1
|
Meyer L, Marschall T, Verhülsdonk S. [Depressive symptoms in older prisoners : Results of two studies]. Z Gerontol Geriatr 2024; 57:192-198. [PMID: 38622267 DOI: 10.1007/s00391-024-02293-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 03/06/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND The proportion of prisoners aged 60 years and above is steadily rising both nationally and internationally. With advancing age the risk of developing physical and mental illnesses also increases. International studies have demonstrated a higher prevalence of mental disorders among older prisoners compared to the general population; however, there are few data on this, at least for Germany. OBJECTIVE Collation of empirical data on the presence of depressive symptoms among older prisoners. MATERIAL AND METHODS There were two independent cross-sectional studies conducted in North Rhine-Westphalia (NRW) and Rhineland-Palatinate (RLP), which included prisoners aged 50 years and above. In NRW a purely quantitative survey of depressive symptoms was carried out using the German version of the patient health questionnaire (PHQ-D) and in RLP the quantitative measurements using the general depression scale short form (ADS-K) were supplemented by qualitative interviews. RESULTS In total, data from 315 inmates were available for a joint analysis (222 from RLP, 93 from NRW). Among the prisoners in RLP 63.4% exhibited mild to clinically significant depressive symptoms, while in NRW this was the case for 46.2%. The treatment with antidepressants was carried out only in a small proportion in both federal states. DISCUSSION Both surveys showed a clearly elevated prevalence of depressive symptoms compared to the non-prison population. The results also suggest a need for optimization in terms of treatment. Particularly concerning potential interactions with somatic illnesses, efforts should be made to improve the diagnostics and treatment of depressive symptoms.
Collapse
Affiliation(s)
- Liane Meyer
- Angewandte Gesundheits- und Pflegewissenschaften, Duale Hochschule Baden-Württemberg Karlsruhe, Erzbergerstraße 121, 76133, Karlsruhe, Deutschland
| | - Tanja Marschall
- Angewandte Gesundheits- und Pflegewissenschaften, Duale Hochschule Baden-Württemberg Karlsruhe, Erzbergerstraße 121, 76133, Karlsruhe, Deutschland
| | - Sandra Verhülsdonk
- LVR-Klinikum Düsseldorf - Kliniken der Heinrich-Heine-Universität Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Deutschland.
- Medizinische Fakultät, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
| |
Collapse
|
2
|
Palm A, Talaslahti T, Vataja R, Ginters M, Kautiainen H, Elonheimo H, Suvisaari J, Lindberg N, Koponen H. Criminal behavior in alcohol-related dementia and Wernicke-Korsakoff syndrome: a Nationwide Register Study. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01804-0. [PMID: 38613687 DOI: 10.1007/s00406-024-01804-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 03/19/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND Chronic heavy alcohol use may lead to permanent brain damage, cognitive impairment, and dementia. While the link between alcohol use and crime is strong, virtually no research exists on the criminal behavior of patients with the alcohol-related neurocognitive disorders of Wernicke-Korsakoff syndrome (WKS) and alcohol-related dementia (ARD). METHODS The study population included all persons diagnosed with WKS (n = 1149) or ARD (n = 2432) in Finland in 1998-2015. Data on diagnoses, mortality, and crime were obtained from Finnish nationwide registers. Crime incidences were calculated 4 years before and after diagnosis. Crime types, incidences, and mortality were compared between disorders and with the general population. RESULTS Altogether 35.6% of WKS patients and 23.6% of ARD patients had committed crimes in the 4 years preceding diagnosis, most commonly property and traffic crimes, followed by violent crimes. The incidence of criminal behavior decreased significantly after diagnosis; in WKS patients, the standardized criminality ratio (SCR), the ratio of observed to expected number of crimes (95% CI), was 3.91 (3.72-4.10) in 4 years before and 2.80 (2.61-3.00) in 4 years after diagnosis. Likewise, in ARD patients, the SCRs were 2.63 (2.51-2.75) before and 0.84 (0.75-0.92) after diagnosis. No significant difference emerged in mortality between persons with and without a criminal history. CONCLUSIONS Persons with alcohol-related neurocognitive disorders frequently engage in criminal behavior prior to diagnosis, especially multiple offending. In the 4 years before and after diagnosis, crime rates declined in a linear fashion, with a marked reduction after diagnosis.
Collapse
Affiliation(s)
- Anniina Palm
- Department of Psychiatry, Helsinki University Hospital, P.O. Box 590, FI-00029, Helsinki, Finland.
- University of Helsinki, Helsinki, Finland.
| | - Tiina Talaslahti
- Department of Psychiatry, Helsinki University Hospital, P.O. Box 590, FI-00029, Helsinki, Finland
- University of Helsinki, Helsinki, Finland
| | - Risto Vataja
- Department of Psychiatry, Helsinki University Hospital, P.O. Box 590, FI-00029, Helsinki, Finland
- University of Helsinki, Helsinki, Finland
| | - Milena Ginters
- Department of Psychiatry, Helsinki University Hospital, P.O. Box 590, FI-00029, Helsinki, Finland
- University of Helsinki, Helsinki, Finland
| | - Hannu Kautiainen
- Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | | | - Jaana Suvisaari
- Mental Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Nina Lindberg
- Department of Psychiatry, Helsinki University Hospital, P.O. Box 590, FI-00029, Helsinki, Finland
- University of Helsinki, Helsinki, Finland
| | - Hannu Koponen
- Department of Psychiatry, Helsinki University Hospital, P.O. Box 590, FI-00029, Helsinki, Finland
- University of Helsinki, Helsinki, Finland
| |
Collapse
|
3
|
Avieli H. The role of substance use in the lives of incarcerated older adults: A qualitative study. Front Psychiatry 2023; 14:1116654. [PMID: 36993924 PMCID: PMC10040766 DOI: 10.3389/fpsyt.2023.1116654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/22/2023] [Indexed: 03/14/2023] Open
Abstract
BackgroundThe prevalence of drug abuse among older adults has grown over the last decade. Despite the expanding development of a body of research dedicated to studying this phenomenon, drug abuse by incarcerated older adults has been marginalized. Thus, the aim of the present study was to explore drug abuse patterns in the lives of incarcerated older adults.MethodSemi-structured interviews were conducted with 28 incarcerated older adults, and an interpretive analysis was used to analyze the participants’ narratives.FindingsFour themes emerged: (1) Growing up around drugs; (2) Prison onset; (3) Professionals, and (4) Lifelong substance abuse.ConclusionThe study findings reveal a unique typology of drug-related themes in the lives of incarcerated older adults. This typology sheds light on the interplay between aging, drug use, and incarceration and the way these three socially marginalized positions may intersect.
