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Altintas, Merih and Bilici, Mustafa 2018. Evaluation of childhood trauma with respect to criminal behavior, dissociative experiences, adverse family experiences and psychiatric backgrounds among prison inmates. Comprehensive Psychiatry,
Putkonen, Hanna and Taylor, Pamela J. 2018. Making sense of mental health service changes. Nordic Journal of Psychiatry, Vol. 72, Issue. 2, p. 82.
Hopkin, G. Evans-Lacko, S. Forrester, A. Shaw, J. and Thornicroft, G. 2018. Interventions at the Transition from Prison to the Community for Prisoners with Mental Illness: A Systematic Review. Administration and Policy in Mental Health and Mental Health Services Research,
van Beek, J. Vuijk, P. J. Harte, J. M. and Scherder, E. J. A. 2018. Symptom Profile of Psychiatric Patients With Psychosis or Psychotic Mood Disorder in Prison. International Journal of Offender Therapy and Comparative Criminology, p. 0306624X1875711.
Krammer, Sandy Eisenbarth, Hedwig Hügli, David Liebrenz, Michael and Kuwert, Philipp 2018. The relationship between childhood traumatic events, social support, and mental health problems in prisoners. The Journal of Forensic Psychiatry & Psychology, Vol. 29, Issue. 1, p. 72.
Kingston, Drew A. and Olver, Mark E. 2018. Psychometric Examination of Treatment Change Among Mentally Disordered Offenders: A Risk–Needs Analysis. Criminal Justice and Behavior, Vol. 45, Issue. 2, p. 153.
Lüdtke, Janine In-Albon, Tina Schmeck, Klaus Plener, Paul L Fegert, Jörg M and Schmid, Marc 2018. Nonsuicidal Self-Injury in Adolescents Placed in Youth Welfare and Juvenile Justice Group Homes: Associations with Mental Disorders and Suicidality. Journal of Abnormal Child Psychology, Vol. 46, Issue. 2, p. 343.
Dewa, Lindsay H. Hassan, Lamiece Shaw, Jenny J. and Senior, Jane 2017. Trouble sleeping inside: a cross-sectional study of the prevalence and associated risk factors of insomnia in adult prison populations in England. Sleep Medicine, Vol. 32, p. 129.
Michalski, Joseph H. 2017. Mental health issues and the Canadian criminal justice system*. Contemporary Justice Review, Vol. 20, Issue. 1, p. 2.
Kerekes, Nóra Fielding, Cecilia and Apelqvist, Susanne 2017. Yoga in Correctional Settings: A Randomized Controlled Study. Frontiers in Psychiatry, Vol. 8,
Saavedra, Javier López, Marcelino and Trigo, M. Eva 2017. Association between Violent Crime and Psychosis in Men Serving Prison Terms. The Spanish Journal of Psychology, Vol. 20,
Shrestha, Gambhir Yadav, Deepak Kumar Sapkota, Nidesh Baral, Dharanidhar Yadav, Birendra Kumar Chakravartty, Avaniendra and Pokharel, Paras Kumar 2017. Depression among inmates in a regional prison of eastern Nepal: a cross-sectional study. BMC Psychiatry, Vol. 17, Issue. 1,
Gulati, G. Whelan, D. Spain, E. Meagher, D. and Dunne, C. P. 2017. Hunger strikes in prison: a legal perspective for psychiatrists. Irish Journal of Psychological Medicine, p. 1.
Tuominen, Tiina Korhonen, Tapio Hämäläinen, Heikki Katajisto, Jouko Vartiainen, Heikki Joukamaa, Matti Lintonen, Tomi Wuolijoki, Terhi Jüriloo, Alo and Lauerma, Hannu 2017. The factors associated with criminal recidivism in Finnish male offenders: importance of neurocognitive deficits and substance dependence. Journal of Scandinavian Studies in Criminology and Crime Prevention, Vol. 18, Issue. 1, p. 52.
Wojciechowski, Thomas W. 2017. ADHD Presentation and Alcohol Use Among Juvenile Offenders: A Group-Based Trajectory Modeling Approach. Journal of Child & Adolescent Substance Abuse, p. 1.
View all Google Scholar citations for this article.
High levels of psychiatric morbidity in prisoners have been documented in many countries, but it is not known whether rates of mental illness have been increasing over time or whether the prevalence differs between low–middle-income countries compared with high-income ones.
To systematically review prevalence studies for psychotic illness and major depression in prisoners, provide summary estimates and investigate sources of heterogeneity between studies using meta-regression.
Studies from 1966 to 2010 were identified using ten bibliographic indexes and reference lists. Inclusion criteria were unselected prison samples and that clinical examination or semi-structured instruments were used to make DSM or ICD diagnoses of the relevant disorders.
