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Fazel S, Favril L. Prevalence of attention-deficit hyperactivity disorder in adult prisoners: An updated meta-analysis. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2024; 34:339-346. [PMID: 38568877 DOI: 10.1002/cbm.2337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/20/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Previous meta-analyses may have overestimated the prevalence of attention-deficit hyperactivity disorder (ADHD) in prisoners by including data from selected samples. AIMS To estimate the prevalence of ADHD in unselected samples of adults in prison and examine potential sources of heterogeneity by meta-regression and subgroup analyses. METHODS We assessed all studies included in a 2018 systematic review for eligibility and updated the literature search to include studies published up to September 2023. RESULTS A total of 11 studies reporting robust diagnostic data on ADHD in 3919 unselected adults in prison were included. In meta-regression, ADHD prevalence did not differ between men and women but it was significantly higher in studies using a two-phase design. In random sampling studies, the pooled prevalence of ADHD was 8.3% (95% CI: 3.8-12.8) which was further halved after the removal of an outlier. CONCLUSION One in 12 adults in prison have been diagnosed with ADHD. Our findings highlight the importance of using clear and consistent inclusion criteria in meta-analyses of prevalence.
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Affiliation(s)
- Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Louis Favril
- Faculty of Law and Criminology, Ghent University, Ghent, Belgium
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Beigel L, Forrester A, Torales J, Aboaja A, Rivera Aroyo G, Roche MO, Opitz-Welke A, Mundt AP. Mental health intervention research in Latin American correctional settings: A scoping review. Int J Soc Psychiatry 2023; 69:1560-1577. [PMID: 37332202 DOI: 10.1177/00207640231174372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
BACKGROUND The Latin American prison population has grown faster than anywhere else globally over the past two decades, reaching a total of 1.7 million people at any given time. However, research on mental health prevention and treatment interventions in Latin American prisons remains scarce. AIMS This study aimed to systematically review and synthesize research on prison mental health interventions conducted in the region. METHODS We used a two-stage scoping review design guided by the JBI Manual for Evidence Synthesis. Searches took place in December 2021 in nine databases using descriptors and synonyms. First, all prison mental health research in Latin America was retained. Secondly, using title and abstract screening, all research possibly related to interventions was retained for full text evaluation. Studies reporting interventions were assessed by country, language, institution, population, intervention type, intervention focus and outcomes. RESULTS N = 34 studies were included in this review. These were 13 case reports, seven expert consensus papers and 14 quantitative studies (four randomized controlled trials, nine cohort studies, one quasi-experimental study). Fourteen interventions were targeted at promoting prosocial behavior, seven studies each aimed to improve mental health and to treat substance use disorders. Six studies involved the treatment of sexual offending behavior, and 3 focused on reducing criminal recidivism. Psychoeducation (n = 12) and motivational interviewing (n = 5) were the most frequent intervention types studied. Promising data from trials showed that anger management, depression, substance use and reoffending could be successfully addressed through interventions. CONCLUSIONS Implementation and effectiveness research of mental health interventions in Latin American prisons is scarce. Addressing mental health, substance use and prosocial behavior outcomes should be considered in future research. There is a particular dearth of controlled trials describing quantifiable outcomes.
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Affiliation(s)
- Lukas Beigel
- Department of Psychiatry and Psychotherapy Charité Campus Mitte, Charité Universitätsmedizin Berlin, Germany
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Andrew Forrester
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, UK
| | - Julio Torales
- Department of Mental Health, Universidad Nacional de Asunción, Paraguay
| | - Anne Aboaja
- Mental Health and Addictions Research Group, University of York, UK
- Tees, Esk and Wear Valleys NHS Foundation Trust, Middlesbrough, UK
| | | | | | - Annette Opitz-Welke
- Department of Forensic Psychiatry, Charité Universitätsmedizin Berlin, Germany
| | - Adrian P Mundt
- Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Chile, Santiago, Chile
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Seifu BL, Nigatu SG, Gezie LD. Health-related quality of life and associated factors among prisoners in Gondar city prison, Northwest Ethiopia: Using structural equation modeling. PLoS One 2023; 18:e0290626. [PMID: 37624811 PMCID: PMC10456194 DOI: 10.1371/journal.pone.0290626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 08/13/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Prisoners usually need more comprehensive health and social support than the general population. Due to the growing number of prisoners in Ethiopia and limited access to health service, quality of life is a key concern. Compromised health-related quality of life imposes short and long-term consequences on the prisoners, their families, and the healthcare system. In Ethiopia, there are limited studies that investigate health outcomes and health-related quality of life in this particular population. Therefore, this study aimed to assess the magnitude of health-related quality of life and associated factors among prisoners considering the multidimensional nature of health related quality of life. METHODS An institution-based cross-sectional study was conducted on 1,246 prisoners who were enrolled using simple random sampling. The World Health Organization Quality of Life (WHOQoL-BREF-26) and Patient Health Questionnaire (PHQ-9) tools were used to assess the HRQoL and depression among prisoners, respectively. The relationships between exogenous, mediating, and endogenous variables were identified using structural equation modeling. As the mediation of effects were present, then the direct, indirect, and total effects were determined. General fit indices of the final model were acceptable (x2/df = 1.76, p < 0.001, RMSEA = 0.06, TLI = 0.90, CFI = 0.91, and SRMR = 0.06). RESULT The mean (standard deviation) score of the overall health related quality of life was 53.25 (15.12). Having an underlying medical condition had negative total effect on health related quality of life while visits in prison had positive total effect. Having income-generating work in prison had only a direct positive effect. Whereas, older age, being married, longer duration of imprisonment, and depression all had only a negative direct effect on one or more domains of quality of life (p<0.05). CONCLUSION Inmates in Gondar Prison have very poor and compromised levels of physical and psychological health despite having a modest degree of overall HRQoL. The result of this study is significant for people who work in and research the prison environment because it can assist in recognizing prisoners' health needs and devising treatment procedures that take into consideration physical, psychological, environmental, and social relationship aspects.
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Affiliation(s)
- Beminate Lemma Seifu
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Solomon Gedlu Nigatu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Lemma Derseh Gezie
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
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Aboaja A, Blackwood D, Alvarado R, Grant L. The mental wellbeing of female prisoners in Chile. BMC Res Notes 2023; 16:78. [PMID: 37189158 DOI: 10.1186/s13104-023-06342-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 04/25/2023] [Indexed: 05/17/2023] Open
Abstract
OBJECTIVE To measure and understand mental wellbeing among women prisoners in Chile, as part of a larger study. RESULT Sixty-eight sentenced prisoners in a women's prison participated in a survey, giving a response rate of 56.7%. Using the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), the mean wellbeing score of participants was 53.77 out of maximum score of 70. Whilst 90% of the 68 women felt useful at least some of the time, 25% rarely felt relaxed, close to others or able to make up their own minds about things. Data generated from two focus groups attended by six women offered explanations for survey findings. Thematic analysis identified stress and loss of autonomy due to the prison regime as factors which negatively affect mental wellbeing. Interestingly, whilst offering prisoners an opportunity to feel useful, work was identified as a source of stress. Interpersonal factors linked to a lack of safe friendships within the prison and little contact with family had an adverse impact on mental wellbeing. The routine measurement of mental wellbeing among prisoners using the WEMWBS is recommended in Chile and other Latin American countries to identify the impact of policies, regimes, healthcare systems and programmes on mental health and wellbeing.
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Affiliation(s)
- Anne Aboaja
- Tees, Esk and Wear Valleys NHS Foundation Trust, Darlington, UK.
- University of Edinburgh, Edinburgh, UK.
- University of York, York, UK.
| | | | - Rubén Alvarado
- University of Chile, Santiago, Chile
- University of Valparaíso, Valparaíso, Chile
| | - Liz Grant
- University of Edinburgh, Edinburgh, UK
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Meruelo AD, Timmins MA, Irwin MR, Coccaro EF. Salivary cortisol awakening levels are reduced in human subjects with intermittent explosive disorder compared with controls. Psychoneuroendocrinology 2023; 151:106070. [PMID: 36863129 PMCID: PMC10262314 DOI: 10.1016/j.psyneuen.2023.106070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 02/20/2023] [Accepted: 02/20/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND The role of the hypothalamic-pituitary-adrenal (HPA) axis in human aggressive behavior is poorly characterized, though some studies report that, unlike depression, circulating or salivary levels of cortisol are low compared with controls. METHODS In this study, we collected three salivary cortisol levels (two in the morning and one in the evening) on three separate days in 78 adult study participants with (n = 28) and without (n = 52) prominent histories of impulsive aggressive behavior. Plasma C-Reactive Protein (CRP) and Interleukin-6 (IL-6) were also collected in most study participants. Aggressive study participants meet DSM-5 criteria for Intermittent Explosive Disorder (IED) while non-aggressive participants either had a history of a psychiatric disorder or no such history (Controls). RESULTS Morning, but not evening, salivary cortisol levels were significantly lower in IED (p < 0.05), compared with control, study participants. In addition, salivary cortisol levels correlated with measures of trait anger (partial r = -0.26, p < 0.05) and aggression (partial r = -0.25, p < 0.05) but not with measures of impulsivity, psychopathy, depression, history of childhood maltreatment, or other tested variables that often differ in individuals with IED. Finally, plasma CRP levels correlated inversely with morning salivary cortisol levels (partial r = -0.28, p < 0.05); plasma IL-6 levels showed a similar, though not statistically significant (rp = -0.20, p = 0.12) relationship with morning salivary cortisol levels. CONCLUSION The cortisol awakening response appears to be lower in individuals with IED compared with controls. In all study participants, morning salivary cortisol levels correlated inversely with trait anger, trait aggression, and plasma CRP, a marker of systemic inflammation. This suggests the present of a complex interaction between chronic-low level inflammation, the HPA axis, and IED that warrants further investigation.
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Affiliation(s)
- Alejandro D Meruelo
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | - Matthew A Timmins
- Clinical Neuroscience and Psychotherapeutics Research Unit, Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Michael R Irwin
- Department of Psychiatry & Biobehavioral Sciences and Medicine, Norman Cousins Center, and Semel Institute, UCLA School of Medicine, Los Angeles, CA, USA
| | - Emil F Coccaro
- Clinical Neuroscience and Psychotherapeutics Research Unit, Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
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Rodrigues Monteiro A, Schadock I, Carneiro da Rosa Aranalde L, Peres Martinez D, Rodrigues Fernandes N, Caurio Lobato R, Silveira Vianna J, Castilho Barros C, Bastos Ramis I, Aguiar Dos Anjos Gatti F, Andrés Mendoza Sassi R, Vitola Gonçalves C, Pousada da Hora V. Prevalence of Overweight and Associated Factors in a Male Prison Population in the Extreme South of Brazil: A Cross-Sectional Study. Metab Syndr Relat Disord 2023; 21:63-69. [PMID: 36409532 DOI: 10.1089/met.2021.0142] [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: 11/23/2022] Open
Abstract
Background: This cross-sectional study serves as a first Brazilian inventory about overweight as a marker for metabolic health and risk factor to develop noncommunicable chronic diseases in prison populations. The prevalence of overweight, and its associated factors in prisoners of the Fifth Regional State Penitentiary of Rio Grande do Sul (5th DPR) in the extreme South of Brazil were investigated using a precoded questionnaire with sociodemographic, behavioral, and health questions, applied to proportional stratified random sampled prisoners. Methods: Five hundred eighty male prisoners (70%) in the closed regime agreed to answer the questionnaire and allowed anthropomorphic body measurement, carried out by trained scientists. We used bivariate Pearson's chi-squared test and adjusted multinomial logistic regression for analyses. Results: Considering that the studied incarcerated population is young (mean age 33 years) it is concerning that already 43.6% of them are overweight, report regular sweets and sugary soft drink consumption (77.7%, and 81.4%, respectively), 60.2% are smokers, and 19.4% are at elevated risk to develop cardiovascular diseases. Further, 13.8% of the respondents reported a diagnosis of hypertension, 4.9% hypercholesterolemia, and 2.7% diabetes mellitus type 2. Among those who reported not smoking, excess weight was almost four times higher (prevalence ratio: 3.79; 95% confidence interval: 2.61-5.50). Conclusions: Our study suggests that the prison environment promotes modifiable risk factors for chronic diseases. These data deserve attention and intervention, aiming to prevent and reduce the current levels of excess weight.
