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Eck M, Da Costa J, Wathelet M, Beunas C, D'Ovidio K, Moncany AH, Thomas P, Fovet T. [Prevalence of mental disorders in French prisons: A systematic review]. L'ENCEPHALE 2024; 50:446-464. [PMID: 38378405 DOI: 10.1016/j.encep.2023.11.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 11/20/2023] [Accepted: 11/24/2023] [Indexed: 02/22/2024]
Abstract
INTRODUCTION The prevalence of psychiatric disorders among prisoners remains a major public health issue worldwide. In France, despite the increasing number of persons who are incarcerated (+30% between 1992 and 2002 with a 120% prison overcrowding), and a historical concern about the mental health of persons in detention and its management, no systematic review has been published on this subject. The aim of this article is to present the results of a systematic review of the literature on the prevalence of psychiatric disorders in French prisons. METHOD The reporting of this systematic review conforms to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) checklist. We searched the PubMed and Web of Science databases. We used combinations of keywords relating to prison (prison*, jail*, inmate*), to psychiatry ("mental health", psychiatr*), and to France (France, French). This work was completed with a search through the digital libraries of the École des Hautes Études en Santé Publique (EHESP) and of the Système Universitaire de Documentation (Sudoc) to obtain data from academic works and the gray literature. References cited in studies included in this review were also examined. All references published up to September 2022, written in English or French, presenting the results of original quantitative studies on the prevalence of psychiatric disorders in correctional settings were included. Two researchers independently extracted data from included references according to a pre-established protocol. RESULTS Among 501 records identified, a total of 35 papers based on 24 epidemiological studies met the eligibility criteria for inclusion in this review: 16 were cross-sectional, 7 retrospective and 1 both cross-sectional and retrospective. All papers were published between 1999 and 2022. We found one European study, 5 international studies, 18 regional or local studies. Of these, 21 studies had all-male or mixed gender samples (but when the sample was mixed gender, it was always at least 92% male). Almost half of the studies (n=11) involved a small sample of fewer than 500 persons. Half of the studies involved a sample of recently incarcerated persons: 6 involved a random sample of persons in detention, and 1 involved a sample of people incarcerated for more than 5 years. The last 5 studies focused on persons aged over 50 years and incarcerated for more than one year (n=1), incarcerated for sexual offences (n=2), placed in disciplinary cells (n=1) or in a special wing for radicalized or suspected radicalized individuals (n=1). Nine studies used standardized and validated diagnostic tools. According to the 4 studies involving representative samples and using standardized and validated diagnostic tools, the prevalence of the following psychiatric disorders was: 29.4-44.4% for anxiety disorders, 5-14.2% for PTSD, 28-31.2% for mood disorders, 6.9-17% for psychotic disorders, 32% for personality disorders and 11% for ADHD. CONCLUSION This systematic review of the literature highlights the high prevalence of psychiatric disorders in French prisons. The data collected are in line with international studies. The great methodological heterogeneity of the papers included in this review calls for further rigorous research to better understand the rates of mental disorders in French prisons and to explore their determinants.
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Affiliation(s)
- Marion Eck
- Pôle de psychiatrie légale et de conduites addictives en milieu pénitentiaire, centre hospitalier Gérard Marchant, 31057 Toulouse, France; Inserm, U1172 - Lille neuroscience & cognition, université de Lille, 59000 Lille, France.
| | - Julien Da Costa
- Pôle de psychiatrie légale et de conduites addictives en milieu pénitentiaire, centre hospitalier Gérard Marchant, 31057 Toulouse, France
| | - Marielle Wathelet
- Pôle de psychiatrie, médecine légale et médecine en milieu pénitentiaire, CHU de Lille, 59000 Lille, France; Fédération régionale de recherche en psychiatrie et santé mentale Hauts-de-France (F2RSM Psy), Saint-André-lez-Lille, France
| | - Clément Beunas
- Fédération régionale de recherche en psychiatrie et santé mentale Hauts-de-France (F2RSM Psy), Saint-André-lez-Lille, France
| | - Kevin D'Ovidio
- Fédération régionale de recherche en psychiatrie et santé mentale Hauts-de-France (F2RSM Psy), Saint-André-lez-Lille, France
| | - Anne-Hélène Moncany
- Pôle de psychiatrie légale et de conduites addictives en milieu pénitentiaire, centre hospitalier Gérard Marchant, 31057 Toulouse, France
| | - Pierre Thomas
- Inserm, U1172 - Lille neuroscience & cognition, université de Lille, 59000 Lille, France; Pôle de psychiatrie, médecine légale et médecine en milieu pénitentiaire, CHU de Lille, 59000 Lille, France
| | - Thomas Fovet
- Inserm, U1172 - Lille neuroscience & cognition, université de Lille, 59000 Lille, France; Pôle de psychiatrie, médecine légale et médecine en milieu pénitentiaire, CHU de Lille, 59000 Lille, France
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Collica-Cox K, Day GJ, Bennett A, Maruszewski C. The Impact of Trauma-Sensitive Yoga on Persons Who Are Incarcerated: Identifying, Understanding, and Controlling Emotions. JOURNAL OF FORENSIC NURSING 2024; 20:195-204. [PMID: 38488399 DOI: 10.1097/jfn.0000000000000482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/21/2024]
Abstract
BACKGROUND While persons who are incarcerated have high rates of previous trauma, further traumatization can result from the experience of incarceration. The inability to effectively process trauma can lead to maladaptive behavior, a serious concern for correctional administrators. Acquiring the skills to regulate emotions and mitigate feelings of impulsivity help persons who are incarcerated take responsibility for their actions to make better decisions, simultaneously encouraging prosocial behavior, decreasing institutional misconduct, and reducing behaviors that place one at risk for repeated involvement in the criminal justice system. PURPOSE Trauma-sensitive yoga (TSY) is one correctional intervention that can effectively address misconduct issues. Yet, the specific impact of TSY on populations who are incarcerated has not been empirically investigated. METHODS A mixed-methods study, utilizing pretest and posttest interviewing, was conducted with male residents in a New York jail who completed a 4-week TSY program. RESULTS Data indicated that those who participated in TSY experienced statistically significant improvements in self-esteem, self-control, resilience, institutional conduct, self-efficacy, and emotion regulation. Qualitative data also indicated high levels of connectivity with other TSY class participants. IMPLICATIONS This research implies that cost-effective interventions like TSY have the ability to produce beneficial outcomes within a short time, which is integral to furthering rehabilitative efforts within the transient nature of the jail setting.
