to 60.8). Poor social support (AOR: 3.33, 95% CI 2.03 to 5.458), personal history of mental illness (AOR=3.16, 95% CI 1.62 to 6.14), physical abuse (AOR=2.31, 95% CI 1.41 to 3.78) and comorbid chronic medical illness (AOR=3.47, 95% CI 2.09 to 5.74) were independent correlates of depressive symptoms.

CONCLUSION

Our study shows that around one in two prisoners screened positive for depressive symptoms. There should be a regular screening of depressive symptoms for prisoners, and those screened positive should be linked to proper psychiatric service for early diagnosis and treatment.

Prevalência e fatores associados a sintomas ansiosos e depressivos em mulheres privadas de liberdade em Juiz de Fora-MG, Brasil

Resumo Sofrimento psíquico e desenvolvimento de transtornos mentais nas prisões são questões de saúde pública reconhecidas mundialmente. Objetivou-se identificar a prevalência destes sintomas e os fatores associados em 99 mulheres com mais de 18 anos de idade, nos regimes provisório, fechado e semiaberto de Juiz de Fora-MG. Trata-se de um estudo transversal, do tipo censo, com dados coletados face a face através de questionário semiestruturado e multidimensional. Os desfechos foram avaliados pelo Patient Health Questionannaire-4 (PHQ-4). Para a análise de associação foi construído um modelo teórico de determinação com três blocos hierarquizados. Foram estimadas razões de prevalência brutas por meio do teste Qui-quadrado e ajustadas entre si dentro de cada bloco (p≤0,20). Para o modelo final de regressão de Poisson com variância robusta foi adotado p≤0,05. A prevalência de sintomas ansiosos e depressivos foi, respectivamente, de 75,8% (IC95% 66,1%-83,8%) e 65,7% (IC95% 55,4%-74,9%). No modelo final, sintomas ansiosos associaram-se à presença de sintomas depressivos. Já sintomas depressivos associaram-se à faixa etária de 20 a 29 anos e à presença de sintomas ansiosos. Verificou-se prevalência dos desfechos em mais da metade das participantes, com destaque para interassociação entre eles.

Prevalence and factors associated with anxiety and depressive symptoms in women deprived of liberty in Juiz de Fora-MG, Brazil

Abstract Psychological distress and developing mental disorders in prisons are globally recognized public health issues. This study aimed to identify the prevalence of these symptoms and associated factors in 99 women over 18 years of age in the provisional, closed, and semi-open regimes in Juiz de Fora-MG, Brazil. This cross-sectional census study collected data face-to-face through a semi-structured and multidimensional questionnaire. We assessed outcomes using the Patient Health Questionnaire-4 (PHQ-4). We built a theoretical determination model with three hierarchical blocks for the association analysis. We estimated crude prevalence ratios using the chi-square test and adjusted for each other within each block (p≤0.20). We adopted p≤0.05 for the final Poisson regression model with robust variance. The prevalence of anxiety and depressive symptoms was 75.8% (95%CI 66.1%-83.8%) and 65.7% (95%CI 55.4%-74.9%), respectively. In the final model, anxiety symptoms were associated with depressive symptoms. On the other hand, depressive symptoms were associated with the 20-29 years age group and anxiety symptoms. We identified a prevalence of the outcomes in more than half of the participants, emphasizing the inter-association between them.

Risks of Comorbidities in Patients With Palmoplantar Pustulosis vs Patients With Psoriasis Vulgaris or Pompholyx in Korea

Importance

Palmoplantar pustulosis (PPP) has been reported to be accompanied by systemic conditions. However, the risks of comorbidities in patients with PPP have rarely been evaluated.

Objective

To assess the risks of comorbidities in patients with PPP compared with patients with psoriasis vulgaris or pompholyx.

Design, Setting, and Participants

This nationwide population-based cross-sectional study used data from the Korean National Health Insurance database and the National Health Screening Program collected from January 1, 2010, to December 31, 2019. Data were analyzed from July 1, 2020, to October 31, 2021. Korean patients diagnosed with PPP, psoriasis vulgaris, or pompholyx who visited a dermatologist between January 1, 2010, and December 31, 2019, were enrolled.

Exposures

Presence of PPP.

Main Outcomes and Measures

The risks of comorbidities among patients with PPP vs patients with psoriasis vulgaris or pompholyx were evaluated using a multivariable logistic regression model.