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Affiliation(s)
| | - Ines Schadock
- Medical School, Federal University of Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | | | | | | | - Rubens Caurio Lobato
- Medical School, Federal University of Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | - Julia Silveira Vianna
- Medical School, Federal University of Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | | | - Ivy Bastos Ramis
- Medical School, Federal University of Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
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Mundt AP, Langerfeldt SD, Maphisa JM, Sourabié O, Yongsi BN, Serri ER, Bukasa Tshilonda JC, Te JH, Bitta MA, Mathe L, Liwimbi O, Dos Santos PF, Atilola O, Jansen S, Diegane Tine JA, Akran C, Jalloh A, Kagee A, Van Wyk ES, Forry JB, Imasiku ML, Chigiji H, Priebe S. Changes in rates of psychiatric beds and prison populations in sub-Saharan Africa from 1990 to 2020. J Glob Health 2022; 12:04054. [PMID: 36056592 PMCID: PMC9440375 DOI: 10.7189/jogh.12.04054] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Psychiatric bed numbers (general, forensic, and residential) and prison populations have been considered indicators of institutionalization. The present study aimed to assess changes of those indicators across sub-Saharan Africa (SSA) from 1990 to 2020. Methods We retrospectively obtained data on psychiatric bed numbers and prison populations from 46 countries in SSA between 1990 and 2020. Mean and median rates, as well as percentage changes between first and last data points were calculated for all of SSA and for groups of countries based on income levels. Results Primary data were retrieved from 17 out of 48 countries. Data from secondary sources were used for 29 countries. From two countries, data were unavailable. The median rate of psychiatric beds decreased from 3.0 to 2.2 per 100 000 population (median percentage change = -16.1%) between 1990 and 2020. Beds in forensic and residential facilities were nonexistent in most countries of SSA in 2020, and no trend for building those capacities was detected. The median prison population rate also decreased from 77.8 to 71.0 per 100 000 population (-7.8%). There were lower rates of psychiatric beds and prison populations in low-income and lower-middle income countries compared with upper-middle income countries. Conclusions SSA countries showed, on average, a reduction of psychiatric bed rates from already very low levels, which may correspond to a crisis in acute psychiatric care. Psychiatric bed rates were, on average, about one twenty-fifth of countries in the Organization for Economic Co-operation and Development (OECD), while prison population rates were similar. The heterogeneity of trends among SSA countries over the last three decades indicates that developments in the region may not have been based on coordinated policies and reflects unique circumstances faced by the individual countries.
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Affiliation(s)
- Adrian P Mundt
- Medical Faculty, Universidad Diego Portales, Santiago, Chile
- Departamento de Neurología y Psiquiatría, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | | | - J Maphisa Maphisa
- Department of Psychology, University of Botswana, Gaborone, Botswana
| | - Oumar Sourabié
- Psychiatrist, Regional Center Hospital of Fada N'gourma, Fada N'gourma, Burkina Faso
| | - Blaise Nguendo Yongsi
- Institute for Training & Research in Population Studies, University of Yaoundé, Yaoundé, Cameroon
| | - Enzo Rozas Serri
- Departamento de Neurología y Psiquiatría, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
- Department of Psychiatry and Mental Health, Hospital Clínico Universidad de Chile, Santiago, Chile
| | | | - Jeronimo H Te
- West African Epidemiology Network on Drug Use (WENDU), Bissau, Guinea-Bissau
| | - Mary A Bitta
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- KEMRI-Welcome Trust Research Program, Kilifi, Kenya
| | | | - Olive Liwimbi
- Zomba Mental Hospital, Ministry of Health, Zomba, Malawi
| | | | - Olayinka Atilola
- Lagos State University College of Medicine (LASUCOM), Lagos, Nigeria
| | - Stefan Jansen
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Jean A Diegane Tine
- Institute of Health and Development, Cheikh Anta Diop University, Dakar, Senegal
| | | | - Abdul Jalloh
- Sierra Leone Psychiatric Teaching Hospital, Freetown, Sierra Leone
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Ashraf Kagee
- Alan Fisher Centre for Public Mental Health, University of Cape Town, Cape Town
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Elizabeth S Van Wyk
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Jimmy B Forry
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Mental Health and Psychiatry, Faculty of Clinical Medicine and Dentistry, Kampala, International University-Western Campus, Bushenyi, Uganda
- Department of Psychiatry, Mubende Regional Referral Hospital, Mubende, Uganda
| | | | | | - Stefan Priebe
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
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Abdulkadir H, Girma M, Gebru Z, Sidamo NB, Temesgen G, Jemal K. Anxiety and its associated factors among inmates in ARBA Minch and JINKA town, southern Ethiopia. BMC Psychiatry 2022; 22:582. [PMID: 36050698 PMCID: PMC9434509 DOI: 10.1186/s12888-022-04230-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prison populations are more affected by mental illness than the general population but little attention is given to this population. And there is a limitation of study on the magnitude of anxiety and its associated factors. So this study aimed to assess the magnitude of anxiety and its associated factors among prisoners in Arba Minch and Jinka town, Ethiopia. METHODS An institution-based cross-sectional study was conducted among 650 randomly selected prisoners at Arba Minch and Jinka town. Data was collected by using open data kit then converted to excel and exported to SPSS version 25 for analysis. Descriptive statistics including frequency, means, and proportion were performed. Binary logistic regression was used to identify the associated variables. P < 0.05 was used to declare statistical significance. RESULTS The proportion of Anxiety among prisoners was 28% [N = 174, (95%CI, 25-32%)]. Age ≥ 48 (AOR = 4.21, 95%CI 1.99-8.93), age 38-47 (3.95, 1.94-8.07), being an urban resident (2.48, 1.56-3.95), not doing physical exercise (2.71, 1.53-4.79), having a chronic disease (1.63, 1.07-2.47), having 1-2 stressful life events (2.92, 1.59-5.35), duration of punishment > 5 years (2.92, 1.59-5.35) and lack of income-generating job in prison (2.54, 1.48-4.35) were significantly associated with anxiety. CONCLUSION The magnitude of anxiety among prisoners was high. Age ≥ 48 and 38-47, urban residence, not doing physical exercise, having a chronic disease, having 1-2 stressful life events, duration of punishment > 5 years, and lack of income-generating job in prison were significantly associated with anxiety. Giving special attention and being supportive to older age and those who have a chronic disease, facilitating physical exercise, creating job opportunity in the prison, and giving training for prisoners on stress coping mechanism and anxiety is recommended.
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Affiliation(s)
- Hanan Abdulkadir
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
| | - Meseret Girma
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Zeleke Gebru
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Negussie Boti Sidamo
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Gebremaryam Temesgen
- Department of Midwifery, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Kiyar Jemal
- Departement of laboratory, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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Baranyi G, Fazel S, Langerfeldt SD, Mundt AP. The prevalence of comorbid serious mental illnesses and substance use disorders in prison populations: a systematic review and meta-analysis. Lancet Public Health 2022; 7:e557-e568. [PMID: 35660217 PMCID: PMC9178214 DOI: 10.1016/s2468-2667(22)00093-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 03/31/2022] [Accepted: 04/04/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Comorbid mental illnesses and substance use disorders are associated with adverse criminal, social, and health outcomes. Yet, their burden is not reliably known among prison populations. We therefore aimed to estimate the prevalence of comorbid serious mental illnesses and substance use disorders (dual disorders) among people in prison worldwide. METHODS In this systematic review and meta-analysis, we searched 15 electronic databases (ASSIA, CAB Abstracts, Criminal Justice Database, Embase, Global Health, Global Index Medicus, IBSS, MEDLINE, NCJRS, PAIS Index, PsycINFO, Russian Science Citation Index, Scielo, Social Services Abstracts, and Web of Science) and the grey literature (Open Grey and ProQuest Dissertations & Theses Global) for studies reporting the prevalence of serious mental illnesses and substance use disorders in prison populations published between Jan 1, 1980, and Sept 25, 2021, and contacted the authors of relevant studies. Empirical studies among unselected adult prison populations that applied representative sampling strategies and validated diagnostic instruments, and either reported the prevalence of dual disorders or had authors who could provide prevalence data in correspondence, were included. Two reviewers (GB and SDL) independently extracted data from the eligible studies; both current (up to 1 year) and lifetime prevalence were extracted, if available. We sought summary estimates. Our primary outcomes were comorbid non-affective psychosis with substance use disorders and comorbid major depression with substance use disorders. We conducted a random-effects meta-analysis, explored between-sample heterogeneity with meta-regression, and calculated odds ratios (ORs) to assess bidirectional relationships between mental and substance use disorders. Risk of bias was assessed by use of a standard tool. The study protocol was registered with PROSPERO, CRD42020207301. FINDINGS Of 11 346 records screened, we identified 34 studies reporting the prevalence of dual disorders among individuals in prison and received unpublished prevalence data for 16 studies, totalling 50 eligible studies and 24 915 people. The mean quality score of included studies was 7·8 (SD 1·2). We found that 3·5% (95% CI 2·2-5·0) had current non-affective psychosis with any comorbid substance use disorder, representing 443 (49·2%) of 900 people with non-affective psychosis, and 9·1% (5·6-13·3) had current major depression and comorbid substance use disorders, representing 1105 (51·6%) of 2143 people with major depression. Between-sample heterogeneity was high (I2>80%). People in prison with current non-affective psychosis were significantly more likely to have substance use disorders compared with those without (OR 1·7, 95% CI 1·4-2·2). People with major depression had higher odds of substance use disorders than those without (1·6, 1·3-2·0). INTERPRETATION Around half of the prison population with non-affective psychosis or major depression have a comorbid substance use disorder. Consideration should be given to screening for dual disorders and implementing integrated and scalable treatments. FUNDING Economic and Social Research Council, Agencia Nacional de Investigación y Desarrollo (Chile), and the Wellcome Trust.
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Affiliation(s)
- Gergő Baranyi
- Centre for Research on Environment, Society and Health, Department of Geography, School of GeoSciences, The University of Edinburgh, Edinburgh, UK
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Sabine Delhey Langerfeldt
- Facultad de Medicina, Universidad Diego Portales, Santiago, Chile; Department of Psychiatry and Mental Health, Medical Faculty, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Adrian P Mundt
- Facultad de Medicina, Universidad Diego Portales, Santiago, Chile; Departamento de Neurología y Psiquiatría, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile.
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10
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Yousefi F, Talib MA. Predictors of personality disorders in prisoners. J Med Life 2022; 15:454-461. [PMID: 35646191 PMCID: PMC9126463 DOI: 10.25122/jml-2021-0317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 12/08/2021] [Indexed: 11/10/2022] Open
Abstract
Personality disorders can lead to difficult social or occupational functional processes rooted in chronic maladaptive thoughts, feelings, and behaviors. This study aimed to investigate factors of personality disorder in prisoners from the central prison of Sanandaj, Iran. We conducted a cross-sectional study, which included all prisoners in the central prison of Sanandaj, Iran. The study sample includes 343 prisoners, of which 329 were male, and 14 were female, selected by randomized multistage sampling method. Participants filled in Millon's multi-axis clinical questionnaire. The data were analyzed using Chi-square, multiple logistic regression, and bootstrap analysis. There were 183 participants without personality disorders (53.4%) and 99 participants (28.9%) with cluster B personality disorders (narcissistic, histrionic, anti-social, and borderline). Male gender (OR=0.07) and elementary education level (OR=0.18) have a significant relationship with cluster A personality disorders (paranoid, schizoid, schizotypal). Cluster B has a significant relationship only with the elementary education level (OR=0.27). Cluster C (avoidant, dependent, obsessive-compulsive personality disorder) has a significant relationship with male gender (OR=0.20), elementary education level (OR=0.30), unemployment (OR=2.64), theft crime types (OR=0.38) and disputes and assaults (OR=0.18). Based on these results, psychological and psychiatric interventions in prisoners are suggested.