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Affiliation(s)
- Kimberly Collica-Cox
- Author Affiliations: Criminal Justice, Pace University & Security Department in New York City and Pleasantville
| | - George J Day
- Department of Government, Stephen F. Austin State University
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Collica-Cox K, Day GJ, Maruszewski C, Bennett A. Coping with Depression, Anxiety & Stress: The Healing Effects of a Jail-Based Trauma Sensitive Yoga Program. Issues Ment Health Nurs 2024; 45:152-163. [PMID: 38266232 DOI: 10.1080/01612840.2023.2284770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
Stress, anxiety and depression, often linked to internalizing/externalizing behaviors, are remarkedly high in a jail-based setting when one's future is uncertain. While research demonstrates that carceral yoga programs can provide physiological/psychological benefits, persons who are incarcerated, who have high rates of trauma-related experiences and mental illness, might benefit more from a trauma sensitive approach. Empirical studies examining the specific impact of trauma sensitive yoga (TSY) on populations who are incarcerated appear unavailable, necessitating this exploratory investigation with male residents in a TSY intervention at a New York jail. Through pre and post-test interviewing and a mixed methods data analysis, data indicated that those who participated in TSY experienced statistically significant increases in overall health, in addition to statistically significant reductions in stress, anxiety, depression and institutional misconduct. Qualitative analyses suggested that male participants experienced transcendence of the jail environment, easing the monotony of the correctional setting. TSY also provided them with new opportunities, the ability to regulate emotions/behaviors and initiate personal growth/changes within. Hence, this research implies that TSY, a benign intervention, easily implemented in a correctional setting, has the ability to beget benefits for persons who are incarcerated within a short period of time. This is vital to providing rehabilitative options within the transient nature of the jail setting.
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Affiliation(s)
- Kimberly Collica-Cox
- Criminal Justice & Security Department, Pace University, New York, New York, USA
| | - George J Day
- Department of Government, Stephen F. Austin State University, Nacogdoches, Texas, USA
| | | | - Alicia Bennett
- Criminal Justice, Pace University, New York, New York, USA
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Koch M, Dvorak A, Hobersdorfer M, Yeghiazaryan L, Rabl U, Komorowski A. The impact of the COVID-19 pandemic on the psychosocial rehabilitation of forensic psychiatric patients in Austria. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2023; 88:101889. [PMID: 37121203 PMCID: PMC10110938 DOI: 10.1016/j.ijlp.2023.101889] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 03/28/2023] [Accepted: 04/15/2023] [Indexed: 05/04/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic led to increased psychological distress and far-reaching restrictions of freedom. In March 2020, Austrian penal authorities enacted various safety and protection measures to mitigate the propagation of COVID-19. While infection rates in penal institutions were low, restrictive conditions of detention limited the forensic care of offenders. This retrospective longitudinal observational study aimed to evaluate the impact of the pandemic on the psychosocial rehabilitation in forensic psychiatry. Administrative and clinical data obtained from 97 males treated at an inpatient forensic mental health institution were compared before (January 2019 - mid-March 2020) and after (mid-March 2020 - May 2021) the enactment of pandemic-related restrictive measures. The study outcomes related to rehabilitative activities, social contacts, psychopathological stability, and compliance with institutional regulations. During the pandemic, a decrease in individual one-day temporary releases (64 vs. 3, p < .001) and one-day group excursions (103 vs. 10, p < .001) was observed. Likewise, visits by relatives (1440 vs. 429, p < .001) and legal guardians (286 vs. 130, p = .009) decreased. Regarding compliance with institutional regulations, illegal activities decreased from 27 to 8 after enactment of restrictive measures (p = .024). In contrast, long-term temporary releases (122 vs. 188 weeks, p = .131) and admissions to the acute ward (141 vs. 143, p = .712) remained unchanged. Overall, this study demonstrates the substantial impact of COVID-19 on the psychosocial care of forensic psychiatric patients and implies the necessity for guidelines to uphold an appropriate standard of forensic rehabilitation during future pandemics.