Collapse
|
4
|
Pageau F, Cornaz CD, Seaward H, Elger BS, Wangmo T. Crime hierarchy, victimization and coping results of a qualitative study on the older incarcerated Person's mental health in Switzerland. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2023; 87:101870. [PMID: 36863198 DOI: 10.1016/j.ijlp.2023.101870] [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: 12/16/2022] [Revised: 02/08/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Incarcerated persons rank themselves according to the crime they have committed. Due to which, those lower in this hierarchy (e.g., paedophiles) are bullied. The goal of this paper was to better knowledge on older incarcerated adults' experiences of crime and social hierarchy in prisons. METHODS Our results comprise data from 50 semi-structured interviews with older incarcerated persons. Data was assessed following thematic analysis. RESULTS Our research showed that crime hierarchy occurs in prison and is recognized by older incarcerated individuals. Also, a social hierarchy based on various characteristics (e.g., ethnicity, education, language, mental health) is established within detention centres. This hierarchy is put forth by all persons deprived of liberty, but mostly by the ones at the bottom of the crime hierarchy, thus using it to portray themselves as better human beings than other incarcerated adults. They use the social hierarchy to cope with bullying whilst exhibiting coping mechanisms, such as the narcissistic facade. A concept we put forth as a novel idea. DISCUSSION Our results show that crime hierarchy prevails in prison. Also, we explain the social hierarchy based on ethnicity, education, and other characteristics. Hence, being a victim of bullies, make lower-ranked (on the crime hierarchy) persons resort to social hierarchy to portray themselves as better individuals. This should not be considered as a personality disorder, but rather a narcissistic facade.
Collapse
Affiliation(s)
- Félix Pageau
- Institute for Biomedical Ethics (IBMB), University Basel, Bernoullistrasse 28 - 2nd Floor, Basel 4056, Switzerland.
| | - Corinne Devaud Cornaz
- Unité Thérapeutique, Centre de Psychiatrie Forensique, Réseau Fribourgeois de Santé Mentale, RFSM Marsens, Centre de soins hospitaliers, L'Hôpital 140, Marsens 1633, Switzerland
| | - Helene Seaward
- Institute for Biomedical Ethics (IBMB), University Basel, Bernoullistrasse 28 - 2nd Floor, Basel 4056, Switzerland
| | - Bernice Simone Elger
- Institute for Biomedical Ethics (IBMB), University Basel, Bernoullistrasse 28 - 2nd Floor, Basel 4056, Switzerland; Center for Legal Medicine, University of Geneva, Rue Michel-Servet 1, Genève 1205, Switzerland
| | - Tenzin Wangmo
- Institute for Biomedical Ethics (IBMB), University Basel, Bernoullistrasse 28 - 2nd Floor, Basel 4056, Switzerland
| |
Collapse
|
5
|
Solares C, Garcia-Argibay M, Chang Z, Dobrosavljevic M, Larsson H, Andershed H. Risk of dementia and mild cognitive impairment in older adults with a criminal background: a population-based register study in Sweden. Sci Rep 2023; 13:1915. [PMID: 36732577 PMCID: PMC9894846 DOI: 10.1038/s41598-023-28962-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 01/27/2023] [Indexed: 02/04/2023] Open
Abstract
Criminal behaviour has previously been associated with an increased risk for several mental health problems, but little is known about the association between criminal behaviour and dementia. We aimed to examine how the criminal background (type of crime, number of convictions, length of the sentence) is associated with dementia and mild cognitive impairment (MCI), and how mental and physical health disorders and educational attainment influenced these associations. A nationwide cohort of 3,617,028 individuals born between 1932 and 1962 were linked with criminal and medical records using Swedish national registers. We used Cox regression models to examine the associations. Increased risks for dementia (Hazard ratios (HRs) 1.54, 95% confidence interval (CI) 1.50-1.57) and MCI (1.55, 1.50-1.61) were found in individuals with criminal background, particularly among those who committed violent or several crimes, or with long sentences. After full adjustment of covariates, the associations attenuated but remained statistically significant for dementia (1.25, 1.22-1.28) and MCI (1.27, 1.22-1.32). The attenuation was mostly explained by mental health problems -depression, anxiety, schizophrenia spectrum disorders, substance use disorder (SUD), and bipolar disorder- (dementia: 1.34, 1.31-1.37; MCI: 1.35, 1.30-1.40). SUD contributed the most to attenuate the associations. Our results may provide important insights to health and penal systems by showing the importance of considering the severity of the criminal background and life-course mental health when assessing the risk of neurodegenerative disorders.
