Abstract
Epidemiological studies conducted with prisoners in several countries have shown a high prevalence of mental disorders. To determine the prevalence of psychiatric disorders in the prison population in the State of São Paulo, Brazil. Through stratified random sampling, 1,192 men and 617 women prisoners were evaluated for the presence of psychiatric disorders by the Composite International Diagnostic Interview, 2.1 version, according to definitions and criteria of International Classification of Diseases (ICD-10). The prevalence estimates of mental disorders and their respective 95% confidence intervals were calculated and adjusted for sample design through complex sample analysis. Lifetime and 12-month prevalence rates differed between genders. Lifetime and 12-month prevalence of any mental disorder was, respectively, 68.9% and 39.2% among women, and 56.1% and 22.1% among men. Lifetime and 12-month prevalence of anxious-phobic disorders was, respectively, 50% and 27.7% among women and 35.3% and 13.6% among men, of affective disorders was 40% and 21% among women and 20.8% and 9.9% among men, and of drug-related disorders was 25.2% and 1.6% among women and 26.5% and 1.3% among men. For severe mental disorders (psychotic, bipolar disorders, and severe depression), the lifetime and 12-month prevalence rates were, respectively, 25.8% and 14.7% among women, and 12.3% and 6.3% among men. This study, which was performed with a representative prison population, showed high rates of psychiatric disorders among men and women. Epidemiological studies on mental health needs of prisoners are crucial for planning and development of appropriate health care programs for specific prison populations.
Highlights
Epidemiological studies conducted with prisoners in several countries have shown a high prevalence of psychiatric morbidity
The lifetime and 12-month prevalence for any mental disorder was, respectively, 68.9% and 38.4% among women and 56.1% and 21.5% among men. These rates are two times higher than those found in the general population of Sao Paulo [13] [14] [15]. This is the first large-scale epidemiological study performed with the prison population in Brazil
While rates vary between 0.4% and 7.7% in the general population [28], we found 12-month prevalence rates of 14.7% and 6.9% among women and men prisoners, respectively
Summary
Epidemiological studies conducted with prisoners in several countries have shown a high prevalence of psychiatric morbidity. A few studies have reported high rates of health problems in Brazil’s prison system, including mental disorders. In a women’s prison in Sao Paulo, the prevalence of common mental disorders was reported as being 26.6% [4]. A study conducted in Salvador, in the northeast of Brazil, with 497 prisoners in closed and semiopened systems reported high prevalence rates of mental disorders. The rates found for prisoners in closed systems were 5.2% for bipolar affective disorder, 17.6% for depression, and 1.4% for psychotic disorders. For prisoners in semi-open systems, the rates were 10.1% for bipolar affective disorder, 18.8% for depression, and 12.6% for psychotic disorders [5]
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