Personality disorders among Spanish prisoners starting hepatitis C treatment: Prevalence and associated factors

Antisocial personality disorder and determinants among prisoners in South Gondar zone correctional institutions, Northwest Ethiopia: An institution-based cross-sectional study

BACKGROUND

Antisocial personality disorder (ASPD) is a common mental health condition with major public health consequences, affecting 0.2-3.3 % of the general population. ASPD has become increasingly common in correctional settings. Therefore, this study aimed to assess antisocial personality disorder and its determinants among prisoners in South Gondar zone correctional centers, which has a vital role in early intervention.

METHODS

An institution-based cross-sectional study was conducted using the simple random sampling technique to recruit a total of 552 participants. Antisocial personality disorder was assessed by the Diagnostic and Statistical Manual of Mental Disorders 5th text revision (DSM-5) using an interviewer-administered questionnaire. We used binary and multivariate analyses to identify factors associated with ASPD. Statistical significance was declared at a 95 % confidence interval (CI) of p-value ˂0.05.

RESULTS

A total of 552 participants took part with a response rate of 97.87 %. The prevalence of antisocial personality disorder among prisoners was found to be 27.5 %, with a 95 % CI (23.96, 31.42). The study revealed that male sex (AOR = 5.25, 95 % CI: 1.60, 17.31), being unemployed (AOR = 4.38, 95 % CI: 1.27, 15.08), family history of mental illness (AOR = 2.23, 95 % CI: 1.30, 3.81), and repeated incarceration (AOR = 2.04, 95 % CI: 1.28, 3.23) were factors significantly associated with antisocial personality disorder.

CONCLUSIONS

This study showed a higher prevalence of antisocial personality disorder among prisoners. Male sex, unemployment, family history of mental illness, and history of incarceration were significantly associated with antisocial personality disorder. Therefore, the findings of this study recommend that incarcerated people require more attention and early intervention for antisocial personality disorder in correctional centers.

Causal associations between chronic viral hepatitis and psychiatric disorders: a Mendelian randomization study

Background

There may be an interaction between viral hepatitis and psychiatric disorders during disease progression. Herein, we conducted Mendelian randomization (MR) to explore the causal associations and mediators between viral hepatitis and psychiatric disorders.

Methods

Genome-wide association studies summary data for viral hepatitis [including chronic hepatitis B (CHB) and chronic hepatitis C (CHC)] and psychiatric disorders (including depression, anxiety, schizophrenia, obsessive-compulsive disorder, bipolar disorder, and post-traumatic stress disorder) were obtained. Two-sample MR was performed to assess the causal associations between viral hepatitis and psychiatric disorders. Further, a mediation analysis was conducted to evaluate the potential mediators. Inverse-variance weighted, MR-Egger, and weighted median were used as the main methods, while a sensitivity analysis was performed to evaluate pleiotropy and heterogeneity.

Results

There was no causal effect of CHB/CHC on psychiatric disorders, as well as psychiatric disorders on CHB. However, schizophrenia presented a causal effect on increased CHC risk [odds ratio (OR)=1.378, 95%CI: 1.012-1.876]. Further, a mediation analysis identified coffee consumption and body mass index as mediators in the effect of schizophrenia on CHC, mediating 3.75% (95%CI: 0.76%-7.04%) and 0.94% (95%CI: 0.00%-1.70%) proportion, respectively.

Conclusion

We revealed that schizophrenia patients faced a high risk of CHC, and insufficient coffee consumption and underweight could mediate the causal effect of schizophrenia on CHC. The prevention of hepatitis C might be a beneficial strategy for patients with schizophrenia. The right amount of nutrition supplements and coffee consumption might be part of a beneficial lifestyle in preventing the high CHC risk in patients with schizophrenia.