We identified 109 samples including 33 588 prisoners in 24 countries. Data were meta-analysed using random-effects models, and we found a pooled prevalence of psychosis of 3.6% (95% CI 3.1–4.2) in male prisoners and 3.9% (95% CI 2.7–5.0) in female prisoners. There were high levels of heterogeneity, some of which was explained by studies in low–middle-income countries reporting higher prevalences of psychosis (5.5%, 95% CI 4.2–6.8; P=0.035 on meta-regression). The pooled prevalence of major depression was 10.2% (95% CI 8.8–11.7) in male prisoners and 14.1% (95% CI 10.2–18.1) in female prisoners. The prevalence of these disorders did not appear to be increasing over time, apart from depression in the USA (P=0.008).
High levels of psychiatric morbidity are consistently reported in prisoners from many countries over four decades. Further research is needed to confirm whether higher rates of mental illness are found in low- and middle-income nations, and examine trends over time within nations with large prison populations.
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K.S. was funded by the German Friedrich-Ebert Stiftung.
Declaration of interest
None.
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Altintas, Merih and Bilici, Mustafa 2018. Evaluation of childhood trauma with respect to criminal behavior, dissociative experiences, adverse family experiences and psychiatric backgrounds among prison inmates. Comprehensive Psychiatry,
Putkonen, Hanna and Taylor, Pamela J. 2018. Making sense of mental health service changes. Nordic Journal of Psychiatry, Vol. 72, Issue. 2, p. 82.
Hopkin, G. Evans-Lacko, S. Forrester, A. Shaw, J. and Thornicroft, G. 2018. Interventions at the Transition from Prison to the Community for Prisoners with Mental Illness: A Systematic Review. Administration and Policy in Mental Health and Mental Health Services Research,
van Beek, J. Vuijk, P. J. Harte, J. M. and Scherder, E. J. A. 2018. Symptom Profile of Psychiatric Patients With Psychosis or Psychotic Mood Disorder in Prison. International Journal of Offender Therapy and Comparative Criminology, p. 0306624X1875711.
Krammer, Sandy Eisenbarth, Hedwig Hügli, David Liebrenz, Michael and Kuwert, Philipp 2018. The relationship between childhood traumatic events, social support, and mental health problems in prisoners. The Journal of Forensic Psychiatry & Psychology, Vol. 29, Issue. 1, p. 72.
Kingston, Drew A. and Olver, Mark E. 2018. Psychometric Examination of Treatment Change Among Mentally Disordered Offenders: A Risk–Needs Analysis. Criminal Justice and Behavior, Vol. 45, Issue. 2, p. 153.
Lüdtke, Janine In-Albon, Tina Schmeck, Klaus Plener, Paul L Fegert, Jörg M and Schmid, Marc 2018. Nonsuicidal Self-Injury in Adolescents Placed in Youth Welfare and Juvenile Justice Group Homes: Associations with Mental Disorders and Suicidality. Journal of Abnormal Child Psychology, Vol. 46, Issue. 2, p. 343.
Dewa, Lindsay H. Hassan, Lamiece Shaw, Jenny J. and Senior, Jane 2017. Trouble sleeping inside: a cross-sectional study of the prevalence and associated risk factors of insomnia in adult prison populations in England. Sleep Medicine, Vol. 32, p. 129.
Michalski, Joseph H. 2017. Mental health issues and the Canadian criminal justice system*. Contemporary Justice Review, Vol. 20, Issue. 1, p. 2.
Kerekes, Nóra Fielding, Cecilia and Apelqvist, Susanne 2017. Yoga in Correctional Settings: A Randomized Controlled Study. Frontiers in Psychiatry, Vol. 8,
Saavedra, Javier López, Marcelino and Trigo, M. Eva 2017. Association between Violent Crime and Psychosis in Men Serving Prison Terms. The Spanish Journal of Psychology, Vol. 20,
Shrestha, Gambhir Yadav, Deepak Kumar Sapkota, Nidesh Baral, Dharanidhar Yadav, Birendra Kumar Chakravartty, Avaniendra and Pokharel, Paras Kumar 2017. Depression among inmates in a regional prison of eastern Nepal: a cross-sectional study. BMC Psychiatry, Vol. 17, Issue. 1,
Gulati, G. Whelan, D. Spain, E. Meagher, D. and Dunne, C. P. 2017. Hunger strikes in prison: a legal perspective for psychiatrists. Irish Journal of Psychological Medicine, p. 1.
Tuominen, Tiina Korhonen, Tapio Hämäläinen, Heikki Katajisto, Jouko Vartiainen, Heikki Joukamaa, Matti Lintonen, Tomi Wuolijoki, Terhi Jüriloo, Alo and Lauerma, Hannu 2017. The factors associated with criminal recidivism in Finnish male offenders: importance of neurocognitive deficits and substance dependence. Journal of Scandinavian Studies in Criminology and Crime Prevention, Vol. 18, Issue. 1, p. 52.