Collapse
Affiliation(s)
- Carmen Solares
- School of Behavioural, Social and Legal Sciences, Örebro University, Fakultetsgatan 1, 701 82, Örebro, Sweden.
| | - Miguel Garcia-Argibay
- School of Medical Sciences, Örebro University, Södra Grev Rosengatan 30, 703 62, Örebro, Sweden
| | - Zheng Chang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Maja Dobrosavljevic
- School of Medical Sciences, Örebro University, Södra Grev Rosengatan 30, 703 62, Örebro, Sweden
| | - Henrik Larsson
- School of Medical Sciences, Örebro University, Södra Grev Rosengatan 30, 703 62, Örebro, Sweden.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Henrik Andershed
- School of Behavioural, Social and Legal Sciences, Örebro University, Fakultetsgatan 1, 701 82, Örebro, Sweden
| |
Collapse
|
6
|
Chronic Disease Screening and Health Promotion Strategies for Older Men. J Nurse Pract 2022. [DOI: 10.1016/j.nurpra.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
7
|
van Gils Y, Dom G, Dierckx E, van Alphen SPJ, Franck E. Gender-specific characteristics of alcohol use in community-dwelling older adults in Belgium. Clin Gerontol 2022; 46:433-445. [PMID: 36255289 DOI: 10.1080/07317115.2022.2137074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Gender has been identified as an important social determinant for health. This study investigates gender-specific characteristics for alcohol use (AU) among community-dwelling older adults. METHODS This is a retrospective cross-sectional study in 1.406 community-dwelling older adults. We used standardized questionnaires to collect self-reported data on alcohol use behavior, mental health, drinking motives and resilience by using, respectively, the Alcohol Use Identification Test (AUDIT), the Brief Symptom Inventory (BSI), the Drinking Motives Questionnaire (DMQ), and the Connor-Davidson Resilience Scale (CD-RISC). Multiple linear regression was used to identify the joint contribution of those factors on AU. Hierarchical regression was used to investigate the influence of the interaction between gender and those factors on AU. RESULTS Linear regression analyses showed different associations with AU in men and women. Hierarchical regression analyses showed that gender presented a two-way interaction effect with enhancement and anxiety variables related to AU. CONCLUSIONS Different characteristics were found as predictors for AU among older men and women. CLINICAL IMPLICATIONS Clinicians and health-care providers should be aware of these differences in order to provide tailored screening and intervention programs to reduce AU in older adults.
Collapse
Affiliation(s)
- Y van Gils
- Faculty of Medicine and Social Sciences, University of Antwerp, Wilrijk, Belgium.,Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Elsene, Belgium
| | - G Dom
- Faculty of Medicine and Social Sciences, University of Antwerp, Wilrijk, Belgium.,Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium
| | - E Dierckx
- Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Elsene, Belgium.,Alexianen Zorggroep Tienen, Psychiatric Hospital, Tienen, Belgium
| | - S P J van Alphen
- Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Elsene, Belgium.,Clinical Centre of Excellence for Personality Disorders in Older Adults, Mondriaan Hospital, Heerlen-Maastricht, The Netherlands.,Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - E Franck
- Faculty of Medicine and Social Sciences, University of Antwerp, Wilrijk, Belgium
| |
Collapse
|
8
|
Hediger K, Marti R, Urfer V, Schenk A, Gutwein V, Dörr C. Effects of a Dog-Assisted Social- and Emotional-Competence Training for Prisoners: A Controlled Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10553. [PMID: 36078276 PMCID: PMC9518512 DOI: 10.3390/ijerph191710553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/15/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Previous research has called for improving psychological interventions and developing new treatments for prisoners. Animal-assisted prison-based programmes have increasingly been used as an approach, but there is a lack of studies investigating the effectiveness of such programmes. OBJECTIVE To investigate the effects of a dog-assisted social- and emotional-competence training on the socioemotional competences of prisoners compared to treatment as usual. METHODS In a controlled trial, we investigated 62 prisoners that participated in either a 6-month dog-assisted psychotherapeutic programme or the standard treatment. We assessed social and emotional competences before and after the training and at a 4-month follow-up. Data were analysed with linear models. RESULTS The prisoners' self-assessed social and emotional competences did not differ. The psychotherapists rated the prisoners' emotional competences in the intervention group higher at the follow-up but not after the training. The psychotherapists did not rate the prisoners' social competences in the intervention group differently but did find them to have higher self-regulation at follow-up and lower aggressiveness after the training than the control group. CONCLUSIONS This study indicates that dog-assisted programmes with a therapeutic aim might be beneficial for prisoners. However, the inconsistent results indicate that more research is needed to determine the potential and limits of animal-assisted programmes in forensic settings.