Patients with severe mental illness and hepatitis C virus infection benefit from new pangenotypic direct-acting antivirals: Results of a literature review

INTRODUCTION

Hepatitis C virus (HCV) infection is a global health problem that can results in cirrhosis, hepatocellular carcinoma and even death. HCV infection is 3-20-fold more prevalent among patients with versus without severe mental illness (SMI), such as major depressive disorder, personality disorder, bipolar disorder and schizophrenia. Treatment options for HCV were formerly based on pegylated interferon alpha, which is associated with neuropsychiatric adverse events, and this contributed to the exclusion of patients with SMI from HCV treatment, elimination programmes, and clinical trials. Moreover, the assumption of poor adherence, scant access to healthcare and the stigma and vulnerability of this population emerged as barriers and contributed to the low rates of treatment and efficacy.

METHODS

This paper reviews the literature published between December 2010 and December 2020 exploring the epidemiology of HCV in patients with SMI, and vice versa, the effect of HCV infection, barriers to the management of illness in these patients, and benefits of new therapeutic options with pangenotypic direct antiviral agents (DAAs).

RESULTS

The approval of DAAs has changed the paradigm of HCV infection treatment. DAAs have proven to be an equally efficacious and safe option that improves quality of life (QoL) in patients SMI.

CONCLUSIONS

Knowledge of the consequences of the HCV infection and the benefits of treatment with new pangenotypic DAAs among psychiatrists can increase screening, referral and treatment of HCV infection in patients with SMI.

Failure to replicate associations between Toxoplasma gondii or hepatitis C virus infection and personality traits

Background

Infections with Toxoplasma gondii (Toxo), a protozoan that can infect the brain, have been reported to alter behavior in rodents and humans; several investigators have related Toxo infection to personality traits such as novelty seeking in humans. We investigated human personality traits in relation to Toxo in Egypt, where such infection is common.

Results

In a community-based sample of Egyptian adults (N = 255), Toxo infection were indexed by levels of IgG antibodies. Viruses like hepatitis C virus (HCV) have also been associated with cognitive dysfunction and mood disorders; therefore, HCV antibody titers were also assayed for comparison. The antibody levels were analyzed in relation to the Arabic version of the NEO personality inventory (NEO-FFI-3), accounting for demographic variables. No significant correlations were noted with Toxo or HCV antibody levels, after co-varying for demographic and socio-economic factors and following corrections for multiple comparisons.

Conclusions

Infection with Toxo or HCV infection was not associated with variations in personality traits in a sample of Egyptian adults. The possible reasons for the discordance with prior reported associations are discussed.

Antisocial personality disorder and associated factors among incarcerated in prison in Dessie city correctional center, Dessie, Ethiopia: a cross-sectional study

BACKGROUND

Antisocial Personality Disorder (ASPD) describes individuals who engage in repetitive aggressiveness, deceitfulness, impulsivity, and unlawful behavior. It has a broad impact on families, relationships, and social functioning, and also people with ASPD make heavy demands on the judicial system, social and mental health services. Even though ASPD is a common problem among incarcerated in prisons, it is not well studied in developing countries including Ethiopia. Therefore, this study aimed to determine the prevalence and associated factors of ASPD among incarcerated in prison in Dessie city correctional center.

METHOD

A cross-sectional study design was conducted among 320 incarcerated in prison at Dessie correctional center, Ethiopia. The study subjects were selected by using a simple random sampling technique and the Diagnostic and Statistical Manual 5th text revision (DSM-5) was used to measure ASPD using face-to-face interviews. Social support was assessed using the Oslo social support scale (Oslo-3). The collected data were checked for completeness and entered into Epi-data Version 3.1 and then exported to SPSS version 26 for analysis. Bivariate and multivariable logistic regressions were done to identify factors related to antisocial personality disorder. In multivariable logistic regression variables with a p-value, less than 0.05 were considered significant and, adjusted OR (AOR) with 95% CI was used to present the strength of the association.

RESULTS

The current study showed that the prevalence of ASPD was found to be 30.6% (95% CI:25.6,35.9). In a multivariable analysis, being single [AOR = 2.33; 95%CI (1.39,3.89)], monthly income of 1000-2000 ETB (Ethiopian Birr) [AOR = 2.12; 95%CI (1.163,3.45)], reconviction [AOR = 2.37; 95%CI (1.08,5.19)], and alcohol use [AOR = 2.00; 95% CI (1.16,3.45)] were discovered to be predictors of antisocial personality disorder.