Results

A total of 37 399 patients with PPP (mean [SD] age, 48.98 [17.20] years; 51.7% female), 332 279 patients with psoriasis vulgaris (mean [SD] age, 47.29 [18.34] years; 58.7% male), and 365 415 patients with pompholyx (mean [SD] age, 40.92 [17.63] years; 57.4% female) were included in the analyses. Compared with patients with pompholyx, those with PPP had significantly higher risks of developing psoriasis vulgaris (adjusted odds ratio [aOR], 72.96; 95% CI, 68.19-78.05; P < .001), psoriatic arthritis (aOR, 8.06; 95% CI, 6.55-9.92; P < .001), ankylosing spondylitis (aOR, 1.91; 95% CI, 1.61-2.27; P < .001), type 1 diabetes (aOR, 1.33; 95% CI, 1.16-1.52; P < .001), type 2 diabetes (aOR, 1.33; 95% CI, 1.29-1.38; P < .001), Graves disease (aOR, 1.25; 95% CI, 1.11-1.42; P < .001), Crohn disease (aOR, 1.63; 95% CI, 1.11-2.40; P = .01), and vitiligo (aOR, 1.87; 95% CI, 1.65-2.12; P < .001) after adjusting for demographic covariates. The risks of ankylosing spondylitis (aOR, 1.37; 95% CI, 1.16-1.62; P < .001) and Graves disease (aOR, 1.40; 95% CI, 1.23-1.58; P < .001) were significantly higher among patients with PPP vs psoriasis vulgaris. However, the risks of psoriatic arthritis (aOR, 0.54; 95% CI, 0.47-0.63; P < .001), systemic lupus erythematosus (aOR, 0.67; 95% CI, 0.46-0.97; P = .04), Sjögren syndrome (aOR, 0.70; 95% CI, 0.50-0.96; P = .03), systemic sclerosis (aOR, 0.29; 95% CI, 0.11-0.77; P = .01), vitiligo (aOR, 0.53; 95% CI, 0.47-0.60; P < .001), and alopecia areata (aOR, 0.88; 95% CI, 0.81-0.95; P = .001) were significantly lower among those with PPP vs psoriasis vulgaris.

Conclusions and Relevance

The results of this cross-sectional study suggest that patients with PPP have an overlapping comorbidity profile with patients with psoriasis vulgaris but not patients with pompholyx. However, the risks of comorbidities among patients with PPP may be substantially different from those among patients with psoriasis vulgaris.

Psychotropic drug use rate among detention house residents and association with the category of the crimes in Japan

Aim

The White Paper on Crime 2019 from the Japanese Ministry of Justice reported that the percentage of crimes committed by people with mental disabilities was only 1.0%. In contrast, the findings of a statistical survey of correctional facilities reported that 15.1% of the prisoners were diagnosed with a mental illness. This study aimed at clarifying the relationship between mental illness and crime among suspects in a detention house and explaining this large gap.

Methods

Criminal suspects who were newly admitted in the Gifu detention house in Japan were eligible for the study. The status of psychotropic drug use was investigated, and its relationship with age, sex, offense history, and type of crime was analyzed. Newly prescribed medications in detention houses or police stations were excluded.

Results

In total, 26.5% of the residents in a detention house used psychotropic drugs. The psychotropic drug use rate was 16.7% (excluding the sleeping pill use rate). The use rates of sleeping pills, anxiolytics, antidepressants, and antipsychotics were 22.6%, 11.1%, 3.0%, and 9.6%, respectively. Psychotropic drug use was high in illicit drug users and low in suspects for immigration violence. Psychotropic drug use was higher among female suspects, suspects in their 40s and 50s, and suspects with a multiple crime history. Anxiolytic (17.0%) and antipsychotic (11.9%) use rates were high among suspects for violence.

Conclusion

In total, 26.5% of the subjects used psychotropic drugs. Psychotropic drug use was high in illicit drug users and low in suspects for immigration violence.

In total, 26.5% of the residents in a detention house used psychotropic drugs. The psychotropic drug use rate was 16.7% (excluding the sleeping pill use rate). The use rates of sleeping pills, anxiolytics, antidepressants, and antipsychotics were 22.6%, 11.1%, 3.0%, and 9.6%, respectively.

Associations of substance abuse histories and gambling addiction history with post-traumatic stress symptoms and depressive symptoms among Chinese prisoners

Background: Although there are over two million prisoners in China, few studies have reported the prevalence and correlates of mental health problems in this population. Objective: This study investigated the prevalence rates of trauma exposure, post-traumatic stress disorder (PTSD) and depression among Chinese male prisoners and further examined the associations of substance abuse histories and gambling addiction history with PTSD and depressive symptoms. Method: Participants were 1,484 male prisoners (mean age 35.44 years, sd = 9.66) recruited from a large prison in Guangdong, China. Self-administered standardized questionnaires were used to assess trauma exposure, histories of substance abuse and perceived gambling addiction, social supports, childhood trauma, PTSD and depression. Criminal background information was extracted from jail record. Linear regressions were performed to examine the correlates of PTSD and depressive symptoms. Results: Of these participants, 78.8% had experienced at least one trauma exposure, 26.7% had drug addiction, 85.5% had smoked cigarettes, 70.8% had used alcohol and 21.4% had gambling addiction before incarceration. The prevalence rates of PTSD and depression were 7.1% and 28.8%, respectively. Trauma exposure was significantly associated with PTSD and depressive symptoms, but not substance abuse histories and gambling history except for drinking. Histories of drinking and perceived gambling addiction were significantly related to PTSD and depressive symptoms after adjustment of demographics, criminal background, health status, social supports, childhood trauma and lifetime traumatic exposure. Conclusions: Trauma exposure, PTSD and depression are common among prisoners. Furthermore, this study for the first time demonstrates a significant relationship between gambling addiction history and PTSD.