Collapse
Affiliation(s)
- Karin Hediger
- Division of Clinical Psychology and Animal-Assisted Interventions, Faculty of Psychology, University of Basel, Missionsstrasse 62, 4056 Basel, Switzerland
- Human and Animal Health Unit, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute Basel, Kreuzstrasse 2, 4123 Allschwil, Switzerland
- Faculty of Psychology, Open University, Postbus 2960, 6401 AT Heerlen, The Netherlands
- Institute for Interdisciplinary Research on Human-Animal Interaction (IEMT), Kreuzstrasse 2, 4123 Allschwil, Switzerland
| | - Rahel Marti
- Division of Clinical Psychology and Animal-Assisted Interventions, Faculty of Psychology, University of Basel, Missionsstrasse 62, 4056 Basel, Switzerland
- Institute for Interdisciplinary Research on Human-Animal Interaction (IEMT), Kreuzstrasse 2, 4123 Allschwil, Switzerland
| | - Vivien Urfer
- Division of Clinical Psychology and Animal-Assisted Interventions, Faculty of Psychology, University of Basel, Missionsstrasse 62, 4056 Basel, Switzerland
| | - Armin Schenk
- Division of Clinical Psychology and Animal-Assisted Interventions, Faculty of Psychology, University of Basel, Missionsstrasse 62, 4056 Basel, Switzerland
| | | | - Christine Dörr
- Department of Corrections Bruchsal, Schönbornstrasse 32, 76646 Bruchsal, Germany
| |
Collapse
|
9
|
Covariation of suicide and HIV in 186 countries: a spatial autoregressive and multiscale geographically weighted regression analyses. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01436-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
|
10
|
Tronick LN, Amendolara B, Morris NP, Longley J, Kois LE, Canada KE, Augustine D, Zaller N. Decarceration of older adults with mental illness in the USA - beyond the COVID-19 pandemic. Int J Prison Health 2022; ahead-of-print:10.1108/IJPH-06-2021-0049. [PMID: 35584307 PMCID: PMC10141497 DOI: 10.1108/ijph-06-2021-0049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Aging and mental illness both represent significant public health challenges for incarcerated people in the USA. The COVID-19 pandemic has further highlighted the vulnerabilities of incarcerated people because of the risks of infectious disease transmission in correctional facilities. Focusing on older adults with mental illness, this paper aims to examine efforts to decarcerate US correctional facilities during the COVID-19 pandemic and whether these approaches may lead to sustainable reforms beyond the pandemic. DESIGN/METHODOLOGY/APPROACH A narrative literature review was conducted using numerous online resources, including PubMed, Google Scholar and LexisNexis. Search terms used included "decarceration pandemic," "COVID-19 decarceration," "aging mental illness decarceration," "jails prisons decarceration," "early release COVID-19" and "correctional decarceration pandemic," among others. Given the rapidly changing nature of the COVID-19 pandemic, this narrative literature review included content from not only scholarly articles and federal and state government publications but also relevant media articles and policy-related reports. The authors reviewed these sources collaboratively to synthesize a review of existing evidence and opinions on these topics and generate conclusions and policy recommendations moving forward. FINDINGS To mitigate the risks of COVID-19, policymakers have pursued various decarceration strategies across the USA. Some efforts have focused on reducing inflow into correctional systems, including advising police to reduce numbers of arrests and limiting use of pretrial detention. Other policies have sought to increase outflow from correctional systems, such as facilitating early release of people convicted of nonviolent offenses or those nearing the end of their sentences. Given the well-known risks of COVID-19 among older individuals, age was commonly cited as a reason for diverting or expediting release of people from incarceration. In contrast, despite their vulnerability to complications from COVID-19, people with serious mental illness (SMI), particularly those with acute treatment needs, may have been less likely in some instances to be diverted or released early from incarceration. ORIGINALITY/VALUE Although much has been written about decarceration during the COVID-19 pandemic, little attention has been paid to the relevance of these efforts for older adults with mental illness. This paper synthesizes existing proposals and evidence while drawing attention to the public health implications of aging and SMI in US correctional settings and explores opportunities for decarceration of older adults with SMI beyond the COVID-19 pandemic.
Collapse
Affiliation(s)
- Lauren N Tronick
- School of Medicine, University of California San Diego, La Jolla, California, USA
| | - Benjamin Amendolara
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Nathaniel P Morris
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California, USA
| | - Joseph Longley
- American Civil Liberties Union National Prison Project, Washington, District of Columbia, USA
| | - Lauren E Kois
- Department of Psychology, University of Alabama, Tuscaloosa, Alabama, USA
| | - Kelli E Canada
- School of Social Work, University of Missouri, Columbia, Missouri, USA
| | - Dallas Augustine
- Benioff Homeless and Housing Initiative, University of California San Francisco, San Francisco, California, USA
| | - Nickolas Zaller
- College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| |
Collapse
|
11
|
Jamal M, Waheed S, Shakoor A. The prevalence of substance abuse and associated factors among male prisoners in Karachi jails, Pakistan. J Taibah Univ Med Sci 2022; 17:929-935. [PMID: 36212581 PMCID: PMC9513596 DOI: 10.1016/j.jtumed.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 04/25/2022] [Accepted: 05/13/2022] [Indexed: 11/19/2022] Open
Abstract
Objective Substance abuse and cigarette smoking are now regarded as major public health problems. This study aims to determine the prevalence, risk profile, and associated sociodemographic factors of substance abuse among male prisoners in Karachi jails. Methods This descriptive cross-sectional study was carried out among 600 male prisoners in Malir and Central Jails in Karachi. The principal investigator collected the data via one-on-one basis interviews, using a survey questionnaire consisting of the WHO ASSIST version 3, and structured demographic proforma. The data analysis regarding ever and current use of ten substances was done according to the standard instruction manual. A Chi-square test was applied to determine the association between categorical sociodemographic variables and current/ever substance use among prisoners. A p-value of <0.05 was considered statistically significant. Results In this study, 97.1% of prisoners had a history of substance abuse at least once in their lifetime. For the current use of a substance, the majority of the prisoners fell into the low-risk category, except for tobacco for which 80.5% of prisoners were at moderate risk of use. 13%, 12.7%, and 9.5% of prisoners were at high risk for using opioids, cannabis, and tobacco, respectively. Several associations were found between the socioeconomic factors of the study subjects and their substance use. Conclusion The study demonstrates a high prevalence and alarming current risk profile of substance abuse among prisoners of Karachi Jails. Considering the associated disease burden, substance abuse among prisoners should be considered a public health priority. Further exploration of associated and causative factors can help policymakers devise adequate measures for prevention and rehabilitation.