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Affiliation(s)
- Marlene Koch
- Department of Psychiatry and Psychotherapy, Comprehensive Center for Clinical Neurosciences and Mental Health (C3NMH), Medical University of Vienna, Vienna, Austria
| | | | | | - Lusine Yeghiazaryan
- Center for Medical Data Science, Institute of Medical Statistics, Medical University of Vienna, Vienna, Austria
| | - Ulrich Rabl
- Department of Psychiatry and Psychotherapy, Comprehensive Center for Clinical Neurosciences and Mental Health (C3NMH), Medical University of Vienna, Vienna, Austria
| | - Arkadiusz Komorowski
- Department of Psychiatry and Psychotherapy, Comprehensive Center for Clinical Neurosciences and Mental Health (C3NMH), Medical University of Vienna, Vienna, Austria.
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Fovet T, Villa C, Belet B, Carton F, Bauer T, Buyle-Bodin S, D’Hondt F, Bouchard JP. Le psychotraumatisme en milieu pénitentiaire. ANNALES MÉDICO-PSYCHOLOGIQUES, REVUE PSYCHIATRIQUE 2022. [DOI: 10.1016/j.amp.2022.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Fovet T, Eck M, Bouchard JP. De quels troubles psychiatriques souffrent les personnes détenues en France ? ANNALES MÉDICO-PSYCHOLOGIQUES, REVUE PSYCHIATRIQUE 2022. [DOI: 10.1016/j.amp.2022.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Fovet T, Wathelet M, Amad A, Horn M, Belet B, Benradia I, Roelandt JL, Thomas P, Vaiva G, D'Hondt F. Trauma exposure and PTSD among men entering jail: A comparative study with the general population. J Psychiatr Res 2021; 145:205-212. [PMID: 34929470 DOI: 10.1016/j.jpsychires.2021.12.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/27/2021] [Accepted: 12/10/2021] [Indexed: 12/17/2022]
Abstract
Research has consistently shown high levels of post-traumatic stress disorder (PTSD) in correctional settings. We aimed to compare the prevalences of trauma exposure, subthreshold PTSD, and full PTSD in incarcerated people with those observed in the general population. We used the Mini-International Neuropsychiatric Interview to screen for psychiatric disorders among men upon admission to jail (N = 630) and non-incarcerated men living in the same geographic area (the northern district of France; N = 5793). We utilized a multinomial regression model to assess the association between admission to jail and the prevalences of trauma exposure, subthreshold PTSD, and full PTSD. We employed logistic regression models to verify the interaction between admission to jail and PTSD status on the presence of psychiatric comorbidities. Full PTSD was overrepresented among men in jail after adjustment for all covariates (OR [95% CI] = 3.49 [1.55-7.85], p = 0.002). The association between PTSD status and the presence of at least one psychiatric comorbidity was also more important upon admission to jail than in the general population. Admission to jail was not associated with a higher prevalence of trauma exposure (OR [95% CI] = 1.12 [0.85-1.46], p = 0.419) or subthreshold PTSD (OR [95% CI] = 1.17 [0.81-1.68], p = 0.413). These results suggest higher prevalence rates of full PTSD and psychiatric comorbidities associated with PTSD symptoms in incarcerated people than in the general population. The provision of trauma-focused interventions tailored to these clinical specificities should be considered for the jail population.
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Affiliation(s)
- Thomas Fovet
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Centre national de ressources et de résilience Lille-Paris (CN2R), F-59000 Lille, France.
| | - Marielle Wathelet
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Centre national de ressources et de résilience Lille-Paris (CN2R), F-59000 Lille, France; Fédération régionale de recherche en psychiatrie et santé mentale, Hauts-de, France
| | - Ali Amad
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Fédération régionale de recherche en psychiatrie et santé mentale, Hauts-de, France
| | - Mathilde Horn
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France
| | - Bettina Belet
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Centre national de ressources et de résilience Lille-Paris (CN2R), F-59000 Lille, France
| | - Imane Benradia
- EPSM Lille Métropole, Centre Collaborateur de l'Organisation Mondiale de la Santé pour la recherche et la formation en santé mentale, Lille, France
| | - Jean-Luc Roelandt
- EPSM Lille Métropole, Centre Collaborateur de l'Organisation Mondiale de la Santé pour la recherche et la formation en santé mentale, Lille, France; ECEVE, UMRS 1123, Université Paris Diderot, Sorbonne Paris Cité, INSERM, Paris, France
| | - Pierre Thomas
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Fédération régionale de recherche en psychiatrie et santé mentale, Hauts-de, France
| | - Guillaume Vaiva
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Centre national de ressources et de résilience Lille-Paris (CN2R), F-59000 Lille, France
| | - Fabien D'Hondt
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience & Cognition, F-59000 Lille, France; Centre national de ressources et de résilience Lille-Paris (CN2R), F-59000 Lille, France
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