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Affiliation(s)
- Fayegh Yousefi
- Department of Psychiatry, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran,Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mansor Abu Talib
- Department of Psychology, Faculty of Social Sciences & Liberal Arts, UCSI University, Kuala Lumpur, Malaysia,Corresponding Author: Mansor Abu Talib, Department of Psychology, Faculty of Social Sciences & Liberal Arts, UCSI University, Kuala Lumpur, Malaysia. E-mail:
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Barra S, Turner D, Müller M, Hertz PG, Retz-Junginger P, Tüscher O, Huss M, Retz W. ADHD symptom profiles, intermittent explosive disorder, adverse childhood experiences, and internalizing/externalizing problems in young offenders. Eur Arch Psychiatry Clin Neurosci 2022; 272:257-269. [PMID: 32780159 PMCID: PMC8866272 DOI: 10.1007/s00406-020-01181-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 07/31/2020] [Indexed: 02/07/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) and co-existing psychiatric/psychological impairments as well as adverse childhood experiences (ACEs) are common among young offenders. Research on their associations is of major importance for early intervention and crime prevention. Intermittent explosive disorder (IED) warrants specific consideration in this regard. To gain sophisticated insights into the occurrence and associations of ADHD, IED, ACEs, and further psychiatric/psychological impairments in young (male and female) offenders, we used latent profile analysis (LPA) to empirically derive subtypes among 156 young offenders who were at an early stage of crime development based on their self-reported ADHD symptoms, and combined those with the presence of IED. We found four distinct ADHD subtypes that differed rather quantitatively than qualitatively (very low, low, moderate, and severe symptomatology). Additional IED, ACEs, and further internalizing and externalizing problems were found most frequently in the severe ADHD subtype. Furthermore, females were over-represented in the severe ADHD subtype. Finally, ACEs predicted high ADHD symptomatology with co-existing IED, but not without IED. Because ACEs were positively associated with the occurrence of ADHD/IED and ADHD is one important risk factor for on-going criminal behaviors, our findings highlight the need for early identification of ACEs and ADHD/IED in young offenders to identify those adolescents who are at increased risk for long-lasting criminal careers. Furthermore, they contribute to the debate about how to best conceptualize ADHD regarding further emotional and behavioral disturbances.
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Affiliation(s)
- Steffen Barra
- Institute for Forensic Psychology and Psychiatry, Saarland University Hospital, Kirrberger Str. 100, 66421, Homburg, Germany.
| | - Daniel Turner
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Marcus Müller
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Priscilla Gregorio Hertz
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Petra Retz-Junginger
- Institute for Forensic Psychology and Psychiatry, Saarland University Hospital, Kirrberger Str. 100, 66421, Homburg, Germany
| | - Oliver Tüscher
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Michael Huss
- Department of Child and Adolescent Psychiatry, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Wolfgang Retz
- Institute for Forensic Psychology and Psychiatry, Saarland University Hospital, Kirrberger Str. 100, 66421, Homburg, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
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12
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Mundt AP, Rozas Serri E, Siebenförcher M, Alikaj V, Ismayilov F, Razvodovsky YE, Hasanovic M, Marinov P, Frančišković T, Cermakova P, Harro J, Sulaberidze L, Kalapos MP, Assimov M, Nurmagambetova S, Ibishi NF, Molchanova E, Taube M, Chihai J, Dedovic J, Gosek P, Tataru N, Golenkov A, Lecic-Tosevski D, Randjelovic D, Izakova L, Švab V, Vohidova M, Kerimi N, Sukhovii O, Priebe S. Changes in national rates of psychiatric beds and incarceration in Central Eastern Europe and Central Asia from 1990-2019: A retrospective database analysis. LANCET REGIONAL HEALTH-EUROPE 2021; 7:100137. [PMID: 34557842 PMCID: PMC8454862 DOI: 10.1016/j.lanepe.2021.100137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background Numbers of psychiatric beds (general, forensic, and residential) and prison populations have been considered to be indicators of institutionalisation of people with mental illnesses. The present study aimed to assess changes of those indicators across Central Eastern Europe and Central Asia (CEECA) over the last three decades to capture how care has developed during that historical period. Methods We retrospectively obtained data on numbers of psychiatric beds and prison populations from 30 countries in CEECA between 1990 and 2019. We calculated the median of the percent changes between the first and last available data points for all CEECA and for groups of countries based on former political alliances and income levels. Findings Primary national data were retrieved from 25 out of 30 countries. Data from international registries were used for the remaining five countries. For all of CEECA, the median decrease of the general psychiatric bed rates was 33•8% between 1990 and 2019. Median increases were observed for forensic psychiatric beds (24•7%), residential facility beds (12•0%), and for prison populations (36•0%). Greater reductions of rates of psychiatric beds were observed in countries with lower per capita income as well as in countries that were formerly part of the Soviet Union. Seventeen out of 30 countries showed inverse trends for general psychiatric beds and prison populations over time, indicating a possible shift of institutionalisation towards correctional settings. Interpretation Most countries had decreased rates of general psychiatric beds, while there was an increase of forensic capacities. There was an increase in incarceration rates in a majority of countries. The large variation of changes underlines the need for policies that are informed by data and by comparisons across countries. Funding Agencia Nacional de Investigación y Desarrollo in Chile, grant scheme FONDECYT Regular, grant number 1190613.
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Affiliation(s)
- Adrian P Mundt
- Medical Faculty, Universidad Diego Portales, Santiago, Chile; Departamento de Neurología y Psiquiatría, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Enzo Rozas Serri
- Department of Psychiatry and Mental Health, Hospital Clínico Universidad de Chile, Santiago, Chile; Medical Faculty, Universidad Diego Portales, Santiago, Chile
| | - Mathias Siebenförcher
- Department of Psychiatry and Psychotherapy Campus Mitte, Charité Universitätsmedizin Berlin, Germany
| | - Valbona Alikaj
- Department of Neuroscience, Faculty of Medicine, Medical University, Tirana, Albania
| | | | | | - Mevludin Hasanovic
- Department of Psychiatry, University Clinical Centre Tuzla, Medical Faculty, University of Tuzla, Bosnia and Herzegovina
| | - Petar Marinov
- Association of Experts in Mental Health, Sofia, Bulgaria; Standing Committee for Professional Standards and By-Laws of the Bulgarian Psychiatric Association, Sofia, Bulgaria; Sofia University "St. Kliment Ohridski", Thrakian University St. Zagora, Bulgaria
| | | | - Pavla Cermakova
- National Institute of Mental Health, Klecany, Czech Republic; Third Faculty of Medicine, Charles University Prague, Czech Republic; Second Faculty of Medicine, Charles University Prague, Czech Republic
| | - Jaanus Harro
- North Estonia Medical Centre, Psychiatry Clinic, Tallinn, and Chair of Neuropsychopharmacology, Institute of Chemistry, University of Tartu, Tartu, Estonia
| | | | | | - Marat Assimov
- Department of Communication Skills of the Kazakh National Medical University, Almaty, Kazakhstan
| | | | - Nazmie F Ibishi
- Clinic of Psychiatry, University Clinical Centre of Kosovo, Pristina, Kosovo
| | | | - Māris Taube
- Department of Psychiatry, Riga Stradin's University, Riga, Latvia
| | - Jana Chihai
- Psychiatry, Narcology and Medical Psychology Department, State Medical and Pharmaceutical University Nicolae Testemitanu, Chisinau, Moldova
| | - Jovo Dedovic
- Forensic Psychiatry Unit - Special Psychiatric Hospital Kotor, Kotor, Montenegro
| | - Paweł Gosek
- Institute of Psychiatry and Neurology • Department of Forensic Psychiatry, Warsaw, Poland
| | - Nicoleta Tataru
- Senior consultant psychiatrist, Psychiatry Ambulatory Clinic, Oradea, România
| | - Andrei Golenkov
- Psychiatry and Medical Psychology, Chuvash State University, Cheboksary, Russia
| | | | | | - Lubomira Izakova
- Department of Psychiatry, Comenius University in Bratislava, Faculty of Medicine, Bratislava, Slovak Republic
| | - Vesna Švab
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | | | - Nina Kerimi
- Consultant, United Nations Office on Drugs and Crime (UNODC), Programme Office in Turkmenistan, Ashgabat, Turkmenistan
| | - Oleksii Sukhovii
- Center for Mental Health and Monitoring of Drugs and Alcohol MoH of Ukraine
| | - Stefan Priebe
- Unit of Social and Community Psychiatry, Queen Mary University of London, UK
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Welu SG, Aregawi DH, Gebreslassie HT, Kidanu KG. Prevalence and Associated Factors of Depressive Disorder among Prisoners in Mekelle General Prison Center, Tigray, Ethiopia: A Cross-Sectional Study Design. DEPRESSION RESEARCH AND TREATMENT 2021; 2021:1942674. [PMID: 34158975 PMCID: PMC8187058 DOI: 10.1155/2021/1942674] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 10/24/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Depression is the most prevalent mental disorder among prisoners and is the second leading cause of disability worldwide. Depression affects more for those who are less educated, female, single, and young prisoners, and worldwide prevalence of depression among prisoners is 10.2% and 14% for male and female prisoners, respectively. However, a study conducted on prevalence of depression and associated factors is scarce in Ethiopia (Tigray) despite there is high magnitude. Methodology. An institution-based cross-sectional study was conducted among randomly selected 414 prisoners in Mekelle General Prison Center. Data were collected from April to May 2019. A structured and standardized data collection tool (PHQ-9) was used. Bivariate and multivariable logistic regression analysis was carried out by SPSS version 20. Statistical significance was determined at P value < 0.05. RESULT In this study, 408 prisoners had participated. The prevalence of depression among prisoners was found to be 228 (55.9%; 95% CI: 51.2%, 61%). Being unemployed and student, lifetime substance use, history of child abuse, weight loss in prison, quality of meal in prison, being not happy inside prison, being sentenced for more than six years, and poor and moderate social support were significantly associated with depression. CONCLUSION Prevalence of depression among prisoners was found to be high (55.9%). Prisoners who had lifetime substance use, being unemployed and student, history of childhood abuse, weight loss inside prison, being sentenced for more than six years, not happy inside prison, lack of social support, and poor quality of prison meal were more likely to have depression. Thus, giving training to strengthen social support, giving training on how to cope up with prison environment, giving training to scale up a happy life, and improving quality of prison meal as well as mental health service will help to reduce the problem. Conducting interventional study is relevant.