CONCLUSION

This study revealed that nearly one-third of incarcerated in prison were found to have an anti-social personality disorder. Being single, 1000-2000 ETB income, reconviction, and alcohol users were variables that are independent predictors of ASPD. A screening and intervention program is required and further research should be needed.

Psychopathy and Associated Factors Among Newly Admitted Prisoners in Correctional Institution Located in Bench Sheko and West Omo Zone, South West Ethiopia: A Cross-Sectional Study

Background

Psychopathy is an emerging health and behavioral problem worldwide. Psychopathy is linked to risk substance use, maltreatment, violence, crime, and reoffending, but little is known about psychopathy in low income countries like Ethiopia. Therefore, we assessed the prevalence and factors associated with psychopathy among newly-admitted prisoners in Bench Sheko and West Omo zone correctional center, Mizan Aman, Ethiopia.

Methods

A cross-sectional study was conducted from April 20 to July 19, 2019, among 411 (N=422) newly-admitted Bench Sheko and West Omo zone correctional center prisoners by using a consecutive sampling technique. A semi-structured and interviewer administered psychopathy checklist revised tool was used for screening psychopathy. WHO, ASSIST tool was used for screening risk use of khat, tobacco, and alcohol. Trauma, maltreatment, and social support were assessed with a life event checklist, adverse life experience screening tool, and Oslo social support scale, respectively. In addition, Criminal and clinical history of the prisoner was also assessed. The data was entered into Epi-data 3.1 and exported to Statistical Package for Social Science (SPSS) Version 21 for statistical analysis. A logistic regression model was used. Variables with a p-value less than 0.05 in the final fitting model were declared as independent predictors of psychopathy.

Results

The prevalence of psychopathy was 24.3%. Childhood maltreatment (AOR=6, 95% CI=2.2–17.5), risky khat use (AOR=4.6, 95% CI=2.4–8.7), poor social support (AOR=3.5, 95% CI=1.9–6.6), family history of imprisonment (AOR=3, 95% CI=1.5–6), history of trauma (AOR=2.3, 95% CI=1.1–4.8), and reoffending (AOR=2, 95% CI=1.1–3.8) were positively associated variables with psychopathy.

Conclusion

Psychopathy is highly prevalent among newly-admitted prisoners. Integrated efforts involving relevant stakeholders are needed to design strategies for early screening of psychopathy to prevent reoffending, and management of risk substance use at admission is crucial.

Personality in Combination with Alcohol and Drug Use and Psychiatric Disorders to Predict Psychosocial Characteristics and Behaviors of Hepatitis C Patients

The objectives of this study were to assess the prevalence of personality disorders and to examine personality as a predictor of psychosocial characteristics and behaviors of HCV patients. HCV patients (n = 259) from three infectious disease and liver clinics who completed Cloninger's Temperament and Character Inventory (TCI), an inventory for personality traits, were included in the study. Patients with low scale scores in the character dimension of both cooperativeness and self-directedness (low CO/SD) were defined as having a personality disorder. Using low CO/SD in combination with demographic, psychiatric/substance use, and HCV-related variables, linear regression was used to construct separate models of risky behaviors, quality of life, functioning, burden of illness, and social support. The prevalence of low CO/SD was high in this sample of HCV patients. Low CO/SD was an independent predictor of risky behaviors, quality of life, functioning, and social support.

