Abstract
BackgroundMajor mental disorders in prison populations have been recognised as a long-term problem with an important impact on public health. Despite this, screening activities in prisons are still weak in Latin America. We proposed to estimate the prevalence of depression and psychosis and associated factors in the largest Ecuadorian prison for male inmates.MethodsCross-sectional study with 309 prisoners chosen at random between January and February 2017, who were administered two structured questionnaires. The first examined socio-demographic and occupational characteristics prior to incarceration and presence of social support networks; the second was the Mini International Neuropsychiatric Interview version in Spanish 5.0.0. We used maximum likelihood tests and multiple logistic regression to assess associations between depression, psychosis and study factors.ResultsThe prevalence of depression and psychosis were 50.2% (95% CI 44.6–55.8) and 25.9% (95% CI 21.0–30.8), respectively. The two conditions occurred together in 22.0% of the cases (95% CI 14.8–29.2), and depression or psychosis (D/P) was found in 54.0% (95% CI 48.4–59.6). Consuming drugs while in prison was found in 41.4% (95% CI 35.9–46.9). When age was considered among those consuming drugs, the prevalence of D/P were 72.2, 88.0, and 92.3%, respectively for the age-groups 18–29, 30–39 and 40 years or over (p-value < 0.001). Using a multivariate model, we found that not receiving visits (AOR 3.15 95%CI 1.42–6.96) and consuming drugs while in prison (AOR 5.85 95%CI 3.06–11.16) were associated with D/P, while the age effect disappears. Inmates who stopped drug consumption in prison or who had never consumed did not present any significant differences.ConclusionsDepression and psychosis in prisoners are strongly affected by the absence of visitors and by consumption of drugs in prison. Greater presence of social support networks and preventive actions targeting drug abuse would contribute to improving the mental health of prison inmates.
Highlights
Major mental disorders in prison populations have been recognised as a long-term problem with an important impact on public health
We proposed to quantify the prevalence of depression or psychosis and relationships with demographic, social, and drug abuse factors among male prison inmates in the Ecuadorian prison with the largest male population, through a cross-sectional study, with the aim of contributing epidemiological information to the mental health system in a penitentiary setting that was recently incorporated into the new health model for prisons
Demographic and social characteristics Demographic and social characteristics and data on past incarceration and patterns of drug use are presented in Estimation of the prevalence of depression, psychotic illness and drug consumption Overall, the prevalence of depression was 50.2%, and of psychosis, 25.9%; the prevalence of the two disorders simultaneously was 22.0%, and depression or psychosis (D/P) was present in 54.0%
Summary
Major mental disorders in prison populations have been recognised as a long-term problem with an important impact on public health. We proposed to estimate the prevalence of depression and psychosis and associated factors in the largest Ecuadorian prison for male inmates. Depression and psychotic illness are among the most common mental disorders in prisons [1] and have been recognized as a public health problem for several reasons. Priority is given to treating acute rather than chronic problems, the prevalence of the latter is much higher than in the general population. A recent systematic review of information from over 24 countries and a population of 33,588 prison inmates found that the prevalence of depression and psychosis was 10.2 and 3.6%, respectively [3]. Data for South America are scarce; Andreoli and colleagues (2014) found depression in 12.3% of 1192 male prisoners in the state of Sao Paolo, Brazil between 2006 and 2007 [5] and Pondé and colleagues obtained figures of 17.6, 1.4, and 27.9% for depression, psychosis, and drug abuse, respectively, in 497 prison inmates in the city of Salvador, Brazil, using the Mini International Neuropsychiatric Interview [6]
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