Mental disorders among offenders in correctional settings

Author(s):  
James R. P. Ogloff

Incontrovertible evidence now exists to show that the prevalence of mental disorders among prisoners far exceeds that found in the general community. A surprising concordance is emerging from several large international studies to show that, in western developed societies at least, the rates of major mental disorders in prisons are quite consistent. This chapter will provide an overview of relevant research examining rates of mental illness in prisons with those found in the community. Some observations regarding trends and implications for prisons also will be provided. At the outset it is useful to reflect on the scope of illnesses which have been subsumed under the ‘mental disorder’ umbrella as it has been applied to the prison research. Most of the research that exists has focussed serious mental illnesses within the Axis I disorders—namely psychotic illnesses, mood disorders, and anxiety disorders. Considerable attention has been paid regarding the prevalence of personality disorders within prisons. Over the past 20 years much of that work has investigated antisocial or dissocial personality disorder and psychopathy. By comparison, relatively little attention has been paid to other personality disorders. A growing area of importance concerns substance abuse and dependence disorders and, of course, co-occurring substance use and mental illness disorders. Considerable research also exists exploring the prevalence of mental retardation or intellectual disabilities in prison. Thereafter, fragments of research exist exploring any number of mental syndromes and conditions. The focus of this chapter will be on the major mental disorders which fall into Axis I. Some mention will be made of substance use disorders and personality disorders. In addition, with the growing number of women in prisons, information will be provided regarding this important group.

CNS Spectrums ◽  
2020 ◽  
Vol 25 (5) ◽  
pp. 638-650 ◽  
Author(s):  
Joel A. Dvoskin ◽  
James L. Knoll ◽  
Mollie Silva

This article traces the history of the way in which mental disorders were viewed and treated, from before the birth of Christ to the present day. Special attention is paid to the process of deinstitutionalization in the United States and the failure to create an adequately robust community mental health system to care for the people who, in a previous era, might have experienced lifelong hospitalization. As a result, far too many people with serious mental illnesses are living in jails and prisons that are ill-suited and unprepared to meet their needs.


Author(s):  
Kim T. Mueser ◽  
Douglas L. Noordsy ◽  
Robert E. Drake

The high comorbidity between substance use disorders and serious mental illnesses is a significant challenge to traditional treatment systems that have historically treated psychiatric and substance use disorders with different providers and agencies. Defining characteristics of serious mental illness include difficulty with work, performing in school or parenting, social difficulties, and problems caring for oneself. Common serious psychiatric disorders include schizophrenia, schizoaffective disorder, bipolar disorder, and severe major depression, posttraumatic stress disorder, and borderline personality disorder. The epidemiology of substance use disorders in serious mental illness is reviewed, including prevalence, correlates, and onset and course of the disorder. The clinical consequences of substance use disorders in this population are devastating for every possible aspect of the illness. Common factors may increase vulnerability to both substance abuse and psychiatric disorders. The principles of treating co-occurring disorders are based on modern integrated methods, as well as research on the effectiveness of integrated treatment.


2017 ◽  
Vol 41 (S1) ◽  
pp. S153-S153
Author(s):  
I. Khemiri ◽  
F. Fekih Romdhane ◽  
A. Belkhiria ◽  
J. Lamia ◽  
R. Trabelsi ◽  
...  

IntroductionViolence has important relevance for the criminal justice and health care systems especially forensic psychiatry. Previous studies reported the relation between violence, mental illness and substance abuse. We purpose to investigate the association between addiction and violence among people with severe mental illness through a review of literature.Methodwe conducted a Medline and Pubmed literature search of studies published between “2000 and 2015”, combining the terms “psychotic disorders”, “addiction” “substance use disorder”.ResultsThe studies published showed that much of the excessive violence observed in patients with severe psychiatric disorders is due to co-morbid substance use. Increasing violence associated with substance use disorders in these patients had same level than that observed among subjects without severe psychiatric disorders. Increasing violence in subjects with substance use disorder but without severe mental disorders was higher than in patients with only severe mental disorders. In fact, mental disorders could increase the risk of installing on substance use disorders, and therefore increase the risk of partner violence. Among the substances used, if alcohol is frequently identified as a consumer risk for the emergence of violence among subjects with severe psychiatric disorders, stimulants could be causing more violence than alcohol.ConclusionsSevere mental illnesses are associated with violence. However, most of the excess risk appears to be mediated by substance abuse co-morbidity. This finding improves the need of prevention of substance use disorders and emphasizes the fact that patients with severe mental disorders are more often victims than perpetrators of violence.


Author(s):  
Anne Høye ◽  
Bjarne K. Jacobsen ◽  
Jørgen G. Bramness ◽  
Ragnar Nesvåg ◽  
Ted Reichborn-Kjennerud ◽  
...  