Collapse
Affiliation(s)
- Madiha Jamal
- General Dental Practitioner, Royal College of Surgeons of England, Cornwall, United Kingdom
- Corresponding address: Smile Dental Care, Parkvale Dental Practice, 15 Kimberly Park Road, Falmouth, Cornwall, United Kingdom.
| | | | - Asma Shakoor
- Community & Preventive Dentistry Department, Institute of Dentistry, Combined Military Hospital- Lahore Medical College, National University of Medical Sciences, Lahore, Pakistan
| |
Collapse
|
12
|
Prost SG, Golembeski C, Periyakoil VS, Arias J, Knittel AK, Ballin J, Oliver HD, Tran NT. Standardized outcome measures of mental health in research with older adults who are incarcerated. Int J Prison Health 2022; ahead-of-print:10.1108/IJPH-08-2021-0085. [PMID: 35362688 PMCID: PMC9328480 DOI: 10.1108/ijph-08-2021-0085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The targeted use of standardized outcome measures (SOMs) of mental health in research with older adults who are incarcerated promotes a common language that enables interdisciplinary dialogue, contributes to the identification of disparities and supports data harmonization and subsequent synthesis. This paper aims to provide researchers with rationale for using "gold-standard" measures used in research with community-dwelling older adults, reporting associated study sample psychometric indexes, and detailing alterations in the approach or measure. DESIGN/METHODOLOGY/APPROACH The authors highlight the mental health of older adults who are incarcerated. They also discuss the benefits of SOMs in practice and research and then identify gold-standard measures of mental health used in research with community-dwelling older adults and measures used in research with older adults who are incarcerated. Finally, the authors provide several recommendations related to the use of SOMs of mental health in research with this population. FINDINGS Depression, anxiety and post-traumatic stress disorder are common among older adults who are incarcerated. Researchers have used a variety of measures to capture these mental health problems, some parallel to those used with community-dwelling samples. However, a more targeted use of SOMs of mental health in research with this population will contribute to important strides in this burgeoning field. ORIGINALITY/VALUE This review offers several practical recommendations related to SOMs of mental health in research with older adults who are incarcerated to contribute to a rigorous evidence base and thus inform practice and potentially improve the health and well-being of this population.
Collapse
Affiliation(s)
- Stephanie Grace Prost
- Raymond A. Kent School of Social Work, University of Louisville, Louisville, Kentucky, USA
| | - Cynthia Golembeski
- Milano School of Policy, Management, and Environment, The New School, New York, New York, USA
| | | | - Jalayne Arias
- University of California San Francisco, San Francisco, California, USA
| | - Andrea K Knittel
- Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Jessica Ballin
- Department of Health Promotion and Sports Medicine, Oregon Health and Science University, Portland, Oregon, USA
| | - Heather D Oliver
- Raymond A. Kent School of Social Work, University of Louisville, Louisville, Kentucky, USA
| | | |
Collapse
|
13
|
Pageau F, Seaward H, Habermeyer E, Elger B, Wangmo T. Loneliness and social isolation among the older person in a Swiss secure institution: a qualitative study. BMC Geriatr 2022; 22:90. [PMID: 35105337 PMCID: PMC8806358 DOI: 10.1186/s12877-022-02764-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 01/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A pandemic of loneliness is hitting the aging population. As COVID19 forced us to isolate ourselves, we are in a better position to understand consequences of social distancing. The recent literature showed that older incarcerated adults are particularly at risk of health-related complications due to isolation in the prison environment, reducing their social capital. Mental and physical health can be severely affected by loneliness and social isolation, especially in prison. METHODS Our qualitative study investigates the view of older persons deprieved of their liberty on loneliness and social isolation pertaining to their mental health. We interviewed 57 older participants, including imprisoned individuals and forensic patients, following a semi-structured interview guide. During the data management and data analysis process, we excluded 7 interviews which were of poorer quality. Thereafter, we analyzed the remainders following a thematic approach. RESULTS Most interviewees experience loneliness following lack of significant human relationships in prison. Making friends appears to be a challenge for all the participants, because, for one thing, they do not find people with similar interests. Also, secure institution setting aggravates isolation due to the restrictions of movement placed such as rules concerning movement between floors, hindering intimate relationship, and separation between friends. Moreover, contact with prison personnel is limited and lack social capital (e.g. trust). CONCLUSION To our knowledge, this study is one of the first to present incarcerated persons' perspective on loneliness, social isolation and poor social capital in the Swiss prison setting. These has been reported to cause health problems both somatic and psychological. Our participants experience these deleterious factors in detention. As prisons have the possibility to become a health-promoting environment through connectedness, friendship, and trust promotion, stakeholders need to better their social capital.
Collapse
Affiliation(s)
- Félix Pageau
- Institute for Biomedical Ethics, University Basel, Basel, Switzerland.
| | - Helene Seaward
- Institute for Biomedical Ethics, University Basel, Basel, Switzerland
| | - Elmar Habermeyer
- Psychiatrische Universitätsklinik, Klinik für Forensische Psychiatrie, Zurich, Switzerland
| | - Bernice Elger
- Institute for Biomedical Ethics, University Basel, Basel, Switzerland.,Unit of Health Law and Humanitarian Medicine, Center for legal medicine, University of Geneva, Geneva, Switzerland
| | - Tenzin Wangmo
- Institute for Biomedical Ethics, University Basel, Basel, Switzerland
| |
Collapse
|
14
|
Holzer KJ, AbiNader MA, Vaughn MG, Salas-Wright CP, Oh S. Crime and Violence in Older Adults: Findings From the 2002 to 2017 National Survey on Drug Use and Health. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:764-781. [PMID: 32306830 DOI: 10.1177/0886260520913652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Studies on criminal behaviors largely focus on youth and younger adults. While criminal engagement declines with age, the aging population and significant costs associated with older offenders warrant their increased clinical and research attention. The present study utilizes data from the 2002 to 2017 National Survey on Drug Use and Health to estimate the prevalence and explore the sociodemographic and psychosocial correlates of criminal behavior in adults aged 50 years and older. The overall prevalence of older adults engaging in criminal behaviors during this time was approximately 1.20%. There was no significant difference in crime involvement between adults aged 50 to 64 years and 65 years and older. Older individuals who committed crimes were more likely to be male and Black and earning low income. Criminality was also associated with use of illicit substances and depression as well as receipt of mental health treatment.
