Prevalence of psychiatric disorders, comorbidity patterns, and repeat offending among male juvenile detainees in South Korea: a cross-sectional study

Psychiatric disorders and comorbidity in a Spanish sample of prisoners at the end of their sentence: Prevalence rates and associations with criminal history

Introduction

This study examined, for the first time, the prevalence of mental disorders and comorbidities among inmates who were about to be released, and their association with criminal history.

Methods

A Spanish sample of 140 prisoners at the end of their sentence was recruited from an occupational program. Psychiatric disorders were determined according to the Diagnostic and Statistical Manual of Mental Disorders criteria. Bivariate analyses followed by multivariate regression models were conducted to identify significant variables for repeat incarceration and violent offending.

Results

The lifetime prevalence of Axis I disorders was 81.4%, with substance use disorders (SUD) and attention deficit/hyperactivity disorder (ADHD) being the most common diagnoses (51.4 and 31.4%, respectively). The current prevalence of Axis I disorders was 59.0%, including learning disorders (38.6%), ADHD (16.4%), and SUD (5.71%) among the most frequent syndromes. Thirty-six (26.5%) participants met criteria for a current Axis II disorder, which commonly was an antisocial personality disorder (12.5%). The majority of the sample (60.8%) suffered from two or more comorbid disorders during their lifetime, although the current prevalence fell to 23.3%. Childhood ADHD increased the number of imprisonments, while inmates convicted of a violent crime were more likely to present a learning disorder. Having a lifetime diagnosis of SUD or multiple psychiatric disorders appeared to be associated with both repeat incarceration and violent offending.

Conclusion

Given the high rate of mental disorders still present among subjects completing prison sentences and the challenges they may encounter to benefit from vocational programs, our results suggest that appropriate psychiatric care should be provided during imprisonment and after release to facilitate their community reintegration.

Psychiatric morbidity amongst adolescents in a Nigerian juvenile correctional facility

Background

The high occurrence of psychiatric disorders amongst adolescents within the Juvenile Justice System (JJS) has been confirmed. Most of the available data are from developed countries and some of them focus on just a single psychiatric disorder which may not be representative of the situation in low-income countries, hence the need for more studies in developing countries, including Nigeria.

Aim

The study aimed to determine the prevalence of psychiatric disorders amongst adolescent residents of a correctional facility.

Setting

The study was carried out at a Borstal Institution in North-Central Nigeria.

Methods

A descriptive cross-sectional study design was used. One hundred and twenty adolescents were assessed using the socio-demographic pro forma questionnaire designed by the researcher and the Kiddies Schedule for Affective Disorders and Schizophrenia (KSADS-PL). Data were analysed using EPI-INFO 4.06 d version 6.04 software.

Results

A total of 62.5% of the male respondents were older than 15 years. The percentage of respondents with a psychiatric disorder was 82.5%. The rate of psychiatric disorders was high with disruptive behaviour disorders being the most common at 40.8%, others were substance use disorders (15.8%), anxiety disorders (14.2%), psychosis (6.7%) and mood disorders (5%).

Conclusion

This study has established a high prevalence rate of psychiatric disorders amongst incarcerated adolescents. This is in line with the findings of numerous studies worldwide. This study has identified the need to increase awareness and knowledge about the high morbidity of mental disorders in growing juvenile detainee populations. This will allow early identification of adolescents at risk of psychiatric disorders and ensure efficient resource distribution of both JJS service and mental healthcare. Effective and appropriate interventions have shown to improve overall health, quality of life and reduce the rate of recidivism amongst incarcerated juveniles.

An Updated Systematic Review and Meta-regression Analysis: Mental Disorders Among Adolescents in Juvenile Detention and Correctional Facilities

OBJECTIVE

To synthesize evidence on the prevalence of mental disorders in adolescents in juvenile detention and correctional facilities and examine sources of heterogeneity between studies.

METHOD

Electronic databases and relevant reference lists were searched to identify surveys published from January 1966 to October 2019 that reported on the prevalence of mental disorders in unselected populations of detained adolescents. Data on the prevalence of a range of mental disorders (psychotic illnesses, major depression, attention-deficit/hyperactivity disorder [ADHD], conduct disorder, and posttraumatic stress disorder [PTSD]) along with predetermined study characteristics were extracted from the eligible studies. Analyses were reported separately for male and female adolescents, and findings were synthesized using random-effects models. Potential sources of heterogeneity were examined by meta-regression and subgroup analyses.

RESULTS

Forty-seven studies from 19 countries comprising 28,033 male and 4,754 female adolescents were identified. The mean age of adolescents assessed was 16 years (range, 10-19 years). In male adolescents, 2.7% (95% CI 2.0%-3.4%) had a diagnosis of psychotic illness; 10.1% (95% CI 8.1%-12.2%) major depression; 17.3% (95% CI 13.9%-20.7%) ADHD; 61.7% (95% CI 55.4%-67.9%) conduct disorder; and 8.6% (95% CI 6.4%-10.7%) PTSD. In female adolescents, 2.9% (95% CI 2.4%-3.5%) had a psychotic illness; 25.8% (95% CI 20.3%-31.3%) major depression; 17.5% (95% CI 12.1%-22.9%) ADHD; 59.0% (95% CI 44.9%-73.1%) conduct disorder; and 18.2% (95% CI 13.1%-23.2%) PTSD. Meta-regression found higher prevalences of ADHD and conduct disorder in investigations published after 2006. Female adolescents had higher prevalences of major depression and PTSD than male adolescents.