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Affiliation(s)
- Solomon Gidey Welu
- Department of Psychiatry, College of Health Science, Mekelle University, Mekelle, Ethiopia
| | - Desta Hailu Aregawi
- Department of Maternal and Reproductive Health Nursing, College of Health Science, Mekelle University, Mekelle, Ethiopia
| | | | - Kokob Gebru Kidanu
- Department of Psychiatry, College of Health Science, Mekelle University, Mekelle, Ethiopia
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Fritz FD, Fazel S, Benavides Salcedo A, Henry P, Rivera Arroyo G, Torales J, Trujillo Orrego N, Vásquez F, Mundt AP. 1324 prison suicides in 10 countries in South America: incidence, relative risks, and ecological factors. Soc Psychiatry Psychiatr Epidemiol 2021; 56:315-323. [PMID: 32405788 DOI: 10.1007/s00127-020-01871-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 05/02/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Although suicide rates of prison populations and incidence factors have been reported for high-income countries, data from low- and middle-income regions are lacking. The purpose of the study was to estimate suicide rates among prison populations in South America, to examine prison-related factors, and to compare suicide rates between prison and general populations. METHODS In this observational study, we collected the numbers of suicides in prison, rates of prison occupancy, and incarceration rates from primary sources in South America between 2000 and 2017. We compared suicide rates among prisoners with incidence rates in the general populations by calculating incidence rate ratios. We assessed the effect of gender, year, incarceration rates and occupancy on suicide rates in the prison populations using regression analyses. RESULTS There were 1324 suicides reported during 4,437,591 person years of imprisonment between 2000 and 2017 in 10 South American countries. The mean suicide rate was 40 (95% CI 16-65) per 100,000 person years for male and female genders combined. The pooled incidence rate ratio of suicide between prison and general populations was 3.9 (95% CI 3.1-5.1) for both genders combined, 2.4 (95% CI 1.9-3.1) for men and a higher ratio in women (13.5, 95% CI 6.9-26.9). High occupancies of prisons were associated with lower incidence of suicide (β = - 58, 95% CI - 108.5 to - 7.1). CONCLUSIONS Suicides during imprisonment in South America are an important public health problem. Suicide prevention strategies need to target prison populations.
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Affiliation(s)
- Francesco Domenico Fritz
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany.,Department of Psychiatry, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
| | | | - Paulette Henry
- Department of Sociology, University of Guyana, Georgetown, Guyana
| | - Guillermo Rivera Arroyo
- Department of Psychology, Private University of Santa Cruz de la Sierra, Santa Cruz de la Sierra, Bolivia
| | - Julio Torales
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Natalia Trujillo Orrego
- Mental Health Research Group, National Faculty of Public Health, University of Antioquia, Medellin, Colombia
| | - Freddy Vásquez
- Suicide Prevention Program, National Institute for Mental Health, Lima, Peru
| | - Adrian P Mundt
- Medical Faculty, Universidad Diego Portales, Santiago, Chile. .,Medical Faculty, Universidad San Sebastián, Puerto Montt, Chile.
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Vallejos M, Cesoni OM. Child abuse, gender differences and their clinical and criminological implications in incarcerated individuals. ACTA ACUST UNITED AC 2020; 49:271-278. [PMID: 33328020 DOI: 10.1016/j.rcp.2019.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 11/15/2018] [Accepted: 01/15/2019] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Several studies show high rates of childhood traumatic events in subjects incarcerated in prison institutions. OBJECTIVE To assess the prevalence and gender differences of different types of childhood adverse experiences and their correlation with psychopathological and criminological variables in incarcerated individuals. MATERIAL AND METHODS An epidemiological, descriptive-observational study was conducted in two psychiatric prisons located in Argentina and 84 subjects of both sexes participated. A socio-demographic questionnaire was used, the SCID I and II scales and the Adverse Childhood Experiences questionnaire. RESULTS 91.7% of the participants had suffered some adverse experience in childhood. A high rate of physical (63%) and emotional abuse (61%) was detected. We found gender differences in the type of child abuse and the crimes committed. Significant relationships were found between some childhood adverse events and psychiatric disorders, crimes committed and recidivism. CONCLUSIONS In accordance with other studies, there was a high prevalence of adverse childhood experiences in incarcerated individuals and significant gender differences in the type of child abuse, in psychiatric disorders, in the crimes committed and recidivism.
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Affiliation(s)
- Miguel Vallejos
- Hospital Interdisciplinario Psicoasistencial José T. Borda, Buenos Aires, Argentina.
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16
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Trouble de stress post-traumatique en milieu pénitentiaire. Encephale 2020; 46:493-499. [DOI: 10.1016/j.encep.2020.04.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 04/07/2020] [Accepted: 04/08/2020] [Indexed: 11/17/2022]
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COSTA CAROLINERIBEIRO, SASSI RAÚLANDRÉSMENDOZA, TÍMBOLA VINÍCIUSDESOUZA, LAZZARI TALITARUBIN, REIS ANAJULIA, GONÇALVES CARLAVITOLA. Prevalence and associated factors with depression and anxiety in prisoners in South of Brazil. ARCH CLIN PSYCHIAT 2020. [DOI: 10.1590/0101-60830000000239] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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18
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Huang Y, Wu R, Wu J, Yang Q, Zheng S, Wu K. Psychological resilience, self-acceptance, perceived social support and their associations with mental health of incarcerated offenders in China. Asian J Psychiatr 2020; 52:102166. [PMID: 32447270 DOI: 10.1016/j.ajp.2020.102166] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/07/2020] [Accepted: 05/11/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVES We aimed to analyze the mental health status of incarcerated offenders in the detention centers and related factors; and introduce psychological resilience, self-acceptance and perceived social support for further analyses, to explore the relationships between them and mental health in these special populations. METHODS Incarcerated offenders in two detention centers of Guangdong province were recruited. General demographic questionnaire, Self-acceptance Questionnaire (SAQ), Perceived Social Support Scale (PSSS), Connor and Davidson Resilience Scale (CD-RISC) and General Health Questionnaire (GHQ-20) were addressed to the participants for investigation. Pearson correlation analysis, multiple linear regression and Structural Equation Modeling (SEM) were used to identify the associations and related factors. RESULTS Scores for GHQ-20, CD-RISC, SAQ and PSSS were 7.72 ± 4.49, 57.85 ± 17.30, 40.94 ± 5.40 and 42.99 ± 9.90, respectively. Some socio-demographic factors influenced significantly to the mental health status. After adjusting for socio-demographic factors, the scores of self-acceptance (B = -0.23, P < 0.001), perceived social support (B = -0.10, P < 0.001) and psychological resilience (B = -0.06, P < 0.001) were negatively associated with scores of mental health. Further SEM analyses suggested self-acceptance and resilience had not only mediating effects respectively, but also multiple mediating effects between perceived social support and mental health (r = -0.11, P < 0.01; r = -0.12, P < 0.01; r = -0.04, P < 0.01). CONCLUSION The levels of mental health, psychological resilience, self-acceptance and perceived social support among incarcerated offenders are generally low, and influenced by socio-demographic factors. In addition, self-acceptance, perceived social support and resilience are protective factors for mental health status of offenders; and self-acceptance and resilience mediate the association between perceived social support and mental health.
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Affiliation(s)
- Yuanni Huang
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, Guangdong Province, China; Shenzhen Pingle Orthopedics Hospital (Shenzhen Pingshan Hospital of Traditional Chinese Medicine), Shenzhen, 518122, Guangdong Province, China
| | - Ruibin Wu
- Chaozhou People's Hospital, Chaozhou, 521000, Guangdong Province, China
| | - Junkai Wu
- Chaozhou Detention Center, Chaozhou, 521011, Guangdong Province, China
| | - Qingwen Yang
- Xingning Detention Center, Xingning, 514526, Guangdong Province, China
| | - Shukai Zheng
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, Guangdong Province, China
| | - Kusheng Wu
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, Guangdong Province, China.
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van Buitenen N, van den Berg CJW, Meijers J, Harte JM. The prevalence of mental disorders and patterns of comorbidity within a large sample of mentally ill prisoners: A network analysis. Eur Psychiatry 2020; 63:e63. [PMID: 32522312 PMCID: PMC7355171 DOI: 10.1192/j.eurpsy.2020.63] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Comorbidity has profound implications in both the clinical field and research, yet little is known about the prevalence and structure of comorbid mental disorders. This article aims not only to present data on the prevalence of mental disorders and comorbidity, but also to explore relationships between comorbid mental disorders by using a network approach. METHODS Data used in this cross-sectional study are part of a prospective cohort study within penitentiary psychiatric centers (PPCs) in the Netherlands. It includes DSM diagnoses of 5,257 unique male patients incarcerated in one of the PPC's. Prevalence rates of mental disorders and comorbidity were calculated, the network of comorbid DSM diagnoses was constructed using regression coefficients. RESULTS Schizophrenia spectrum and substance-related disorders were most prevalent within this sample (56.7 and 43.1%, respectively), and over half of all patients were diagnosed with a comorbid disorder (56.9%). Four distinctive groups of disorders emerged from the network analysis of DSM diagnoses: substance use, impulsivity, poor social skills, and disruptive behaviors. Psychotic disorders were considered as a separate group as it was unconnected to other disorders. CONCLUSIONS Comorbid mental disorders can be described, at least in part, as connected networks. Underlying attributes as well as direct influences of mental disorders on one another seem to be affecting the presence of comorbidity. Results could contribute to the understanding of a possible causal relation between psychopathology and criminal behavior and the development of treatment programs targeting groups of disorders.
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Affiliation(s)
| | - Chantal J W van den Berg
- Department of Criminal Law and Criminology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jesse Meijers
- Judicial Complex Zaanstad, Westzaan, The Netherlands
| | - Joke M Harte
- Department of Criminal Law and Criminology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Gabrysch C, Sepúlveda C, Bienzobas C, Mundt AP. 'Maybe It Is Only in Prison That I Could Change Like This' The Course of Severe Mental Illnesses During Imprisonment - A Qualitative 3-Year Follow-Up Study From Chile. Front Psychol 2020; 11:1208. [PMID: 32581971 PMCID: PMC7294909 DOI: 10.3389/fpsyg.2020.01208] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 05/11/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Severe mental illness (SMI) among imprisoned individuals is a global health concern. Quantitative research indicates on average mental health symptom improvements during imprisonment, however, it cannot reflect multifaceted factors influencing the course of SMI. This study aimed to explore the subjective course of SMI during imprisonment and to identify influencing factors. METHODS The study has a 3-year-follow-up design of imprisoned individuals in Chile. We conducted semi-structured interviews with 10 men and 9 women at follow-up who had either major depression or psychosis (severe mental illnesses) at baseline. We included individuals who deteriorated, remained stable or improved their mental health according to quantitative assessments. We explored the subjective course of their mental health condition during the follow-up period. Qualitative data was transcribed and coded using NVivo Software for quantitative content analysis. Qualitative data was also manually coded and was subsequently analyzed using the thematic analysis method with an inductive approach. We developed the final themes using the results of this analysis in combination with the inclusion criteria. RESULTS The mental health of 10 individuals subjectively improved, 6 experienced deteriorations, and 3 did not perceive any change. Good infrastructure, structure/occupation, intrapersonal resources (will to change, spirituality) and supportive relationships were identified as factors improving mental health. Factors deteriorating mental health were identified as bad infrastructure (e.g., no running water and bad housing conditions) and crowding, lack of psychological treatment, exposure to violence, interpersonal stress (conflictive relationships and separation from family), perceived injustice through sentencing, intrapersonal stressors and previous medical conditions. DISCUSSION SMI in prison can improve in a supportive environment under certain conditions. These conditions include the improvement of infrastructure (housing and healthcare), the opportunity to work or study, protection from violence during imprisonment, and to develop intrapersonal resources and family relationships. To reduce SMI in prisons the improvement of these conditions should become a priority.