Collapse
Affiliation(s)
| | | | - Michael G Vaughn
- Saint Louis University, MO, USA
- Yonsei University, Seoul, Republic of Korea
| | | | - Sehun Oh
- The Ohio State University, Columbus, USA
| |
Collapse
|
15
|
Mussie KM, Pageau F, Merkt H, Wangmo T, Elger BS. Challenges in providing ethically competent health care to incarcerated older adults with mental illness: a qualitative study exploring mental health professionals' perspectives in Canada. BMC Geriatr 2021; 21:718. [PMID: 34922493 PMCID: PMC8683829 DOI: 10.1186/s12877-021-02687-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 11/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The population of incarcerated older adults is the fastest growing demographic in prisons. Older persons in custody have poorer health as compared with those in the community. The unmet and complex health care needs of incarcerated older adults with mental illness raise justice, safety, dignity and fairness in care as ethical concerns. As there exists research gap to better understand these concerns, the current study aimed at exploring the perspectives of mental health professionals on challenges in delivering ethically competent care to mentally ill incarcerated older adults in Canada. METHODS Thirty-four semi-structured interviews were conducted between August 2017 and November 2018 with prison mental health professionals in Canada who were selected using purposive and convenience sampling techniques. The audio recorded interviews were transcribed verbatim and analysed inductively to generate themes. RESULTS The results were distilled into three main categories and seven subcategories that related to ethical issues in the provision of health care for mentally ill incarcerated older adults. The main categories included imprisoned older persons with special care needs, lack of resources, and the peer-support program. CONCLUSIONS Results of this study showed that existing practices of care of mentally ill incarcerated older adults are characterised by challenges that increase their vulnerability to worse health conditions. It is imperative for local authorities, policy makers and representatives to prepare for and respond to the challenges that compromise ethically competent health care for, and healthy ageing of, mentally ill incarcerated older adults.
Collapse
Affiliation(s)
- Kirubel Manyazewal Mussie
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland.
| | - Félix Pageau
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland
| | - Helene Merkt
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland
| | - Tenzin Wangmo
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland
| | - Bernice Simone Elger
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland.,Center for Legal Medicine, University of Geneva, Geneva, Switzerland
| |
Collapse
|
16
|
Substance Misuse and the Older Offender. Clin Geriatr Med 2021; 38:159-167. [PMID: 34794699 DOI: 10.1016/j.cger.2021.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Substance misuse is prevalent among older adults involved in the criminal justice system. The different classes of older offenders, primarily defined as individuals 50 years and older, as well as their offending behaviors vary in their association with substance misuse. Most prison health care systems do not adequately integrate substance use services. Screening for and treatment of substance misuse should be part of comprehensive mental health programs tailored to older offenders. This article reviews different types of offenses among older offenders, their association with substance misuse, and available treatment services.
Collapse
|
17
|
Wangmo T, Seaward H, Pageau F, Hiersemenzel LP, Elger BS. Forensic-Psychiatric Risk Evaluations: Perspectives of Forensic Psychiatric Experts and Older Incarcerated Persons From Switzerland. Front Psychiatry 2021; 12:643096. [PMID: 34194344 PMCID: PMC8236506 DOI: 10.3389/fpsyt.2021.643096] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 05/17/2021] [Indexed: 01/20/2023] Open
Abstract
Background: Forensic-psychiatric risk assessments of persons in prisons aim to provide treatment for their mental health disorders to prevent risk of recidivism. Based on the outcomes of such evaluations, it is decided, for instance, whether the person can be released or be assigned to further treatment with or without privileges. A negative evaluation would mean that the assessed person must remain in prison or in a forensic institution until his or her mental health has improved to live safely in the community. This paper highlights the process of forensic-psychiatric evaluations and the challenges faced by the two parties directly involved in this process in Switzerland. Methods: Data for this manuscript are gathered using semi-structured one-to-one interviews. The study participants included a purposive sample of 41 older incarcerated persons under measures (i.e., mandated by court order to psychotherapeutic and psychiatric treatment), and 23 expert participants working in Swiss prisons or forensic institutions. We analyzed data using thematic analysis. Results: Study findings within four themes are reported. First we describe the standards and procedures that expert participants use to carry out adequate risk assessments and conditions under which they refuse to perform such assessments. Thereafter, we present expert participants' concerns associated with predictive risk assessments and highlight the need to be cautious in drawing conclusion from them. We then reveal older incarcerated participants' reports on the inconsistencies with the forensic expertise and their belief that these reports tend to be negative toward them. The final theme concerns older participants' experiences of how these evaluations negatively impact their lives and their perspectives of a different future. Conclusion: The study findings about forensic-psychiatric risk assessments point to the need for a clearer communication on how these evaluations take place and how decisions are taken based on them. As incarceration under measures denotes the necessity to continue therapy and reduce dangerousness, it is important that accused person understands his or her real progress, feel that the decisions are objective and justified, and are aware of the progress needed to achieve the goal of eventual release. Such clarity will not only be valuable for those under measures, but also the justice system.