CONCLUSION

Consideration should be given to reviewing whether health care services in juvenile detention can address these levels of psychiatric morbidity.

Psychiatric morbidity among adolescents and youth involved with the juvenile justice system in sub-Saharan Africa: Systematic scoping review of current studies and research gaps

The current body of knowledge on the prevalence rate of psychiatric morbidity among adolescents and youth within the juvenile justice system in sub-Saharan Africa is yet to be systematically synthesized.. Consequently, African literature in the field has remained obscure, out of consideration in global discourses around the subject.; and incoherent to policy-makers. The situation has also hampered the identification of and filling of regional research-gaps in the field. The aim of this study, therefore, was to conduct a systematic scoping review of available data on psychiatric morbidity among adolescents and youth within the juvenile justice system in sub-Saharan Africa. The search was conducted using PubMed/MEDLINE, Science Direct, EMBASE, CINAHL and Psych Info. Additional searches were done in Google Scholar and African Journal Online (AJOL) databases. Twenty-six studies from 21 different research projects were identified. More than two-thirds were conducted in Nigeria and published within the last decade. Similar to what has been established around the world, the prevalence rate of psychiatric disorder was often very high, with a range of 59.7% - 63.0% among respondents. Key strengths of identified studies included use of standardized clinician-administered instruments for assessment and exploration of a wide range of psychiatric disorders. The main weaknesses in the studies included male gender-bias, lack of normative comparison groups, emphasis on custodial settings with little data on non-custodial systems, and considerable length of time-lag between the points of incarceration and psychiatric evaluation among the samples studied.. The study concluded that a modest number of studies have been conducted on psychiatric morbidity among justice-involved adolescents in sub-Saharan Africa, but there are still significant research gaps which could be bridged in order to aid context-appropriate interventions.

Affective Factors That Contribute to the Quality of Life of Juvenile Inmates with Attention-Deficit/Hyperactivity Disorder: A Focus on Items from the Korean Youth Self Report

OBJECTIVES

This study investigated quality of life in Korean juvenile inmates with attention-deficit/hyperactivity disorder (ADHD) and the impact of behavioral and emotional problems on quality of life.

METHODS

In total, 200 inmates were evaluated using the Korean version of the Mini-International Neuropsychiatric Interview (K-MINI) and the Korean version of the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime (K-SADS-PL-K). We extracted the inmates with ADHD and evaluated their quality of life, behavioral problems, and emotional problems with the Pediatric Quality of Life Inventory (PedsQL) and the Korean Youth Self Report (K-YSR) scale. Descriptive statistics, Pearson correlation analysis, and multiple regression analysis were conducted.

RESULTS

Among the 200 total inmates, 68 were diagnosed with ADHD by the K-SADS-PL-K. Most of the correlations between PedsQL scores and K-YSR items were significant. Multiple regression analysis showed that PedsQL could be predicted by affective problems (among the DSM-oriented scales of the K-YSR) and attention problems (among the syndrome scales of the K-YSR).

CONCLUSION

Our results demonstrate that, among juvenile inmates with ADHD, quality of life was negatively correlated with most behavioral and emotional problems. Meanwhile, the significant influence of affective and attention problems on inmates' quality of life suggests the necessity of comprehensive treatments for this group.

Mental health care and delivery system at Temeke hospital in Dar es Salaam, Tanzania

BACKGROUND

Low and middle income countries face many challenges in meeting mental health needs in their regions. Treatment of patients with mental disorders is inadequate in most of these countries and majority of individuals with severe mental disorders remain untreated. The bad news is that mental health problems in these countries are on the rise due to socioeconomic challenges being faced. Regardless of guidelines and directives provided by WHO for organizing mental health services, these countries continue to face many challenges in the effort to cater for mental health needs. Such challenges include lack of human resource for mental health especially at primary health care level, inadequate training of human resource for mental health, misplacement of human resource for mental health, lack of drugs, wrong priorities, problematic insurance coverage for mental disorders, and stigma. This study aimed at exploring mental health care and delivery system at Temeke district hospital, and how services were organized to meet the increasing mental health needs of its population.

METHODS

A qualitative study was conducted at Temeke hospital in Dar es Salaam, involving 7 in-depth interviews with mental health care providers, 7 in-depth interviews with mentally ill patients, and 2 focus group discussions with caregivers. A convenient sampling procedure was used to select participants for the study. All interviews were audio-recorded in Kiswahili and transcribed. A qualitative Content Analysis was used to analyze data after translation with the aid of Nvivo 10 software.

RESULTS

Three main themes were identified. These were resource challenges, environmental/system challenges, and satisfaction with mental health services. Temeke health facility faced resource and environmental/system challenges, and there were mixed feelings on satisfaction with services. Funding and priority issues were found to mainly affect delivery of appropriate services to clients.

CONCLUSION

Health facilities that provide mental health services in the community need to be well equipped with necessary resources to meet the vast needs of people they serve. Having a political will, improving the health systems governance for mental health, and priority setting, are necessary to address the challenges experienced in the delivery of mental health services.