Abstract Purpose To investigate the mortality in both in- and outpatients with personality disorders (PD), and to explore the association between mortality and comorbid substance use disorder (SUD) or severe mental illness (SMI). Methods All residents admitted to Norwegian in- and outpatient specialist health care services during 2009–2015 with a PD diagnosis were included. Standardized mortality ratios (SMRs) with 95% confidence intervals (CI) were estimated in patients with PD only and in patients with PD and comorbid SMI or SUD. Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) with 95% CIs in patients with PD and comorbid SMI or SUD compared to patients with PD only. Results Mortality was increased in both in- and outpatients with PD. The overall SMR was 3.8 (95% CI 3.6–4.0). The highest SMR was estimated for unnatural causes of death (11.0, 95% CI 10.0–12.0), but increased also for natural causes of death (2.2, 95% CI 2.0–2.5). Comorbidity was associated with higher SMRs, particularly due to poisoning and suicide. Patients with comorbid PD & SUD had almost four times higher all-cause mortality HR than patients with PD only; young women had the highest HR. Conclusion The SMR was high in both in- and outpatients with PD, and particularly high in patients with comorbid PD & SUD. Young female patients with PD & SUD were at highest risk. The higher mortality in patients with PD cannot, however, fully be accounted for by comorbidity.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed Saad Mohamed ◽  
Nesreen Mohammed Mohsen ◽  
Lobna AbuBakr Ismail ◽  
Ayat Ullah Mazloum Mahmoud

Abstract Background The magnitude of the problem of substance use in Egypt has been growing lately. Substance use disorders have been associated with depression and suicide, as well as impulsivity and specific personality traits. Suicide is closely linked to the substances use. Therefore it is very important to confirm the factors that affect the possibility of suicide. Aim of the Work This study aimed at evaluating suicide risk and its correlation with each of personality disorders and severity of addiction in a sample of 72 tramadol addicts from outpatient clinic of Institute of psychaitry Ain Shams University hospitals. Patients and Methods This is a descriptive Cross sectional study conducted in outpatient clinic of Institute of psychaitry Ain Shams University hospital. The present study aimed at analyzing the demographic data of 72 tramadol addicts, over six months period from January 2018 to August 2019. The severity of the addiction problem among those patients was assessed using Addiction Severity Index (ASI), suicidal probability was assessed using suicide probability scale (SPS), Structured Clinical Interview for DSM-VI Axis II (SCID-II) for assessing personality disorders and Structured Clinical Interview for DSM-IV Axis I Disorders (SCID I). Results The results showed that 32 (44.44%) of the patients had a risk of suicide probability. Also there was a statistically significant difference between risk of suicidal probability and personality disorders especially antisocial personality. It was found that the need for more power for work and pleasurable effects were the most risk factors for tramadol addiction. Conclusion Suicide probability was found to be (44.44%) among the studied tramadol addicts. The risk of suicide probability among them was found to be significant in each of the following: antisocial personality disorder, longer duration of addiction, being single and positive family history of addiction. Attention should be paid to include the assessment of suicidal risk as part of routine assessment of addicts.


Author(s):  
Lisa Nicole Sharwood ◽  
Taneal Wiseman ◽  
Emma Tseris ◽  
Kate Curtis ◽  
Bharat Vaikuntam ◽  
...  

IntroductionRisk of traumatic injury is increased in individuals with mental illness, substance use disorder and dual diagnosis (mental disorders); these conditions will pre-exist among individuals hospitalised with acute traumatic spinal injury (TSI). Although early intervention can improve outcomes for people who experience mental disorders or TSI, the incidence, management, and cost of this often complex comorbid health profile is not sufficiently understood. Objectives and ApproachIn a whole-population cohort of patients hospitalised with acute TSI, we aimed to describe the prevalence of pre-existing mental disorders, and compare differences in injury epidemiology, costs and inpatient allied health service access. Record-linkage study of all hospitalised cases of TSI between June 2013 and June 2016 in New South Wales, Australia. TSI was defined by specific ICD-10-AM codes. Mental disorder status was considered as pre-existing where specific ICD-10-AM codes were recorded in incident admissions. Results13,489 individuals sustained acute TSI during this study. 13.11%, 6.06%, and 1.82% had pre-existing mental illness, substance use disorder, and dual diagnosis, respectively. Individuals with mental disorder were older (p<0.001), more likely to have had a fall or self-harmed (p<0.001), experienced almost twice the length of stay and inpatient complications, and increased injury severity compared to individuals without mental disorder (p<0.001). Conclusion / ImplicationsIndividuals hospitalised for TSI with pre-existing mental disorder have greater likelihood of increased injury severity and more complex, costly acute care admissions compared to individuals without mental disorder. Care pathway optimisation including prevention of hospital acquired complications for people with pre-existing mental disorders hospitalised for TSI is warranted.