Collapse
Affiliation(s)
- Tenzin Wangmo
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Helene Seaward
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Felix Pageau
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | | | - Bernice S. Elger
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| |
Collapse
|
18
|
Rao S, Ali K, Berdine G, Test V, Nugent K. The evolution of health care in the Texas correctional system and the impact of COVID-19. Proc (Bayl Univ Med Cent) 2021; 34:76-80. [DOI: 10.1080/08998280.2020.1826258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Sanjana Rao
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Kiran Ali
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Gilbert Berdine
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Victor Test
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Kenneth Nugent
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
| |
Collapse
|
19
|
Pageau F, Cornaz CD, Gothuey I, Seaward H, Wangmo T, Elger BS. Prison Unhealthy Lifestyle and Poor Mental Health of Older Persons-A Qualitative Study. Front Psychiatry 2021; 12:690291. [PMID: 34867505 PMCID: PMC8639530 DOI: 10.3389/fpsyt.2021.690291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 10/22/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Mental healthcare and lifestyle habits in prison, especially for older individuals, has been shown to be suboptimal. Most psychiatric conditions left untreated worsen food choices, physical inactivity, and substance abuse. In turn, bad habits lead to poorer mental health. Methods: To comprehensively illustrate this downward spiraling, we completed a thorough analysis of data obtained through semi-structured qualitative interviews. There were 50 interviews of aging incarcerated people included in this article. They were analyzed following a classical six-stepped thematic analysis. Results: According to our participants, sports are not well-adapted to aging individuals, nor to people with medical conditions. Prison is even more unadapted for those who both are aging and have medical conditions. Also, food served is less than optimal. According to our interviews, the older imprisoned individual often does not have access to food adapted to his or her medical conditions. Sport is maladapted for older incarcerated individuals and mostly tailored for younger ones. Finally, boredom and lack of responsibility hinder change toward a better lifestyle for older adults in prison. Conclusion: Our paper shows why prison environmental modifications are needed to help older adults with their lifestyle habits. It also exposes an original way to see the relationship between mental health and lifestyle habits.
Collapse
Affiliation(s)
- Félix Pageau
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Corinne Devaud Cornaz
- Unit of Health Law and Humanitarian Medicine, Center for Legal Medicine, University of Geneva, Geneva, Switzerland
| | - Isabelle Gothuey
- Unit of Health Law and Humanitarian Medicine, Center for Legal Medicine, University of Geneva, Geneva, Switzerland
| | - Helene Seaward
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Tenzin Wangmo
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Bernice S Elger
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland.,Unit of Health Law and Humanitarian Medicine, Center for Legal Medicine, University of Geneva, Geneva, Switzerland
| |
Collapse
|
20
|
Codd H. Prisons, Older People, and Age-Friendly Cities and Communities: Towards an Inclusive Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9200. [PMID: 33317095 PMCID: PMC7764347 DOI: 10.3390/ijerph17249200] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 01/31/2023]
Abstract
This original and ground-breaking interdisciplinary article brings together perspectives from gerontology, criminology, penology, and social policy to explore critically the nature and consequences of the lack of visibility of prisons, prisoners, and ex-prisoners within global research, policy and practice on age-friendly cities and communities (AFCC), at a time when increasing numbers of people are ageing in prison settings in many countries. In addition, the COVID-19 pandemic continues to pose challenges in the contexts both of older peoples' lives, wellbeing, and health, and also within prison settings, and thus it is timely to reflect on the links between older people, prisons, and cities, at a time of ongoing change. Just as there is an extensive body of ongoing research exploring age-friendly cities and communities, there is extensive published research on older people's experiences of imprisonment, and a growing body of research on ageing in the prison setting. However, these two research and policy fields have evolved largely independently and separately, leading to a lack of visibility of prisons and prisoners within AFCC research and policy and, similarly, the omission of consideration of the relevance of AFCC research and policy to older prisoners and ex-prisoners. Existing checklists and tools for assessing and measuring the age-friendliness of cities and communities may be of limited relevance in the context of prisons and prisoners. This article identifies the potential for integration and for cross-disciplinary research in this context, concluding with recommendations for developing inclusive research, policies, and evaluation frameworks which recognise and include prisons and older prisoners, both during and after incarceration.
Collapse
Affiliation(s)
- Helen Codd
- School of Justice, University of Central Lancashire, Preston PR1 2HE, UK
| |
Collapse
|
21
|
Solares C, Dobrosavljevic M, Larsson H, Cortese S, Andershed H. The mental and physical health of older offenders: A systematic review and meta-analysis. Neurosci Biobehav Rev 2020; 118:440-450. [PMID: 32783970 DOI: 10.1016/j.neubiorev.2020.07.043] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 05/31/2020] [Accepted: 07/31/2020] [Indexed: 11/26/2022]
Abstract
A systematic review with meta-analysis was performed to: 1) estimate the prevalence of both mental and physical health problems in older offenders; 2) calculate relative risks for the health conditions in relation to non-offender older adults and; 3) explore the potential confounding role of several variables. We searched five databases up to August 2019. Studies involving offenders older than 50 years old were included. Fifty-five publications met criteria. The pooled prevalence for 18 mental and 28 physical health problems was calculated. In comparison with non-offender older adults, older offenders showed significantly higher risk for Hypertension (RR = 1.16, CI = 1.1, 1.2), Cardiovascular Diseases (RR = 1.24, CI = 1.09, 1.41), Respiratory diseases (RR = 1.75, CI = 1.29, 2.35), and Arthritis (RR = 1.19, CI = 1.12, 1.25). Heterogeneity was significant for all meta-analyses and partially explained by the confounding effect of country, the diagnosis assessment method, and the sample characteristics. Future research should include comparison groups of non-offender older adults and use longitudinal study designs to identify risk factors that can be targeted in preventive programmes.
