High Psychiatric Morbidity and Comorbidity Among Female Prisoners in Hunan, China.

Shaoling Zhong,Xiaoxi Liang,Fanglan Wang,Huijuan Guo,Jiansong Zhou,Yanan Chen,Xiaomin Zhu,Chenyuli Luo,Hui Chen,Xiaoping Wang

doi:10.3389/fpsyt.2020.00271

Abstract

BackgroundHigh prevalence of mental disorders has been found among female prisoners in Western countries, however, little is known about the epidemiology of mental disorders in such populations in China. This study aims to investigate psychiatric morbidity and comorbidity among sentenced prisoners in a female prison in China.MethodsA cluster sample of 2,703 female adult prisoners from Hunan Provincial Female Prison were interviewed with the Mini International Neuropsychiatric Interview, a semi-structured Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV) mental disorder diagnostic tool. The rates of psychotic disorders, affective disorders, anxiety disorders, and substance use disorders were reported.ResultsNearly 2/3 (66.2%, N=1,790) of the sample fulfilled the criteria for at least one lifetime DSM-IV disorder 36.5% had major depression, 22.2% had post-traumatic stress disorder (PTSD), and 16.5% had drug use disorder. Drug use disorders were the major comorbid disorders. 60.8% of people with alcohol use disorder and 37.0% of those with psychotic disorders also had a drug use disorder. More than one-quarter (26.1%) of the population met criteria for a current diagnosis of any mental disorder, of which major depression was the most common (14.7%), followed by PTSD (6.4%) and psychotic disorder (1.8%).ConclusionThe high levels of psychiatric morbidity and comorbidity in a representative sample of female prisoners in China indicate unmet needs that require identification and therapeutic intervention in prisons.

Highlights

IntroductionAccording to a systematic review study in adult prisoners, the prevalence of psychotic illness and major depression is 3.7 and 10.5% in men and is 4 and 12% in women, respectively [2]
In September 2015, the Institute for Criminal Policy Research [1] reported that there were more than 700,000 females in prison worldwide
Among 2,917 female prisoners, 207 were excluded for various reasons—161 prisoners were released during the study period, 21 refused to interview, 14 were in hospitals because of physical diseases, 8 had difficulties in hearing or talking, 2 were released on parole, and 1 was incarcerated

Summary

Introduction

According to a systematic review study in adult prisoners, the prevalence of psychotic illness and major depression is 3.7 and 10.5% in men and is 4 and 12% in women, respectively [2]. The prevalence of psychotic illness and major depression in the general population with similar age is 0.4 and 2.1% in the UK [3], and 0.5 and 4.6% [5] in China, respectively. The various prevalence rates suggest that prisoners have two- to ten-fold excess morbidity of psychotic illness and major depression than the general population. Fazel and colleagues [6] systematically reviewed severe psychiatric morbidity in 33,588 prisoners across 24 countries and found the prevalence of major depression and psychosis was 14.1 and 3.9% in female prisoners respectively, while for male prisoners the rates were 10.2 and 3.6%.

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