Promoting adherence to psychopharmacological treatment among prisoners with mental health problems: Follow-up of a randomized controlled trial

This study presents follow-up results regarding a treatment adherence programme (TAP) for prisoners, the initial effectiveness of which we previously evaluated in a randomized controlled trial. Here we used an experimental design with two randomized groups and assessment at four time points: baseline (pre-intervention), at 3 months (post-intervention), and at 6 and 9 months after baseline. Participants were 151 prisoners with mental health problems (M_age = 41.85, SD = 10.31) who were randomly assigned to either the TAP or treatment as usual (TAU). Prisoners who completed the TAP showed a greater improvement in treatment adherence at 3 and 9 months, compared with those who received TAU. There were no significant differences between the groups in subjective well-being under medication. The availability of an easy-to-apply, universal programme that is able to promote treatment adherence in the prison context could make a positive contribution to the general health of inmates.

The Effects of Mental Health and Substance Abuse/Dependence Disorders on Prison Misconduct Among Male Inmates in Taiwan

This study examined the relative effects of mental illness, substance abuse/dependence, and co-occurring mental disorders and substance abuse/dependence (CODs) on prison misconduct among male inmates (N = 2,065) incarcerated in Taiwan's nine correctional facilities. Both bivariate and multivariate analyses revealed that COD-affected inmates have the highest risk of prison misconduct compared to those with singular drug abuse/dependence disorders or no disorders, similar to the findings of previous studies conducted in the United States. These results highlighted the importance of clinical screenings and assessments for inmates who might have CODs. Integrated treatments may be more appropriate for inmates with CODs, rather than providing separate treatments for mental and drug abuse/dependence disorders.

Firebug! Dissociative Identity Disorder? Malingering? Or …? An Intensive Case Study of an Arsonist

Courts struggle with questions of how to assess competency to stand trial (CTS) and not guilty by reason of insanity (NGRI) in dissociative identity disorder (DID). Concerns about CTS include dissociative amnesia and unpredictable switching behaviors that could cause inconsistent information transfer across self states, with the defendant unable to access important legal information about his/her defense and to collaborate with his/her attorney; DID defendants could not conform their conduct to the law or know right from wrong due to dissociative amnesia, the seemingly independent actions of self states, and the disruption of reality testing by switching. The author presents the case of a woman charged with both a witnessed and an unwitnessed burglary and arson, the latter at the home of her former therapist. The author was the fourth forensic evaluator in the case. Disagreements included whether the defendant met diagnostic criteria for DID or was malingering, and whether she was CTS and/or NGRI. In clinical work with DID, “the whole human being” is held responsible for all behavior, despite reported amnesia or lack of subjective agency. The Discrete Behavioral States (DBS) model of DID avoids reification of the DID self states and their conflation as separate “people.” This model supports evaluating the defendant at the level of specific self states, the self-state system, and that of the whole human being. The author concluded that the defendant met diagnostic criteria for DID and also was malingering its severity. She was competent to stand trial and legally sane.

Global Estimates of the Prevalence of Depression among Prisoners: A Systematic Review and Meta-analysis

BACKGROUND

Prison populations tend to be marginalized and disadvantaged of the rights and freedoms that other people in the community benefit from. Their separation from families, a narrow room and lack of privacy in the prison, violence between prisoners, and the uncertainty about the future result in psychological distress, for example, depression. The review has synthesized previous studies conducted on the topic and summarized to formulate recommendations for future prison health care services.

METHODS

We systematically searched the databases: PubMed, Psych Info, and SCOPUS, as well as manual Google Scholar searches, were conducted to retrieve published literature globally. We have included observational studies, written in English language. Estimates were pooled using a random-effects model. The study protocol was registered in PROSPERO with protocol number CRD42020156108. Subgroup and sensitivity analysis was conducted, and heterogeneity across the studies was evaluated using Q and the I ²-test. Publication bias was assessed by inspection of the funnel plot and Egger's regression test.

RESULT

A total of 1313 studies were initially identified through the electronic database; among these, a total of 73 full-text articles were retrieved for further appraisal. Further, 32 full-text articles were included in the final systematic review and meta-analysis. In this meta-analysis, the pooled prevalence of depression among prisoners was 36.9% (95% CI; 27.3-47.6). The pooled prevalence of depression among prisoners in the developing and developed countries was 39.2% and 33.1%, respectively. Moreover, the prevalence of depression was 19.1% and 54% for the studies that used diagnostic and screen tools to diagnose or screen depression, respectively. A leave-one-out analysis revealed that the pooled prevalence of depression among prisoners was not dependent on a single study removal or addition. Thus, the pooled prevalence of depression ranges between 35.3 and 38.0%.

CONCLUSION

The prevalence of depression among prisoners was high. Therefore, regular and continuous screening of depressive symptoms for prisoners along with its appropriate management is highly recommended.