Wojciechowski, Thomas W. 2017. ADHD Presentation and Alcohol Use Among Juvenile Offenders: A Group-Based Trajectory Modeling Approach. Journal of Child & Adolescent Substance Abuse, p. 1.
View all Google Scholar citations for this article.
Michael Fitzgerald, Consultant Child & Adult Psychiatrist
21 July 2012
Dear Editors,
Fazel and Sewald [1] make useful comments on psychosis and major depression in prisoners. The more serious mental disorders in prisoners responsible for much of imprisonment and re-offending are ADHD and it's comorbidities. It is time researchers focusing on mental disorder in prisoners focus on the common ADHD [2] and comorbidities and not exclusively on the rarer "severe mental illness" that is "psychosis and major depression". The major focus of forensic psychiatry is very out of date now and indeed excessively narrow in assessing prisoners.[3]
References:
1. Fazel S. Sewald K. Severe mental illness in 33588 prisoners worldwide: Systematic review and meta regression analysis. Br. J. Psychiatry 2012; 200: 364/378
2. Curran S. Fitzgerald M. Attention Deficit Hyper Activity Disorder in prison population. American Journal of Psychiatry 1999; 156: 1664/1665
3. Fitzgerald M. Young, Violent and Dangerous To Know. Nova Science:New York 2010
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Conflict of interest: None declared
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David J. Vinkers, Psychiatrist
24 June 2012
To the editor,
With much interest, we read the review article by Fazel and Seewald in the May issue of The Journal (1). The authors conclude that severe mental illness is more prevalent in prisoners in low- and middle-income countries than in high-income countries. This may be related to fewer opportunities and services for diverting offenders to health services, a stronger relationship between mental illness and criminality, and different socio-cutural factors, e.g. poorer legal representation for the mentally ill in low- and middle-income countries. We examined in an earlier study the relationship between mental illness and criminality in pre-trial reported Antillean defendants in the Netherlands and the Netherlands Antilles (2). Defendants who are suspectedto suffer from mental illness are pre-trial examined by a psychiatrist or psychologist both in the Netherlands and the Netherlands Antilles, before diversion to mental health services takes place. We found no significant difference in prevalence of psychotic disorders among pre-trial reported Antillean suspects in the Netherlands and the Netherlands Antilles (14.4 %vs. 15.1 %) and no significant difference in the prevalence of defendants deemed unaccountable due to a mental disorders (3.9 % vs. 4.0 %). There was, however, a much lower registered crime rate of Antilleans in the Netherlands Antilles than the Netherlands (11 vs. 113 offences per year per 1000 persons; p < 0.001) and a much higher rate of pre-trial reports in the Netherlands Antilles than the Netherlands (74 vs. 8 per 1000 Antillean defendants; p < 0.001). Antilleans living in the Netherlands Antilles thus have a low crime rate and a high pre-trial report rate when indicted of a crime as compared with Antilleans in the Netherlands, indicating that they are more frequently suspected to suffer from a mental illness. This finding is in line with the earlier formulatedrule of thumb that the frequency of mental illness is higher in countries with low crime rates (3,4). Indeed, the low- and middle-income countries included in the review of Fazel and Seewald have a combined prison population rate of 77 per 100,000, considerably less than the worldwide prison population rate of 145 per 100,000 (5). The higher prevalence of severe mental illness in prisoners in low- and middle-income countries maybe explained by lower rates of crime and imprisonment. If so, the relationship between mental illness and crime is not stronger in low- and middle- income countries, but weaker in high-income countries.
1. Fazel S, Seewald K. Severe mental illness in 33 588 prisoners worldwide: systematic review and meta-regression analysis. Br J Psychiatry2012; 200: 364-73.2. Vinkers DJ, Heytel FG, Matroos GM, Hermans KM, Hoek HW. Pre-trial psychiatric reports on Antillean suspected offenders in the Netherlands and on the Dutch Antilles. Tijdschr Psychiatr 2010; 52: 745-52.3. Large M, Smith G, Swinson N, Shaw J, Nielssen O. Homicide due to mentaldisorder in England and Wales over 50 years. Br J Psychiatry 2008; 193: 130-3.4. Coid J. The epidemiology of abnormal homicide and murder followed by suicide. Psychol Med 1983; 13: 855-6.5. Walmsley R. (2010). World Prison Population List?(8th ed.). International Centre for Prison Studies, Kings College: London. http://www.apcca.org/stats/8th%20Edition%20(2009).pdf
David J. Vinkers, MD, PhDNetherlands Institute for Forensic Psychiatry and Psychology, the Netherlandsd.vinkers@dji.minjus.nl.
Micha van de Vorst, MScPsychiaters Maatschappij Antillen, Curacao.
Hans W. Hoek, MD, PhDParnassia Bavo Psychiatric Institute, The Hague, the Netherlands.Department of Psychiatry, University Medical Center Groningen, University of Groningen, the Netherlands.Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States.
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Conflict of interest: None declared
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