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Affiliation(s)
- Caroline Gabrysch
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry and Mental Health, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Carolina Sepúlveda
- Department of Psychology, Universidad Academia de Humanismo Cristiano, Santiago, Chile
| | - Carolina Bienzobas
- Department of Psychology, Universidad Academia de Humanismo Cristiano, Santiago, Chile
| | - Adrian P. Mundt
- Medical Faculty, Universidad San Sebastián, Puerto Montt, Chile
- Medical Faculty, Universidad Diego Portales, Santiago, Chile
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Necho M, Belete A, Tsehay M, Zenebe Y. A meta-analysis of depressive symptoms among Ethiopian prisoners and a narrative description of its associated factors: a country based systematic review and meta-analysis study. BMC Psychiatry 2020; 20:281. [PMID: 32503475 PMCID: PMC7275530 DOI: 10.1186/s12888-020-02662-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 05/11/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The burden of depression in prisoners is increasing and factors such as co-existence of medical illness, lack of social support and longer duration of sentences are contributing to it. However, no pooled evidence on the magnitude and factors of depression in prisoners existed in Ethiopia. The current meta-analysis was therefore aimed to have aggregate evidence on the magnitude and factors of depression in prisoners of Ethiopia. METHODS A search of databases on PubMed, Scopus, and EMBASE was carried out systematically. Besides, grey literature sources were extensively investigated. Moreover, the reference lists of the articles selected were searched. Random effects and quality-effects models were used to describe the pooled prevalence of depressive symptoms with 95% CI. We also detect heterogeneity between studies using Cochran's Q- statistic and the Higgs I2 test. A sensitivity analysis was also implemented. Publication bias was checked with Egger's test and funnel plots visually. RESULTS Among 232 papers identified through the specified database searches only 17 full-text articles were assessed for eligibility and only nine (9) studies fulfilled the prespecified criteria and incorporated in the final meta-analysis. The pooled prevalence of Depressive symptoms among prisoners was 53.40%(95% CI: 41.33, 65.46). The pooled prevalence of Depressive symptoms in prisoners was 41.9% in Southwest Ethiopia, 44.43% in North West of Ethiopia, 59.05% in Addis Ababa, and 72.7% Southern Ethiopia. Besides, the pooled Depression symptoms prevalence among prisoners was 51.24% as measured with PHQ-9 and 56.15% with BDI-II. Besides, studies that utilized a relatively large sample size (≥350) yields a smaller pooled prevalence of Depression symptoms, 51.93% than those which utilized smaller sample sizes (< 350); 54.13%. CONCLUSION The pooled magnitude of depression in prisoner's population is very high, 53.40%. This pooled effect size for the Depression symptoms was significantly higher in the southern region of the country than in the southwest region. Besides, the pooled prevalence was significantly higher as measured by the BDI-II tool than by PHQ-9. Also, studies that utilized a larger sample size provided a significantly lower pooled magnitude of symptoms of depression than studies that utilized a smaller sample size.
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Affiliation(s)
- Mogesie Necho
- Department of Psychiatry, Wollo University, College of Medicine and Health Sciences, Dessie, Ethiopia.
| | - Asmare Belete
- grid.467130.70000 0004 0515 5212Department of Psychiatry, Wollo University, College of Medicine and Health Sciences, Dessie, Ethiopia
| | - Mekonnen Tsehay
- grid.467130.70000 0004 0515 5212Department of Psychiatry, Wollo University, College of Medicine and Health Sciences, Dessie, Ethiopia
| | - Yosef Zenebe
- grid.467130.70000 0004 0515 5212Department of Psychiatry, Wollo University, College of Medicine and Health Sciences, Dessie, Ethiopia
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Mundt AP, Baranyi G, Fazel S. Incomplete discussion of bipolar disorder and comorbid substance use disorder - Authors' reply. LANCET GLOBAL HEALTH 2020; 7:e847. [PMID: 31200887 DOI: 10.1016/s2214-109x(19)30226-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 05/03/2019] [Indexed: 11/19/2022]
Affiliation(s)
- Adrian P Mundt
- Medical Faculty, Universidad Diego Portales, Santiago, Chile; Medical School, Universidad San Sebastián, Puerto Montt, Chile.
| | - Gergő Baranyi
- Centre for Research on Environment, Society, and Health, School of GeoSciences, The University of Edinburgh, Edinburgh, UK
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
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Caravaca Sánchez F, Ignatyev Y, Mundt AP. The revolving prison door: Factors associated with repeat incarcerations in Spain. J Forensic Leg Med 2020; 72:101947. [DOI: 10.1016/j.jflm.2020.101947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 03/25/2020] [Accepted: 03/27/2020] [Indexed: 10/24/2022]
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Global Estimates of the Prevalence of Depression among Prisoners: A Systematic Review and Meta-analysis. DEPRESSION RESEARCH AND TREATMENT 2020; 2020:3695209. [PMID: 33294222 PMCID: PMC7718061 DOI: 10.1155/2020/3695209] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 11/09/2020] [Accepted: 11/11/2020] [Indexed: 01/11/2023]
Abstract
BACKGROUND Prison populations tend to be marginalized and disadvantaged of the rights and freedoms that other people in the community benefit from. Their separation from families, a narrow room and lack of privacy in the prison, violence between prisoners, and the uncertainty about the future result in psychological distress, for example, depression. The review has synthesized previous studies conducted on the topic and summarized to formulate recommendations for future prison health care services. METHODS We systematically searched the databases: PubMed, Psych Info, and SCOPUS, as well as manual Google Scholar searches, were conducted to retrieve published literature globally. We have included observational studies, written in English language. Estimates were pooled using a random-effects model. The study protocol was registered in PROSPERO with protocol number CRD42020156108. Subgroup and sensitivity analysis was conducted, and heterogeneity across the studies was evaluated using Q and the I 2-test. Publication bias was assessed by inspection of the funnel plot and Egger's regression test. RESULT A total of 1313 studies were initially identified through the electronic database; among these, a total of 73 full-text articles were retrieved for further appraisal. Further, 32 full-text articles were included in the final systematic review and meta-analysis. In this meta-analysis, the pooled prevalence of depression among prisoners was 36.9% (95% CI; 27.3-47.6). The pooled prevalence of depression among prisoners in the developing and developed countries was 39.2% and 33.1%, respectively. Moreover, the prevalence of depression was 19.1% and 54% for the studies that used diagnostic and screen tools to diagnose or screen depression, respectively. A leave-one-out analysis revealed that the pooled prevalence of depression among prisoners was not dependent on a single study removal or addition. Thus, the pooled prevalence of depression ranges between 35.3 and 38.0%. CONCLUSION The prevalence of depression among prisoners was high. Therefore, regular and continuous screening of depressive symptoms for prisoners along with its appropriate management is highly recommended.
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Adraro W, Kerebih H, Tesema W, Abamecha F, Hailesilassie H. Nearly three in every five prisoners experience common mental disorders (CMDs) in Jimma correctional institution; south-West Ethiopia. BMC Public Health 2019; 19:1559. [PMID: 31771547 PMCID: PMC6880342 DOI: 10.1186/s12889-019-7879-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 11/01/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Millions of people are currently suffering from some form of mental disorders. The prevalence of common disorders is twofold higher in prison than general population and the condition is found to be worst in African in general and Ethiopia in particular. The aim of this study was to assess the prevalence of common mental disorders and its correlates among prisoners in Jimma town correctional institution; Ethiopia. METHODS A cross sectional quantitative study was conducted enrolling 300 prisoners. The participants were recruited using systematic random sampling technique. The World health organization Self Reporting Questionnaire (SRQ-20) scale; was adapted to assess prevalence of mental disorders. Data were collected on interviewer administered basis by trained personnel. Statistical package for social sciences (SPSS) version 20 for widows was used for data analysis. Multivariate logistic regression modelling was conducted to identify the independent predictors of common mental disorders. P-value less than 5% was considered to indicate significant associations. RESULTS The prevalence of common mental disorder was found to be 62.70, 95% CI; [57.30, 68.50]. Prisoners who had monthly income of 1500-3000birr, AOR = 3.30, 95% CI; [1.25, 8.69] and above 3000birr; AOR = 4.75, 95% CI; [1.57, 14.33], family history of mental illness; AOR = 6.14, 95% CI; [1.65, 22.79] and who ever used Khat; AOR = 4.33, 95% CI; [2.02, 9.27] were more likely to experience common mental disorders. Conversely; having some sort of work in prison; AOR = 0.25, 95% CI; [0.12, 0.54], perceived moderate social support; AOR = 0.094, 95% CI; [0.04-0.215] and perceived moderate strong; AOR = 0.025, 95% CI; [0.009, 0.07] were found to be protective factors. CONCLUSION Prevalence of common mental disorder was considerably high as nearly more than three in every five prisoner experience some form of the disorder. Early screening of prisoners up on their arrival, appropriate treatment and follow up should be done. Furthermore; creating prison based jobs that could bring prisoners together and encouraging positive relationships to build social supports as coping strategy is required.
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Affiliation(s)
- Wasihun Adraro
- Department of clinical nursing, Mizan Aman College of Health Science, Mizan Teferi, Ethiopia
| | - Habtamu Kerebih
- Department of psychiatry, School of Medicine, Collage of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Workinesh Tesema
- Department of psychiatry, College of Medical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Fira Abamecha
- Department of Health, Behaviour and Society, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia.
| | - Hailemariam Hailesilassie
- Department of psychiatry, College of Medical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
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Abstract
PURPOSE OF REVIEW To examine recent advances in the understanding of attention deficit hyperactivity disorder (ADHD) among the prison population. RECENT FINDINGS Efforts have been made to develop useful tools for assessing ADHD among prisoners. Prisoners with ADHD demonstrate incremental vulnerability due to comorbid psychiatric disorders, neurodevelopmental disorders and traumatic brain injury. Compared with prisoners without ADHD, prisoners with ADHD become involved in the criminal justice system at a younger age and have higher rates of recidivism in adulthood. Recent studies demonstrate the effectiveness of extended release stimulant medication and psychological interventions. Early identification and treatment of prisoners with ADHD have the potential to demonstrate health economic benefits. Our understanding of ADHD among prisoners continues to develop. However, further research is needed, particularly among neglected groups such as females. Much more attention is needed by the prison service to engender better outcomes for this at-risk population.
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Shrestha G, Mulmi R, Yadav DK, Baral D, Yadav BK, Chakravartty A, Pokharel PK, Sapkota N. Health needs and risky behaviours among inmates in the largest prison of eastern Nepal. Int J Prison Health 2019; 14:254-267. [PMID: 30468108 DOI: 10.1108/ijph-10-2017-0049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this paper is to assess the health status and risky behaviours of inmates in Nepal. DESIGN/METHODOLOGY/APPROACH This cross-sectional study was conducted in Jhumka Regional Prison, the largest male prison in eastern Nepal from September 2014 to August 2015. Data were collected through face-to-face interviews from 434 randomly selected incarcerated participants using semi-structured questionnaires. FINDINGS The mean age of 434 participants was 35.7 years (SD 13.3). The majority (84 per cent) had at least one current health problem, of which the commonest were respiratory (50 per cent), skin (38 per cent) and digestive (26 per cent). Alcohol (73 per cent) and cigarettes (71 per cent) were the most commonly used substances prior to imprisonment. Approximately, 27 and 11 per cent reported illicit drug use and injectable drug use prior to incarceration, respectively. A total of 204 inmates reported having intercourse with sex workers. Of these, 49 per cent did not use a condom in their last intercourse with a sex worker. RESEARCH LIMITATIONS/IMPLICATIONS This paper illustrates that a wide range of physical and mental health problems exist among incarcerated people in Nepal. The study may lack generalisability, however, as it was conducted in a single male prison. PRACTICAL IMPLICATIONS The paper suggests a need for medical, psychiatric and substance abuse care in correctional settings to improve the health status of the prison population. It is also important to develop screening policies for blood-borne viral and other infectious diseases in the prison. ORIGINALITY/VALUE This is the first study of its kind drawn from prisons in Nepal.