Author(s):  
Francesca Guzzetta ◽  
Giovanni de Girolamo

tbegun to be scientifically investigated. This development has taken place because a number of standardized instruments to assess personality and PD in an empirical fashion have been developed, in parallel with the refinement of a valid and reliable diagnostic system based on a categorical approach. The need for the epidemiological investigation of PDs seems justified for several reasons. 1 As seen in recent epidemiological surveys, PDs are frequent and have been found in different countries and sociocultural settings. 2 PDs can seriously impair the life of the affected individual and can be highly disruptive to societies, communities, and families. 3 Personality status is often a major predictive variable in determining the outcome of Axis I mental disorders and the response to treatment. In this chapter, we review the epidemiological literature on PDs up to October 2007, focusing on studies carried out since the development of the DSM-III. First, community prevalence studies of PDs are reviewed. We then look at the prevalence of individual PDs in the community. Finally, we consider the prevalence of PDs in clinical populations, and in special settings (e.g. primary care, prisons, etc.).


CNS Spectrums ◽  
2020 ◽  
Vol 25 (5) ◽  
pp. 584-592
Author(s):  
Brendan Daugherty ◽  
Katherine Warburton ◽  
Stephen M. Stahl

Despite medical, technological, and humanitarian advances, the criminalization of those with serious mental illness continues. This is not an isolated phenomenon. The benefits of treatment reform and innovation are difficult to maintain or sometimes outright harmful. Across time and geography, the care of those with serious mental illness tends towards maltreatment, be it criminalization or other forms of harm. We present a social history of serious mental illness, along with the idea that the treatment of serious mental illness is a Sisyphean task—perpetually pushing a boulder up a hill, only for it to roll down and start again. The history is provided as a basis for deeper reflection of treatment, and treatment reform, of those with serious mental illnesses.


2018 ◽  
Vol 7 (2) ◽  
pp. 46-50
Author(s):  
D.K. Thapa ◽  
N. Lamichhane ◽  
S. Subedi

Introduction: Mental illnesses are commonly linked with a higher disability and burden of disease than many physical illnesses. But despite that fact, it is a general observation that a majority of patients with mental disorder never seek professional help. To elaborate further, the widely prevalent magico-religious beliefs associated with mental illness and lower literacy, poses significant social obstacles in seeking appropriate health care for psychiatric patients. In general, mental illness is seen as related to life stresses, social or family conflicts and evil spirits and the concept of biological causes of mental illness is rare even among the educated. The idea that illness and death are due to malevolent spirits is common notion that is shared practically by all level of society from the so-called primitive to modern industrialized societies, thus indicating the strong influences of cultural background. When there is a magico- religious concepts of disease causation, there is tendency to consult indigenous healers. Therefore, the patients with mental illness often either visit or are taken to faith healers by their relatives. The objective of the study was to determine the various psychiatric cases that were referred by the traditional faith healers to the authors. Material and Method: This is a cross- sectional, hospital- based descriptive study, conducted at the Psychiatric outpatient department of Pokhara Om Hospital, Pokhara, Kaski, Nepal for the period of one year, from June 2016 to May 2017. The total of 35 cases, referred by the traditional faith healers was included in the study. Subjects of any age, any gender, any literacy level, any caste, from any locality and religious background were included in the study after their consent. Subjects who refused to consent were not included in the study. The psychiatric diagnosis was based on the complete history and examination and ICD- 10 DRC criteria. Results: Though the sample size is small, it is interesting to note that patients with various kinds of mental disorders were referred by traditional faith healers. There were patients suffering from neurotic disorders, psychotic disorders, mood disorders, seizure, substance use disorder, intellectual disability etc seeking the treatment from traditional faith healers. Among the cases referred, predominantly were female and neurotic cases. Most patients were educated. Conclusion: The study shows that patients with various mental disorders visit traditional faith healer. This area surely requires further in-depth look as traditional faith healers can be an important source of referral of psychiatric patients.


2001 ◽  
Vol 7 (2) ◽  
pp. 85-92 ◽  
Author(s):  
Rosalind Ramsay ◽  
Sarah Welch ◽  
Elizabeth Youard

Women patients suffer from a range of mental disorders similar to those that men may experience. However, there are some striking differences in the prevalence of specific disorders, and in their presentation and management. Some mental illnesses only occur in women. It seems that women patients may have a different experience of treatment, a consequence of differences in their needs and also of the way that health professionals perceive those needs. These differences are embedded in the wider cultural milieu in which we live. There are particular issues for women patients in relation to, for example, childhood sexual abuse, rape and domestic violence. At present, tools to measure needs of individual patients are generally not gender specific.


Sign in / Sign up

Export Citation Format

Share Document