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      Mental and behavioral disorders in the prison context Translated title: Trastornos mentales y del comportamiento en el contexto carcelario y penitenciario

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          Abstract

          Introduction:

          During the execution of sentences in prison units, there are deficiencies within the adaptation mechanisms of persons deprived of liberty, this varies depending on the place where they serve the sanction and the length of stay in it.

          Objectives:

          To collect information on the prevalence of mental and behavioural disorders in the prison setting, as well as the importance of early psychiatric intervention.

          Material and method:

          Theoretical review. Primary sources of information: scientific articles from indexed journals, in specialized medical information search engines. Original publications on mental and behavioural disorders in the prison and prison context were included, from 2016 to April 2021, with an analytical, observational, prospective, retrospective, cross-sectional and randomized design, systematic reviews and meta-analyzes, complete articles, carried out in any country, with subjects over 15 years of age, of any sex or gender, in English and Spanish.

          Results:

          16 articles were included in this theoretical review. The prevalence of mental disorders within the prison population is high; depression, anxiety, substance use and psychotic disorders predominate. The importance of having mental health programmes in prisons, with initial diagnosis and personalized interventions, was observed. The authors recommend psychopharmacological interventions and cognitive behavioural management.

          Discussion:

          The need to restructure the mental health approach in prisons was evidenced, and early diagnosis and personalized follow-up should be guaranteed. Pharmacological intervention and, to a greater degree, cognitive behavioural therapy seem to be effective for these types of patients.

          Resumen

          Introducción:

          Durante el cumplimiento de condenas en unidades carcelarias, existen deficiencias dentro de los mecanismos de adaptación de las personas privadas de la libertad, esto varía dependiendo del lugar donde cumplan la sanción y el tiempo de estancia.

          Objetivos:

          Recopilar información sobre la prevalencia de trastornos mentales y del comportamiento en el ámbito carcelario y penitenciario, así como la importancia de una intervención psiquiátrica temprana.

          Material y método:

          Revisión teórica. Fuentes de información primarias: artículos científicos de revistas indexadas, en busca- dores de información médica especializados. Se incluyeron publicaciones sobre trastornos mentales y del comportamiento en el contexto carcelario y penitenciario, desde enero del 2016 hasta abril de 2021, originales, con diseño analítico, observacional, prospectivo, retrospectivo, transversal y aleatorizado, revisiones sistemáticas y metaanálisis, artículos completos, realizados en cualquier país, con sujetos mayores de 15 años, de cualquier sexo o género, en idioma inglés y español.

          Resultados:

          Se incluyeron 16 artículos en esta revisión teórica. La prevalencia de trastornos mentales dentro de la población penitenciaria es elevada; predominan los trastornos depresivos, de ansiedad, por consumo de sustancias y psicóticos. Se observó la importancia de contar con programas de salud mental en las instituciones carcelarias, con diagnóstico inicial e intervenciones personalizadas. Los autores recomiendan intervenciones psicofarmacológicas y manejo cognitivo conductual.

          Discusión:

          Se evidenció la necesidad de reestructurar el abordaje en salud mental de los centros carcelarios, garantizando el diagnóstico precoz y un seguimiento personalizado. La intervención farmacológica y, en mayor grado, la terapia cognitiva con- ductual parece ser efectivas en este tipo de pacientes.

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          Most cited references36

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          Mental health of prisoners: prevalence, adverse outcomes, and interventions

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            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

            Summary 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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              Interventions at the Transition from Prison to the Community for Prisoners with Mental Illness: A Systematic Review

              Prisoners have high rates of mental illness and the transition from prison to the community is a problematic time for the provision of mental health services and a range of negative outcomes have been identified in this period. A systematic review was conducted to identify interventions for prisoners with diagnosed mental health conditions that targeted this transition period. Fourteen papers from 13 research studies were included. The interventions identified in this review were targeted at different stages of release from prison and their content differed, ranging from Medicaid enrolment schemes to assertive community treatment. It was found that insurance coverage, and contact with mental health and other services can be improved by interventions in this period but the impact on reoffending and reincarceration is complex and interventions may lead to increased return to prison. There is a developing evidence base that suggests targeting this period can improve contact with community mental health and other health services but further high quality evidence with comparable outcomes is needed to provide more definitive conclusions. The impact of programmes on return to prison should be evaluated further to establish the effect of interventions on clinical outcomes and to clarify the role of interventions on reincarceration. Electronic supplementary material The online version of this article (10.1007/s10488-018-0848-z) contains supplementary material, which is available to authorized users.
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                Author and article information

                Journal
                Rev Esp Sanid Penit
                Rev Esp Sanid Penit
                sanipe
                Revista Española de Sanidad Penitenciaria
                Sociedad Española de Sanidad Penitenciaria
                1575-0620
                2013-6463
                May-Aug 2022
                06 October 2022
                : 24
                : 2
                : 66-74
                Affiliations
                [1 ] original Universidad Central del Ecuador. Psychiatrist. Ecuador. normalizedUniversidad Central del Ecuador orgnameUniversidad Central del Ecuador Ecuador
                [2 ] original Universidad Central del Ecuador. Psychiatrist of the Club de Leones Quito Central. Ecuador. normalizedUniversidad Central del Ecuador orgnameUniversidad Central del Ecuador orgdiv1Club de Leones Quito Central Ecuador
                Author notes
                [Correspondence ] Helen Gómez Figueroa. E-mail: helen.hg131@ 123456gmail.com
                Article
                10.18176/resp.00052
                9578298
                36256558
                0f68593b-7eae-404d-a420-5604653e5a07

                This is an open-access article distributed under the terms of the Creative Commons Attribution License

                History
                : 08 May 2021
                : 14 October 2021
                Page count
                Figures: 0, Tables: 3, Equations: 0, References: 33, Pages: 09
                Categories
                Review

                anxiety,depression,psychotic disorder,prisoners,prisons,ansiedad,depresión,trastornos psicóticos,prisioneros,prisiones.

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