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Affiliation(s)
- Gambhir Shrestha
- Department of Cancer Prevention, Control and Research, B.P. Koirala Memorial Cancer Hospital, Bharatpur, Nepal
| | - Rashmi Mulmi
- Department of Cancer Prevention, Control and Research, B.P. Koirala Memorial Cancer Hospital, Bharatpur, Nepal
| | - Deepak Kumar Yadav
- School of Public Health and Community Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Dharanidhar Baral
- School of Public Health and Community Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Birendra Kumar Yadav
- School of Public Health and Community Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Avaniendra Chakravartty
- School of Public Health and Community Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Paras Kumar Pokharel
- School of Public Health and Community Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Nidesh Sapkota
- B.P. Koirala Institute of Health Sciences, Dharan, Nepal
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Baranyi G, Scholl C, Fazel S, Patel V, Priebe S, Mundt AP. Severe mental illness and substance use disorders in prisoners in low-income and middle-income countries: a systematic review and meta-analysis of prevalence studies. Lancet Glob Health 2019; 7:e461-e471. [PMID: 30879509 PMCID: PMC6419715 DOI: 10.1016/s2214-109x(18)30539-4] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 11/08/2018] [Accepted: 11/26/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Although more than two thirds of the world's incarcerated individuals are based in low-income and middle-income countries (LMICs), the burden of psychiatric disorders in this population is not known. This review provides estimates for the prevalence of severe mental illness and substance use disorders in incarcerated individuals in LMICs. METHODS For this systematic review and meta-analysis, we searched 17 electronic databases to identify prevalence studies of psychiatric disorders in prison populations in LMICs, published between January, 1987, and May, 2018. We included representative studies from general prison samples, providing information about four major psychiatric diagnoses: psychosis, major depression, alcohol use disorders, and drug use disorders. We pooled data from studies using random-effects meta-analyses and assessed the sources of heterogeneity by meta-regression. We extracted general population estimates from the Global Burden of Diseases 2016 database to calculate comparative prevalence ratios. This study is registered with PROSPERO, number CRD42015020905. FINDINGS We identified 23 publications reporting prevalence estimates of severe mental illness and substance use disorders for 14 527 prisoners from 13 LMICs. In this population, the estimated pooled 1 year prevalence rates for psychosis were 6·2% (95% CI 4·0-8·6), 16·0% (11·7-20·8) for major depression, 3·8% (1·2-7·6) for alcohol use disorders, and 5·1% (2·9-7·8) for drug use disorders. We noted increased prevalence at prison intake and geographic variations for substance use disorders. For alcohol use disorders, prevalence was higher in the southeast Asian region than in the eastern Mediterranean region; and drug use disorders were more prevalent in the eastern Mediterranean region than in Europe. Prevalence ratios indicated substantially higher rates of severe mental illness and substance use disorders among prisoners than in the general population (the prevalence of non-affective psychosis was on average 16 times higher, major depression and illicit drug use disorder prevalence were both six times higher, and prevalence of alcohol use disorders was double that of the general population). INTERPRETATION The prevalence of major psychiatric disorders is high in prisoners in LMIC compared with general populations. As these findings are likely to reflect unmet needs, the development of scalable interventions should be a public health priority in resource-poor settings. FUNDING CONICYT of the Chilean government and the Wellcome Trust.
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Affiliation(s)
- Gergő Baranyi
- Centre for Research on Environment, Society and Health, Department of Geography, School of GeoSciences, The University of Edinburgh, Edinburgh, UK
| | - Carolin Scholl
- School of Informatics, The University of Edinburgh, Edinburgh, UK
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Vikram Patel
- Department of Global Health & Social Medicine, Harvard Medical School, Harvard University, Boston, MA, USA
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, UK
| | - Adrian P Mundt
- Medical Faculty, Universidad Diego Portales, Santiago, Chile; Medical School, Universidad San Sebastián, Puerto Montt, Chile.
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The prevalence of mental disorders in Taiwanese prisons: a nationwide population-based study. Soc Psychiatry Psychiatr Epidemiol 2019; 54:379-386. [PMID: 30310945 DOI: 10.1007/s00127-018-1614-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 10/08/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE In Taiwan, few studies explored the morbidity of mental disorders among prisoners. The purpose of this study is conducted to estimate the prevalence of mental disorders in Taiwanese prisoners. METHODS Based on Nationwide population-based databank, 82,650 prisons were studied for mental disorders. Mental disorders were assessed with the International Classification of Diseases 9th revision Clinical Modification (ICD-9-CM). RESULT The prevalence of mental disorders among prisoners was estimated 11.31%. Female prisons exhibited a higher prevalence than males (17.82% vs. 10.56%, p < 0.01). Among all cases that were diagnosed with the contents of mental disorder, anxiety, dissociative and somatoform disorders was the most frequent disease (total: 49.48%, female: 59.42%, male: 47.55%) followed by special symptoms or syndromes (total: 38.24%, female: 33.20%, male: 39.22%), drug dependence (total: 15.41%, female: 9.22%, male: 16.61%), episodic mood disorders (total: 13.56%, female: 26.15%, male: 11.12%), nondependent abuse of drugs (total: 11.23%, female: 2.77%, male: 12.87%) and depressive disorder (total: 11.23%, female: 11.66%, male: 11.14%). CONCLUSION A substantial proportion of prisoners reported having mental disorders. The results suggests the necessity of comprehensive assessment and more treatment programs that offer alternatives to incarceration of mental health for the criminal justice system in Taiwan.
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Shao Y, Qiao Y, Xie B, Zhou M. Intermittent Explosive Disorder in Male Juvenile Delinquents in China. Front Psychiatry 2019; 10:485. [PMID: 31404282 PMCID: PMC6675866 DOI: 10.3389/fpsyt.2019.00485] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 06/20/2019] [Indexed: 12/11/2022] Open
Abstract
Objective: Although several previous studies have focused on the mental health problems in detained juvenile offenders in China and found high levels of major psychiatric morbidity, the prevalence of intermittent explosive disorder (IED) in this group remains unknown. The purpose of this study is to discover the prevalence of IED among juvenile offenders in China as well as the difference in demographic characteristics and personality traits between IED offenders and the general population. Method: A total of 280 delinquent boys (Mean age 16.10 years) were interviewed by trained psychiatrists. The interview procedure included the recording of sociodemographic characteristics, criminal records, Composite International Diagnostic Interviews (CIDI), State-Trait Anger and Expression of Anger Inventory-2 (STAXI-2) and Modified Overt Aggression Scales (MOAS). Results: Of the 280 delinquent boys, 32 (11.4%) were diagnosed with IED, 129 (46.1%) were non-IED psychopathology controls (PC), and 119 (42.5%) were healthy controls (HC). Except for substance use disorder (SUD), no differences in psychiatric comorbidity were found between youths with IED and those with another psychiatric disorder. Compared with the PC and HC groups, those in the IED group were more likely to commit a violent crime such as rape, assault, or an affray but it is less likely that their motive can be explained by money or property. The IED group also had a higher rate of recidivism history than the HC group. The IED group displayed higher levels of state and trait anger and anger expression than the HC group and lower levels of anger control than both the PC and HC groups. MOAS also showed that those in the IED group were more aggressive than those in the PC and HC groups. Conclusion: The relationships between IED, anger and aggression reflect the need to develop and implement specific and individually tailored intervention approaches to correct IED juvenile offenders' behavior in order to prevent new crime.
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Affiliation(s)
- Yang Shao
- Department of Forensic Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Qiao
- Department of Forensic Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Xie
- Department of Forensic Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min Zhou
- Department of Forensic Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Comai S, Bertazzo A, Vachon J, Daigle M, Toupin J, Côté G, Gobbi G. Trace elements among a sample of prisoners with mental and personality disorders and aggression: correlation with impulsivity and ADHD indices. J Trace Elem Med Biol 2019; 51:123-129. [PMID: 30466921 DOI: 10.1016/j.jtemb.2018.10.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 09/10/2018] [Accepted: 10/04/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES Mental, personality and substance use disorders are over represented among prisoners and aggressive individuals. The psychopathological and biological markers linked to mental functioning remain still unclear. In particular, the role of trace elements in mental illness is still matter of debate. Here, we investigated whether trace elements are correlated to specific psychopathological phenotype groups. METHODS Axis I and II disorders, aggression, impulsivity, adult attention deficit/hyperactivity disorders (ADHD) indices and serum levels of zinc, copper and cadmium were evaluated in 160 male prisoners. RESULTS Using latent class analysis we could subdivide prisoners into three distinct psychopathological classes: Class 1 characterized by low prevalence of aggression, personality disorders and substance abuse/dependence (alcohol, cannabis, cocaine); Class 2 represented by low prevalence of aggression and high prevalence of personality disorders and substance abuse/dependence; Class 3 defined by high prevalence of aggression, personality disorders and substance abuse/dependence. Serum levels of zinc were higher in Class 2 and 3 compared to Class 1. Moreover, Class 3 was associated with higher scores of impulsivity and ADHD indices. CONCLUSION Our results suggest that impulsivity but also adult ADHD indices are related to aggressive behaviour, and higher zinc levels are linked to personality disorders and addictions, but not to aggression.
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Affiliation(s)
- Stefano Comai
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University Health Center, McGill University, Montreal, QC, Canada; San Raffaele Scientific Institute and Vita Salute University, Milan, Italy.
| | - Antonella Bertazzo
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova, Italy
| | | | - Marc Daigle
- Institut Philippe-Pinel, Montreal, QC, Canada; Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Jean Toupin
- Institut Philippe-Pinel, Montreal, QC, Canada; Department of Psychoeducation, Sherbrooke University, QC, Canada
| | - Gilles Côté
- Institut Philippe-Pinel, Montreal, QC, Canada; Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Gabriella Gobbi
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University Health Center, McGill University, Montreal, QC, Canada.
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Baranyi G, Cassidy M, Fazel S, Priebe S, Mundt AP. Prevalence of Posttraumatic Stress Disorder in Prisoners. Epidemiol Rev 2018; 40:134-145. [PMID: 29596582 PMCID: PMC5982805 DOI: 10.1093/epirev/mxx015] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Accepted: 10/25/2017] [Indexed: 12/13/2022] Open
Abstract
People involved with criminal justice frequently are exposed to violence and traumatic experiences. This may lead to posttraumatic stress disorder (PTSD); however, no review, to our knowledge, has synthetized findings in this setting. We conducted a systematic review and meta-analysis to estimate prevalence rates of PTSD in prison populations. Original studies in which prevalence rates of PTSD in unselected samples of incarcerated people were reported were systematically searched between 1980 and June 2017. Data were pooled using random-effects meta-analysis, and sources of heterogeneity for prespecified characteristics were assessed by meta-regression. We identified 56 samples comprising 21,099 imprisoned men and women from 20 countries. Point prevalence of PTSD ranged from 0.1% to 27% for male, and from 12% to 38% for female prisoner populations. The random-effects pooled point prevalence was 6.2% (95% confidence interval: 3.9, 9.0) in male prisoners and 21.1% (95% confidence interval: 16.9, 25.6) in female prisoners. The heterogeneity between the included studies was very high. Higher prevalence was reported in samples of female prisoners, smaller studies (n < 100), and for investigations based in high-income countries. Existing evidence shows high levels of PTSD among imprisoned people, especially women. Psychosocial interventions to prevent violence, especially against children and women, and to mitigate its consequences in marginalized communities must be improved. Trauma-informed approaches for correctional programs and scalable PTSD treatments in prisons require further consideration.
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Affiliation(s)
- Gergõ Baranyi
- Center for Research on Environment Society and Health, School of GeoSciences, The University of Edinburgh, Edinburgh, United Kingdom
| | - Megan Cassidy
- Unit for Social and Community Psychiatry, WHO Collaborating Center for Mental Health Services Development, Queen Mary University of London, London, United Kingdom
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, WHO Collaborating Center for Mental Health Services Development, Queen Mary University of London, London, United Kingdom
| | - Adrian P Mundt
- Medical Faculty, Universidad Diego Portales, Santiago, Chile.,Medical School, Universidad San Sebastián, Puerto Montt, Chile
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Caravaca Sánchez F, Navarro Zaragoza J, Fearn NE, Vaughn MG. The Nexus of Trauma, Victimization, and Mental Health Disorders Among Incarcerated Adults in Spain. Psychiatr Q 2017; 88:733-746. [PMID: 28120281 DOI: 10.1007/s11126-017-9493-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Victimization and exposure to trauma, commonly linked to co-occurring mental health disorders, are prevalent among prison populations. The purpose of this study is to shed light on the prevalence of various kinds of victimization and trauma exposure at distinct life stages (childhood, adulthood and during prison) among incarcerated persons in Spain. The research team surveyed a random sample of 453 male and female inmates, serving time in two Spanish prisons, to gather information on experiences of physical and sexual victimization in both childhood and adulthood along with the presence or absence of in-prison treatment for a mental health disorder(s). More than 80% of participants reported experiencing some kind of traumatic/shocking life event - and this was significantly higher for those receiving in-prison mental health treatment than their non-treated counterparts (96.3 versus 83.3%, respectively). Logistic regression analyses revealed that inmates who were receiving in-prison treatment for a mental health disorder reported significantly higher rates of both physical and sexual victimization in prison, prior to prison, and during childhood. The results of this study strongly suggest the importance of comprehensive and accurate identification of inmates' traumatic, victimization, and mental health histories that necessitate treatment during incarceration. We discuss the implications of our study for correctional practice, policy and future research in order to reduce victimization in the Spanish Prison System.