Prevalence of Drug Injection, Sexual Activity, Tattooing, and Piercing Among Prison Inmates

Prisoners engage in a range of risk behaviors that can lead to the transmission of viral infections, such as HIV, hepatitis B and hepatitis C. In this review, we summarize the epidemiologic literature from 2007 to 2017 on 4 key risk behaviors for human immunodeficiency virus and hepatitis C virus among prisoners globally: drug injection, sexual activity, tattooing, and piercing. Of 9,303 peer-reviewed and 4,150 gray literature publications, 140 and 14, respectively, met inclusion criteria covering 53 countries (28%). Regions with high levels of injection drug use were Asia Pacific (20.2%), Eastern Europe and Central Asia (17.3%), and Latin America and the Caribbean (11.3%), although the confidence interval for Latin America was high. Low levels of injection drug use in prison were found in African regions. The highest levels of sexual activity in prison were in Europe and North America (12.1%) and West and Central Africa (13.6%); low levels were reported from the Middle East and North African regions (1.5%). High levels of tattooing were reported from Europe and North America (14.7%), Asia Pacific (21.4%), and Latin America (45.4%). Prisons are burdened with a high prevalence of infectious diseases and risk behaviors for transmission of these diseases, and, commonly, a striking lack of evidence-based infection control measures, even when such measures are available in the surrounding community. Given that most prisoners return to these communities, failure to implement effective responses has repercussions not only prisoner health but also for public health.

The pharmacological interactions between direct-acting antivirals for the treatment of chronic hepatitis c and psychotropic drugs

INTRODUCTION

Most direct-acting antivirals (DAAs) and psychotropic drugs are metabolized by or induct/inhibit CYP enzymes and drug transporters. Although they are frequently coadministered, the drug-drug interactions (DDIs) have been little studied. Therefore, the aim of this review is to describe the interactions between the approved DAA or combination regimens and the main psychoactive substances, including legal and illegal drugs of abuse. Areas covered: We performed a literature search on PubMed database on drug interactions with the currently available antivirals for hepatitis C and a review of the information on pharmacokinetics, metabolism, and drug interactions from www.hep-druginteractions.org and from all the Summary of Product Characteristics (SmPC). This review covers the DDI between the DAA regimens approved, such as simeprevir and sofosbuvir, paritaprevir, glecaprevir, voxilaprevir, ombitasvir, ledipasvir, daclatasvir and sofosbuvir, elbasvir and grazoprevir, sofosbuvir and velpatasvir, glecaprevir/pibrentasvir, sofosbuvir and velpatasvir, and main psychotropic agents. Expert Commentary: DAA regimens based on sofosbuvir combination usually have less DDI than protease inhibitor-based regimens. Among protease inhibitors regimens, new combinations, such as glecaprevir/elbasvir and grazoprevir/elbasvir, seemed to have less DDI than the combination POrD (paritaprevir/ombitasvir/ritonavir/dasabuvir). However, the analysis of each interaction is theoretical and further interaction studies would be necessary to confirm actual effect.

Distribution and Risk Factors of Disability Attributed to Personality Disorders: A National Cross-sectional Survey in China

Background:

Personality disorders can lead to some disability. However, little is known about the disability prevalence and function impairments. This study aimed to describe the disability prevalence attributed to personality disorders, its distribution, impairments of daily activities and social functions, and risk factors in China.

Methods:

Using a descriptive and analytic epidemiological method, data from the Second China National Sample Survey on Disability in 2006 were analyzed. The disability prevalence attributed to personality disorders, its distribution in different people and regions, and risk factors were statistically calculated.

Results:

Respondents included 1,909,205 adults. The disability prevalence rate attributed to personality disorders in China was 5.9/100,000. The disability rate attributed to personality disorders of males was higher than that of females (P = 0.012), while the rate of the unemployed was higher than that of the employed (P < 0.001). Furthermore, the rates of unmarried/divorced/widowed people and the illiterate population were higher than those of married and educated people (P < 0.001). Regarding the severity of disability attributable to personality disorders, mild disability accounted for a majority or 60% of the respondents. The data showed that disability mainly impaired respondents’ ability to engage in daily activities, get along with people, and participate in social situations. According to the case-control study, marriage, employment, and higher education were protective factors of disability.

Conclusions:

The prevalence of disability attributed to personality disorders is low in China and always leads to mild disability. The distribution of disability attributed to personality disorders also varies in the Chinese population.