Collapse
Affiliation(s)
- Carmen Solares
- School of Law, Psychology and Social Work, Örebro University, Fakultetsgatan 1, SE-701 82, Örebro, Sweden.
| | - Maja Dobrosavljevic
- School of Medical Sciences, Örebro University, Södra Grev Rosengatan 30, SE-703 62, Örebro, Sweden.
| | - Henrik Larsson
- School of Medical Sciences, Örebro University, Södra Grev Rosengatan 30, SE-703 62, Örebro, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden.
| | - Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, Life and Environmental Sciences, University of Southampton, SO17 1BJ, UK; Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, SO16 6YD, UK; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK; National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, NG7 2UH, UK; New York University Child Study Center, New York, NY, 10016, USA.
| | - Henrik Andershed
- School of Law, Psychology and Social Work, Örebro University, Fakultetsgatan 1, SE-701 82, Örebro, Sweden.
| |
Collapse
|
22
|
Barry LC, Coman E, Wakefield D, Trestman RL, Conwell Y, Steffens DC. Functional disability, depression, and suicidal ideation in older prisoners. J Affect Disord 2020; 266:366-373. [PMID: 32056900 PMCID: PMC7103559 DOI: 10.1016/j.jad.2020.01.156] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 01/09/2020] [Accepted: 01/26/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND The population of older prisoners (age ≥50), a group with high suicide rates, is growing. We sought to explore the associations among functional disability, depression, and suicidal ideation (SI) among older prisoners, focusing on the mediating role of depression. METHODS Study participants were 220 sentenced male inmates age ≥50 who were incarcerated in 8 prisons. Face-to-face interviews were conducted following consent. Functional disability was assessed objectively, using the Short Physical Performance Battery (SPPB), and via self-report by asking participants their level of difficulty climbing stairs and completing activities necessary for daily living in prison (PADLS) such as standing in line for medications. The PHQ-9 and the Geriatric Suicide Ideation Scale assessed depressive symptoms and SI, respectively. Data were analyzed using linear regression models and causal mediation models. RESULTS Participants were racially diverse and ranged from age 50 to 79 years. Whereas each functional disability measure was significantly associated with depressive symptoms, difficulty climbing stairs and PADL disability, but not SPPB score, were independently associated with SI. Depressive symptoms mediated the relationship between functional disability, assessed both objectively and via self-report, and SI. LIMITATIONS Cross-sectional study design; possible under-sampling of participants with depressive symptoms and SI. CONCLUSIONS Our findings have implications for suicide prevention in older prisoners. As this population continues to grow, prevention efforts should target those with depression, including but not limited to those with functional disability. Furthermore, assessing functional disability may offer a means of identifying those who should be screened for depression and suicidal ideation.
Collapse
Affiliation(s)
- Lisa C Barry
- University of Connecticut School of Medicine, Department of Psychiatry, Farmington, CT 06030-5215, US; University of Connecticut Health Center, UConn Center on Aging, Farmington, CT 06030-5215, US.
| | - Emil Coman
- University of Connecticut Health Center, Health Disparities Institute, Farmington, CT 06030-7030, US
| | - Dorothy Wakefield
- University of Connecticut Health Center, UConn Center on Aging, Farmington, CT 06030-5215, US
| | - Robert L Trestman
- Virginia Tech Carilion School of Medicine, Department of Psychiatry, Roanoke, VA 24016, US
| | - Yeates Conwell
- Yeates Conwell, MD, University of Rochester School of Medicine, Rochester, NY 14627, US
| | - David C Steffens
- University of Connecticut School of Medicine, Department of Psychiatry, Farmington, CT 06030-5215, US
| |
Collapse
|
23
|
Pascali JP, Palumbo D, Umani Ronchi F, Mari F, Fioravanti A, Bertol E. Ethyl Glucuronide Concentration in Hair of Detainees: A Preliminary Study. J Forensic Sci 2020; 65:189-192. [PMID: 31310667 DOI: 10.1111/1556-4029.14132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 06/25/2019] [Accepted: 06/26/2019] [Indexed: 11/30/2022]
Abstract
Through the measurement of ethyl glucuronide in hair (hETG), it is possible to assess chronic alcohol abuse over time. In this paper, we present a study on hETG in Italian prison inmates. Analyses were performed by LC-MS according to a previously published method. Results were evaluated using the cut-offs established by the Society of Hair Testing. Positives samples (ETG > 30 pg/mg) accounted for 6% of all subjects, with concentrations ranging from 42 pg/mg up to 270 pg/mg, abstinent subjects (ETG < 7 pg/mg) accounted for 88%, and moderate alcohol consumption (7 < ETG < 30 pg/mg) for 6% of the subjects. No females displayed ETG values above 30 pg/mg. Among positive samples, only two subjects did not declare heavy alcohol consumption and were found strongly positive at 210 and 270 pg/mg. To the best of our knowledge, this represents the first study on ETG hair concentration on prison inmates.
Collapse
Affiliation(s)
- Jennifer Paola Pascali
- Forensic Toxicology Unit, Department of Health Science, University of Florence, 50139, Florence, Italy
| | - Diego Palumbo
- Forensic Toxicology Unit, Department of Health Science, University of Florence, 50139, Florence, Italy
| | | | - Francesco Mari
- Forensic Toxicology Unit, Department of Health Science, University of Florence, 50139, Florence, Italy
| | - Alessia Fioravanti
- Forensic Toxicology Unit, Department of Health Science, University of Florence, 50139, Florence, Italy
| | - Elisabetta Bertol
- Forensic Toxicology Unit, Department of Health Science, University of Florence, 50139, Florence, Italy
| |
Collapse
|