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Affiliation(s)
| | - Javier Navarro Zaragoza
- Department of Forensic Medicine, School of Medicine, University of Murcia, Espinado, E-30100, Murcia, Spain
| | - Noelle E Fearn
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, 63103, USA
| | - Michael G Vaughn
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, 63103, USA
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Krüger S, Priebe S, Fritsch R, Mundt AP. Burden of separation and suicide risk of prisoners with minor children. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2017; 52:55-61. [PMID: 28395894 DOI: 10.1016/j.ijlp.2017.03.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 02/06/2017] [Accepted: 03/23/2017] [Indexed: 06/07/2023]
Abstract
The present study aimed to explore the burden of separation from children and its relationship with suicide risk in prisoners with minor children at the moment of admission into the penal justice system. Suicide risk was assessed using the Mini International Neuropsychiatric Interview in newly admitted female (n=198) and male (n=229) prisoners in Santiago de Chile. The burden of separation from minor children was rated on a numeric rating scale. Both genders showed high burden of separation from children at imprisonment. Mothers had significantly lower suicide risk than women without children. The relative risk was 0.31 (95% CI [0.16-0.6], p<0.001) to show 'high suicide risk'. There was no difference of suicide risk between imprisoned fathers and male prisoners without children. Within the group of fathers, the suicide risk associated with the burden of separation. Our study indicates that strengthening the parent role and facilitating parent-child contacts during imprisonment could be an important element of suicide prevention interventions.
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Affiliation(s)
- Sinja Krüger
- Klinik für Psychiatrie und Psychotherapie, Charité Campus Mitte Universitätsmedizin Berlin, Germany; Departamento de Psiquiatría y Salud Mental, Hospital Clínico, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, UK
| | - Rosemarie Fritsch
- Departamento de Psiquiatría y Salud Mental, Hospital Clínico, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Adrian P Mundt
- Facultad de Medicina, Universidad Diego Portales, Chile; Facultad de Medicina, Universidad San Sebastián, Chile.
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Yap L, Shu S, Zhang L, Liu W, Chen Y, Wu Z, Li J, Wand H, Donovan B, Butler T. Psychological distress among re-education through labour camp detainees in Guangxi Autonomous Region, China. J Ment Health 2017; 26:57-65. [PMID: 28125302 DOI: 10.1080/09638237.2016.1276529] [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: 10/20/2022]
Abstract
BACKGROUND There is currently no information about the prevalence of, and factors contributing to psychological distress experienced by re-education through labour camp detainees in China. METHODS A cross-sectional face-to-face survey was conducted in three labour camps in Guangxi, China. The questionnaire covered socio-demographic characteristics; sexually transmissible infections (STIs); drug use; psychological distress (K-10); and health service usage and access inside the labour camps. K-10 scores were categorised as ≤30 (low to moderate distress) and >30 or more (highly distressed). Univariate and multivariate logistic regression models identified factors independently associated with high K-10 scores for men and women separately. RESULTS In total, 755 detainees, 576 (76%) men and 179 (24%) women, participated in the health survey. The study found 11.6% men versus 11.2% women detainees experienced high psychological distress, but no significant gender differences were observed (p> 0.05). Multivariate logistic regression showed that multiple physical health problems were significantly associated with high psychological distress among men. CONCLUSION Drug treatment and forensic mental health services need to be established in detention centres in China to treat more than 10% of detainees with drug use and mental health disorders.
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Affiliation(s)
- Lorraine Yap
- a The Kirby Institute, The University of New South Wales , Sydney , Australia
| | - Su Shu
- b School of Public Health and Preventive Medicine, Monash University , Melbourne , Australia
| | - Lei Zhang
- a The Kirby Institute, The University of New South Wales , Sydney , Australia.,b School of Public Health and Preventive Medicine, Monash University , Melbourne , Australia
| | - Wei Liu
- c Division of HIV/AIDS Prevention and Control , Guangxi Center for Disease Control and Prevention , Nanning , China
| | - Yi Chen
- c Division of HIV/AIDS Prevention and Control , Guangxi Center for Disease Control and Prevention , Nanning , China
| | - Zunyou Wu
- d National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention (China CDC) , Beijing , China
| | - Jianghong Li
- e President"s Research Project Group, WZB Berlin Social Research Center , Berlin , Germany.,f The Centre for Population Health Research, Curtin University , Perth , Australia , and
| | - Handan Wand
- a The Kirby Institute, The University of New South Wales , Sydney , Australia
| | - Basil Donovan
- a The Kirby Institute, The University of New South Wales , Sydney , Australia.,g Sydney Sexual Health Centre, Sydney Hospital , Sydney , Australia
| | - Tony Butler
- a The Kirby Institute, The University of New South Wales , Sydney , Australia
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Prevalence of mental disorders at admission to the penal justice system in emerging countries: a study from Chile. Epidemiol Psychiatr Sci 2016; 25:441-449. [PMID: 26088528 PMCID: PMC7137584 DOI: 10.1017/s2045796015000554] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Previous mental health surveys conducted in prisons within emerging countries recruited samples of all prisoners at any single point in time. However, this sampling strategy results in an overrepresentation of long-term prisoners as compared with those studies recruiting from all admissions over time. This study aimed to assess mental disorders in consecutively admitted prisoners soon after admission, in order to address service needs of people with short-term imprisonments and people at early stages of imprisonment. METHOD Disorders were assessed in a sample of 229 male and 198 female prisoners, consecutively committed to the penal justice system in Santiago de Chile, using the structured Mini-Neuropsychiatric interview. Prevalence rates were calculated as per cent values. Ninety-five per cent confidence intervals were calculated for the proportions. RESULTS Illicit drug and/or alcohol use disorders in the year prior to admission were present in 173 (76%) male and 64 (32%) female prisoners. The substances most frequently causing addiction were cocaine-based products in 108 (47%) male and 42 (21%) female prisoners. Current major depression was present in 124 (54%) male and 86 (43%) female prisoners, and current non-affective psychotic disorders in 18 (8%) male and in 10 (5%) female prisoners. High suicidal risk was present in 64 (28%) male prisoners and in 29 (15%) female prisoners. CONCLUSION When consecutive prisoners are assessed at admission, rates of mental health and substance use disorders were higher than in previous studies in emerging countries that had sampled from all existing prisoners at a time. Affective disorders and suicide risk appear more prevalent than in admission studies conducted in Western high-income countries. Previous research may have systematically underestimated the extent of mental health problems in prisoners, which poses a major public health challenge in emerging countries.
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Ignatyev Y, Fritsch R, Priebe S, Mundt AP. Psychometric properties of the symptom check-list-90-R in prison inmates. Psychiatry Res 2016; 239:226-31. [PMID: 27031592 DOI: 10.1016/j.psychres.2016.03.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Revised: 03/01/2016] [Accepted: 03/02/2016] [Indexed: 01/20/2023]
Abstract
The aim of this study was to investigate the reliability, construct and criterion validity of the Symptom Check-List-90-R (SCL-90-R) for prison inmates. A sample of 427 adult prisoners was assessed at admission to the penal justice system in the metropolitan region of Santiago de Chile using the SCL-90-R and the mini international neuropsychiatric interview. We tested internal consistency using Cronbach's alpha. We examined construct validity using Principial Components Analysis and Confirmatory Factor Analysis (PCA and CFA) as well as Mokken Scale Analysis. Receiver Operating Characteristic (ROC) analysis was conducted to examine external criterion validity against diagnoses established using structured clinical interviews. The SCL-90-R showed good internal consistency for all subscales (α=0.76-0.89) and excellent consistency for the global scale (α=0.97). PCA yielded a 1-factor structure, which accounted for 70.7% of the total variance. CFA and MSA confirmed the unidimensional structure. ROC analysis indicated useful accuracy of the SCL-90-R to screen for severe mental disorders. Optimal cut-off on the Global Severity Index between severe mental disorders and not having any severe mental disorder was 1.42. In conclusion, the SCL-90-R is a reliable and valid instrument, which may be useful to screen for severe mental disorders at admission to the prison system.
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Affiliation(s)
- Yuriy Ignatyev
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte Universitätsmedizin Berlin, Germany; Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Germany
| | - Rosemarie Fritsch
- Department of Psychiatry and Mental Health, Hospital Clínico Universidad de Chile, Santiago, Chile; Department of Psychiatry, Universidad de los Andes, Chile
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, UK
| | - Adrian P Mundt
- Department of Psychiatry and Mental Health, Hospital Clínico Universidad de Chile, Santiago, Chile; Facultad de Medicina, Universidad Diego Portales, Chile; Escuela de Medicina sede Puerto Montt, Universidad San Sebastián, Chile.
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Dadi AF, Dachew BA, Kisi T, Yigzaw N, Azale T. Anxiety and associated factors among prisoners in North West of Amhara Regional State, Ethiopia. BMC Psychiatry 2016; 16:83. [PMID: 27036945 PMCID: PMC4815165 DOI: 10.1186/s12888-016-0792-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 03/22/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mental illnesses are more common among the prison population than the general public. However, little attention is given to mental health service in low and middle income countries in general. The problem is more so for prisoners where the overall health care is poor. Therefore, the aim of this study was to assess the prevalence of anxiety and the associated factors among prisoners of North West Amhara, Ethiopia. METHODS Institutional based cross-sectional study was employed from February to March 2015 by taking a sample of 700 prisoners. Simple random sampling method was employed to select three prisons out of 10 prisons found in the North West Amhara region. Generalized Anxiety Disorder 7-item (GAD-7) scale was used to assess prisoners' anxiety status. The receiver- operator characteristic (ROC) curve was used to determine the cutoff point with high sensitivity and specificity. Structured and pretested interviewer administered questionnaire was used for data collection. Data were checked, coded and entered into Epi Info version 7 and analyzed using R version 3.2.0. Bivariable and multivariable logistic regression analyses were carried out to identify factors associated with anxiety. Odds ratio with its 95 % confidence interval was used as a measure of association. Akaike's Information's Criterion (AIC) was used to check model fitness. RESULTS A total of 649 prisoners were included in the analysis making the response rate 92.5 %. The prevalence of Anxiety was found to be 36.1 % (95 % CI: 32.7, 39.9). The odds of Anxiety was 2.49(95 % CI: 1.38, 4.55) times higher among prisoners who used to be unhappy in their life before imprisonment. Moreover, smokers were 2.6 (AOR = 2.6, 95 % CI: 1.08, 6.6) times more likely to have anxiety compared with non smokers. However, the odds of the odds of anxiety was 89% lower among Debre-Tabor prisoners (AOR = 0.11, 95 % CI: 0.06, 0.20) and 57 % lower among Gondar prisoners (AOR = 0.43, 95 % CI: 0.28, 0.67). CONCLUSION The prevalence of anxiety is found to be very high among prisoners in North West Ethiopia. Anxiety was associated with current smoking and having had a dissatisfying life. Screening prisoners for common mental disorders and integrated health care is necessary.
