Abstract
Studies of incarcerates with serious mental illnesses have found elevated rates of chronic medical conditions such as asthma and diabetes, and of infectious diseases such as tuberculosis compared with general population rates. This study explored the pattern of chronic medical conditions in a sample of adult detainees in psychiatric treatment in a large urban jail to develop a clinical profile encompassing the full range of medical conditions. A total of 431 male and female detainees were sampled with certainty from admissions to a residential psychiatric treatment program (overall recruitment rate = 67%). Interviews used the World Mental Health version of the Composite International Diagnostic Interview to assess psychiatric and substance use disorders per DSM-IV criteria and chronic medical conditions. Latent class analysis was conducted using 17 medical conditions as class indicators, yielding a 3-class model composed of: a latent class with a high to intermediate probability of multiple medical conditions (HMC; 12.5% of the sample); an intermediate class with a lower probability of having a smaller number of medical conditions (MMC; 43.2%); and a class with a low probability of any medical condition (44.3%). Those in the HMC class were more likely to report respiratory problems, severe headaches, musculoskeletal pain, hypertension, and arthritis, have greater functional impairment, and have a higher number of co-occurring psychiatric disorders. Being older (50+ years) and female were associated with higher odds of being in the HMC or MMC classes. The policy implications for providing medical care to incarcerates with complex mixtures of medical conditions and psychiatric disorders are considered.
Highlights
Studies of incarcerates with serious mental illnesses have found elevated rates of chronic medical conditions such as asthma and diabetes, and of infectious diseases such as tuberculosis compared with general population rates
As with many studies of the general population, research examining the prevalence of chronic medical conditions in incarcerate populations has documented single disorders or factors related to single disorders but have not investigated how conditions might cluster both within as well as across different classes of disorders
The most common conditions were as follows: frequent and severe headaches (42.7%), back and neck problems (36.8%), and arthritis (29.4%). These results suggest that physical pain and musculoskeletal problems, perhaps secondary to trauma, are among the primary medical concerns among the population of jail detainees in psychiatric treatment
Summary
Studies of incarcerates with serious mental illnesses have found elevated rates of chronic medical conditions such as asthma and diabetes, and of infectious diseases such as tuberculosis compared with general population rates. Jane Addams College of Social Work, University of Illinois at Chicago, or disabilities expected to last longer than a year, and that with the aging of the US population, the prevalence of multi-morbidity is likely to increase.[3] As with cooccurring psychiatric conditions, those with co-occurring chronic medical conditions tended to be more functionally impaired and to use a disproportionate number of services. Rates of multi-morbidity that include co-occurring medical as well as psychiatric and substance use disorders may be especially high among those under the supervision of the criminal justice system and higher still among incarcerates with serious mental illnesses (SMI) and CODs. Studies of jail, prison, and probation populations have consistently found elevated rates of both psychiatric and substance use disorders relative to the general population.[4,5,6,7] Most recently, studies of incarcerate populations have found elevated rates of chronic medical conditions as well as infectious diseases relative to comparison groups derived from the general population. Treatment could be more effective if the prevalence and mutual associations among co-occurring conditions were better understood, leading to the development of clinical guidelines for treating medically complex cases
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
