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      Mental disorders and mental health symptoms during imprisonment: A three-year follow-up study

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          Abstract

          Background

          Data on the course of mental disorders during imprisonment are scarce. Longitudinal studies from high-income Western countries point to improvements of symptoms over time. The aim of the present study was to assess mental disorders and symptoms three years after baseline evaluation at imprisonment and to determine predictors of change in a South American prison context.

          Methods

          Consecutively admitted prisoners in Santiago de Chile were assessed at intake and reassessed after three years using the Mini International Neuropsychiatric Interview and the Symptom-Check-List 90 Revised (SCL-90-R). The global severity index (GSI) was calculated with standard deviations (SD) and compared using paired t-tests. The prevalence of mental disorders at baseline and at follow-up were compared using McNemar tests. Analyses of variance were conducted to evaluate whether prespecified socio-demographic variables and disorders at baseline predicted symptom change at follow-up.

          Results

          73 (94%) out of 78 prisoners participated. The prevalence of major mental illnesses was lower at follow-up: 47 (64%) at intake vs. 23 (32%) at follow-up had major depression ( p<0.001); 22 (30%) at intake vs. 10 (14%) at follow-up had psychosis ( p = 0.008). The mean GSI improved from 1.97 (SD 0.65) at intake to 1.16 (SD 0.82) at follow-up ( p<0.001). Depression at baseline ( F = 9.39;

          = 0.137; β = -0.67; p = 0.003) and working or studying during imprisonment ( F = 10.61;
          = 0.152; β = -0.71; p = 0.002) were associated with strong improvement of the GSI at follow-up, whereas psychosis at intake was associated with relatively small symptom improvement ( F = 12.11;
          = 0.17; β = 0.81; p = 0.001).

          Conclusions

          In a resource poor prison context in South America, mental health symptoms and disorders improve considerably over three years during imprisonment. This applies especially to people with depression at intake. Offers to work or study during imprisonment may improve mental health outcomes.

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          Most cited references33

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          Substance abuse and dependence in prisoners: a systematic review.

          To review studies of the prevalence of substance abuse and dependence in prisoners on reception into custody. A systematic review of studies measuring the prevalence of drug and alcohol abuse and dependence in male and female prisoners on reception into prison was conducted. Only studies using standardized diagnostic criteria were included. Relevant information, such as mean age, gender and type of prisoner, was recorded for eligible studies. The prevalence estimates were compared with those from large cross-sectional studies of prevalence in prison populations. Thirteen studies with a total of 7563 prisoners met the review criteria. There was substantial heterogeneity among the studies. The estimates of prevalence for alcohol abuse and dependence in male prisoners ranged from 18 to 30% and 10 to 24% in female prisoners. The prevalence estimates of drug abuse and dependence varied from 10 to 48% in male prisoners and 30 to 60% in female prisoners. The prevalence of substance abuse and dependence, although highly variable, is typically many orders of magnitude higher in prisoners than the general population, particularly for women with drug problems. This highlights the need for screening for substance abuse and dependence at reception into prison, effective treatment while in custody, and follow-up on release. Specialist addiction services for prisoners have the potential to make a considerable impact.
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            All-cause and external mortality in released prisoners: systematic review and meta-analysis.

            We systematically reviewed studies of mortality following release from prison and examined possible demographic and methodological factors associated with variation in mortality rates.
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              Prison suicide in 12 countries: an ecological study of 861 suicides during 2003-2007.

              Although suicide rates among prisoners are high and vary between countries, it is uncertain whether this reflects the importation of risk from the general population or is associated with incarceration rates.
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                Author and article information

                Contributors
                Role: Data curationRole: Formal analysisRole: InvestigationRole: Writing – original draft
                Role: Data curationRole: Formal analysisRole: Software
                Role: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: Project administrationRole: ResourcesRole: SupervisionRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                14 March 2019
                2019
                : 14
                : 3
                : e0213711
                Affiliations
                [1 ] Department of Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
                [2 ] Department of Psychiatry and Mental Health, Hospital Clínico Universidad de Chile, Santiago, Chile
                [3 ] Department of Social and Community Psychiatry, Queen Mary University of London, London, United Kingdom
                [4 ] Medical Faculty, Universidad Diego Portales, Santiago, Chile
                [5 ] Medical School, Universidad San Sebastián, Puerto Montt, Chile
                University of South Florida, UNITED STATES
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0002-5616-7518
                Article
                PONE-D-18-18659
                10.1371/journal.pone.0213711
                6417738
                30870479
                bb6d2c97-3581-4f78-ba5c-91931dea4cde
                © 2019 Gabrysch et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 22 June 2018
                : 27 February 2019
                Page count
                Figures: 0, Tables: 5, Pages: 13
                Funding
                The study was supported by Comisión Nacional de Investigación Científica y Tecnológica (CONICYT), grant scheme Fondo Nacional de Desarrollo Científico y Tecnológico (FONDECYT) Regular, Number 1160260 ( http://www.conicyt.cl/fondecyt/category/concursos/fondecyt-regular/) and acknowldedge Support from the German Research Foundation (DFG) and the Open Access Publication Fund of Charité Universitätsmedizin Berlin ( https://bibliothek.charite.de/publizieren/publikationsfonds/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Social Sciences
                Law and Legal Sciences
                Criminal Justice System
                Prisons
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Mood Disorders
                Depression
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Suicide
                Social Sciences
                Law and Legal Sciences
                Criminal Justice System
                Prisons
                Prisoners
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Personality Disorders
                People and places
                Geographical locations
                South America
                Chile (Country)
                Biology and Life Sciences
                Psychology
                Addiction
                Alcoholism
                Social Sciences
                Psychology
                Addiction
                Alcoholism
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Substance-Related Disorders
                Alcoholism
                Medicine and Health Sciences
                Public and Occupational Health
                Substance-Related Disorders
                Alcoholism
                Custom metadata
                Data are available from figshare: https://figshare.com/s/04e54cf539d295216a0e (DOI: 10.6084/m9.figshare.7798517).

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                Uncategorized

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