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Affiliation(s)
- Abel Fekadu Dadi
- Department of Epidemiology and Biostatistics, Institute of public Health, University of Gondar, Gondar, Ethiopia.
| | - Berihun Assefa Dachew
- Department of Epidemiology and Biostatistics, Institute of public Health, University of Gondar, Gondar, Ethiopia
| | - Teresa Kisi
- Department of Public Health, College of health sciences, Arsi University, Arsi, Ethiopia
| | - Nigussie Yigzaw
- Department of Psychiatry, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Telake Azale
- Department of Health Education and Behavioral Science, Institute of public Health, University of Gondar, Gondar, Ethiopia
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Baier A, Fritsch R, Ignatyev Y, Priebe S, Mundt AP. The course of major depression during imprisonment - A one year cohort study. J Affect Disord 2016; 189:207-13. [PMID: 26451505 DOI: 10.1016/j.jad.2015.09.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 08/25/2015] [Accepted: 09/05/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND First longitudinal studies in prisoners point to improvements of depressive symptoms during imprisonment. The aim of the present study was to assess the course of major depressive disorder during imprisonment and to identify factors influencing remission. METHODS Prisoners with major depressive disorder in a sample of consecutive admissions to the penal justice system in Santiago de Chile were reassessed after one year of imprisonment. Psychiatric diagnoses were established using the Mini-International Neuropsychiatric Interview; psychological symptoms were assessed with the Symptom-Check-List 90 Revised (SCL-90-R). Mean symptom scores were compared at baseline and follow-up using Student's t-test. Odds ratios (OR) of comorbid disorders and socio-demographic factors at baseline to predict depression at follow-up were calculated. RESULTS N=79 out of 80 inmates (99%) with major depression at baseline were included. Thirty-five prisoners (44%) had major depression at follow-up. The mean global severity score and all mean subscale scores of the SCL-90-R improved. High suicide risk was present in 37 prisoners (47%) at admission and in 11 (14%) at follow-up. The comorbid diagnosis of PTSD (OR 6.3; p<0.001) at admission and having been previously imprisoned (OR 2.5; p=0.05) predicted major depressive disorder at follow-up. LIMITATIONS The study could not account for temporary improvements between the assessments. CONCLUSION In spite of important symptom improvements, only about half of the prisoners with major depression at admission remit after one year of imprisonment. New interventions should target people with major depression and comorbid PTSD at admission.
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Affiliation(s)
- Alicia Baier
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte Universitätsmedizin Berlin, Germany; Department of Psychiatry and Mental Health, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Rosemarie Fritsch
- Department of Psychiatry and Mental Health, Hospital Clínico Universidad de Chile, Santiago, Chile; Department of Psychiatry, Universidad de los Andes, Chile
| | - Yuriy Ignatyev
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte Universitätsmedizin Berlin, Germany
| | - Stefan Priebe
- Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Services Development), Queen Mary University of London, United Kingdom
| | - Adrian P Mundt
- Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Services Development), Queen Mary University of London, United Kingdom; Facultad de Medicina, Universidad Diego Portales, Santiago, Chile; Escuela de Medicina sede Puerto Montt, Universidad San Sebastián, Chile; Facultad de Medicina, Universidad de Chile, Santiago, Chile.
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Dachew BA, Fekadu A, Kisi T, Yigzaw N, Bisetegn TA. Psychological distress and associated factors among prisoners in North West Ethiopia: cross-sectional study. Int J Ment Health Syst 2015; 9:39. [PMID: 26719761 PMCID: PMC4696292 DOI: 10.1186/s13033-015-0033-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 12/22/2015] [Indexed: 11/30/2022] Open
Abstract
Background Currently, mental health is an important public health problem and the leading cause of disability worldwide. Studies have shown that, mental illnesses are more common among the prison population than the general population. However, still there is no accurate count of persons with mental disorder who are incarcerated in Ethiopia and information about prisoners’ health conditions is scarce. The purpose of this study was to assess the prevalence and associated factors of psychological distress among prisoner inmates found in prisons of Northwest, Ethiopia. Methods Institution based cross sectional study was conducted among 649 prisoners from January to February 2015. Multistage sampling technique was used to select the study participants. Data were collected by using a structured interviewer administered questionnaire. Psychological distress was measured using the Kessler Psychological Distress Scale (K10). Receiver Operating Characteristic curve (ROC curve) analysis was done by STATA version 12 software in order to determine a cutoff point with high sensitivity and specificity. Bivariate and multivariable logistic regression models were fitted to identify associated factors. Adjusted odds ratio with its 95 % Confidence interval was used to declare the statistical significance between psychological distress and associated factors. Results Prevalence of psychological distress among prisoners was found to be 83.4 % (95 % CI 80.6, 86.0 %). Long duration of stay in the prison (AOR = 0.95; 95 % CI 0.89–0.97), low to no satisfaction with prison services (AOR = 3.01; 95 % CI 1.38–6.51), and place of prison were factors significantly associated with psychological distress among prisoners. Conclusion The prevalence of psychological distress among prisoners was found to be very high. Due attention needs to be given in addressing the mental health needs of the prisoners.
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Affiliation(s)
- Berihun Assefa Dachew
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abel Fekadu
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Teresa Kisi
- Department of Public Health, College of Medicine and Health Sciences, Arisi University, Assela, Ethiopia
| | - Nigussie Yigzaw
- Deaprtment of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Telake Azale Bisetegn
- Department of Health Education and Behavioral Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Osasona SO, Koleoso ON. Prevalence and correlates of depression and anxiety disorder in a sample of inmates in a Nigerian prison. Int J Psychiatry Med 2015; 50:203-18. [PMID: 26475685 DOI: 10.1177/0091217415605038] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND TO THE STUDY Prisoners tend to be marginalized and deprived of the rights and privileges that other citizens in the community enjoy. Their separation from families, adverse effects on health of prison environment, and the uncertainty about the future place a great psychological burden on them which can lead to the development of mental illness. AIMS AND OBJECTIVES The aim of this study was to determine the prevalence of psychiatric morbidity (depression and anxiety) and the associated factors among a sample of the prison inmates. MATERIALS AND METHOD The study was descriptive and cross-sectional in design; it was conducted in a medium security prison in Benin City, Nigeria. Participants were interviewed with the Self-Reporting Questionnaire-20, the Hospital Anxiety and Depression Scale, and a socio-demographic questionnaire. Two hundred and fifty-two prisoners who were selected by systematic sampling techniques participated in the study and the data were analyzed using the 16th version of the SPSS with the statistical level of significance set at p < 0.05. Data were presented in tables; frequencies and percentages were calculated. Chi-square and logistic regression statistical tests were performed to determine variables that have relationship with psychiatric morbidity. RESULTS The mean age of the respondents was 33.6 years (SD ± 9.29), and the majority of the respondents (43.7%) were in the age range 21-30 years. The prevalence of general psychiatric morbidity (SRQ-20 caseness) was 80.6%, while 72.6% and 77.8% were found to be positive for depression and anxiety symptoms respectively on the HADS. Overall, 84.5% of the respondents had at least one type of psychiatric morbidity. Age, marital status, self-reported physical and mental health, previous mental illness, imprisonment status, prison accommodation, prison meal, and health care services were found to be significantly associated with depression, anxiety or general psychiatric morbidity. Self-reported poor current mental health was the only variable that predicted all the three types of psychiatric morbidity. CONCLUSION Prisoners in this study, and as in previous reports, had high prevalence rates of psychiatric morbidity. Thus, prisoners have a need for regular psychiatric screening and treatment. The consequences of untreated psychiatric morbidity and the need for improved health care services and infrastructure in the prison were discussed.
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Affiliation(s)
- Samuel O Osasona
- Department of Mental Health, University of Benin Teaching Hospital, Nigeria
| | - Olaide N Koleoso
- Department of Mental Health, University of Benin Teaching Hospital, Nigeria
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Treating substance abuse is not enough: comorbidities in consecutively admitted female prisoners. Addict Behav 2015; 46:25-30. [PMID: 25770695 DOI: 10.1016/j.addbeh.2015.02.016] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 01/07/2015] [Accepted: 02/16/2015] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Several studies have pointed to high rates of substance use disorders among female prisoners. The present study aimed to assess comorbidities of substance use disorders with other mental disorders in female prisoners at admission to a penal justice system. METHODS A sample of 150 female prisoners, consecutively admitted to the penal justice system of Berlin, Germany, was interviewed using the Mini-International Neuropsychiatric Interview (MINI). The presence of borderline personality disorder was assessed using the Structured Clinical Interview II for DSM-IV. Prevalence rates and comorbidities were calculated as percentage values and 95% confidence intervals (CIs). RESULTS Ninety-three prisoners (62%; 95% CI: 54-70) had substance use disorders; n=49 (33%; 95% CI: 24-42) had alcohol abuse/dependence; n=76 (51%; 95% CI: 43-59) had illicit drug abuse/dependence; and n=53 (35%; 95% CI: 28-44) had opiate use disorders. In the group of inmates with substance use disorders, 84 (90%) had at least one other mental disorder; n=63 (68%) had comorbid affective disorders; n=45 (49%) had borderline or antisocial personality disorders; and n=41 (44%) had comorbid anxiety disorders. CONCLUSIONS Female prisoners with addiction have high rates of comorbid mental disorders at admission to the penal justice system, ranging from affective to personality and anxiety disorders. Generic and robust interventions that can address different comorbid mental health problems in a flexible manner may be required to tackle widespread addiction and improve mental health of female prisoners.
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Sepehrmanesh Z, Ahmadvand A, Akasheh G, Saei R. Prevalence of psychiatric disorders and related factors in male prisoners. IRANIAN RED CRESCENT MEDICAL JOURNAL 2014; 16:e15205. [PMID: 24719711 PMCID: PMC3964429 DOI: 10.5812/ircmj.15205] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Revised: 11/12/2013] [Accepted: 12/07/2013] [Indexed: 11/16/2022]
Abstract
Background: Prisoners are at risk of mental disorders. Therefore attention to mental health of prisoners is important. Objectives: This study aimed determine to the prevalence of mental disorders among Kashan prisoners. Patients and Methods: This cross sectional study was carried out in Kashan prison (Iran). 180 Subjects were selected by using stratified random sampling and evaluated with Symptoms Check List-90-Revised (SCL-90-R) questionnaire and clinical interview based on Diagnostic Statistical Manual of Disease-IV (DSM-IV) check list by two psychiatrists. Data were analyzed by SPSS-16 software and Chi square, Kolmogrov Smirnov, Mann-whiteny and Leven tests. Results: The mean age of prisoners was 31.9 ± 8.96. The prevalence of psychiatric disorders in prisoners was 43.4 %. The most frequent disorders were major depressive disorders (27.9 %), Post traumatic Stress Disorder (17.4%) and substance use disorder (17.4 %). 28.3% of prisoners had personality disorders, that the most prevalent were antisocial personality and borderline personality. The comorbidity of psychiatric disorders was (36 %) in axis I. Suicidal thoughts there were in 44.6 % of prisoners. History of head trauma in Prisoners with psychiatric disorders was (52.2 %). There was significant difference between head trauma and psychiatric disorders (P = 0.05). Significant difference was between marital status and duration of imprisonment with psychiatric disorders P < 0.05. There was not significant difference between type of crime and educational level with psychiatric disorders. Conclusions: About half of all prisoners suffered from psychiatric disorders; therefore treatment psychiatric disorder in this group is essential for prevention of crime. Prisoners are at risk of mental disorders. Therefore attention to mental health of prisoners is important.
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Affiliation(s)
- Zahra Sepehrmanesh
- Department of Psychiatric, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Afshin Ahmadvand
- Department of Psychiatric, Kashan University of Medical Sciences, Kashan, IR Iran
- Corresponding Author: Afshin Ahmadvand, Department of Psychiatric, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-3615559111, Fax: +98-3615550036, E-mail:
| | - Goudarz Akasheh
- Department of Psychiatric, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Rezvan Saei
- Department of Psychiatric, Kashan University of Medical Sciences, Kashan, IR Iran
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