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At least 433 records · Page 24Linked to original sources
PubMed1998

Prevalence of psychiatric morbidity among convicted inmates in a Nigerian prison community.

Studies of psychiatric morbidity in Nigerian prisons have not involved assessment for specific psychiatric disorders. The general aim of this study was to highlight the prevalence of psychiatric morbidity among convicted inmates at a medium security prison in Nigeria. In a one month period in 1996, 100 inmates (93% males, mean age, 31.4 years) of the prison in Benin City, were assessed, using the General Health Questionnaire (GHQ-30) and the Psychiatric Assessment Schedule (PAS). The 34 subjects who scored upto GHQ-30 cut-off, four, had specific axis I DSM III-R diagnoses, including, schizophrenia in two, major depression in two in recurrent mild depression in twenty one, generalised anxiety disorder in eight and somatisation disorder in one. On axis II, six subjects had antisocial personality disorder while another subject had probable mild mental retardation. On Axis III, 15 subjects had chronic physical illnesses, including one with epilepsy. Twenty five inmates had past histories of drug abuse prior to imprisonment, including cannabis (11%) and alcohol (13%). Total PAS scores were significantly predicted only by GHQ scores and length of stay in prison. There was no association between offence committed and psychiatric morbidity. Most subjects with psychiatric morbidity developed these illnesses while in prison. The findings differed from the situation in developed countries where personality disorders and substance use are much more prevalent. The fairly high level of psychiatric disorders underscores the need to improve medical services in the prison.

Adult↗
PubMed1996

"Just using old works": injecting risk behaviour in prison.

A minority of injecting drug users engage in high risk injecting behaviours when in prison. In the United Kingdom between a quarter and a third of injectors who enter prison inject when in prison, and of these about three-quarters share needles and syringes. In the present study, 44 drug injectors who had been released from prison for no longer than 6 months were recruited and interviewed in three geographical areas in England. Interviewees were asked to recount their experiences of drug use during their most recent period of imprisonment. The majority of interviewees were male (38/44), had a mean age of 28 years, with a mean age of 16 years at first drug use, were primarily opiate users (39) and had multiple imprisonments. All respondents reported drug use when imprisoned and drug injecting was reported by 16 interviewees. Most injected at irregular intervals and at a reduced level, compared with injecting when in the community. Nine reported using needles and syringes that others had previously used. When considering other injecting equipment, more sharing occurred than was actually reported. Much re-use of equipment was viewed simply as "using old works". The sharing of "cookers" and "filters", and drug sharing by "backloading" and "frontloading" were common. The concept of "sharing" tended to be understood by respondents as related to the use of tools of injection (needles and syringes rather than other equipment); the use of tools in the act of injection (rather than for mixing drugs); proximity (multiple use of needles and syringes in the presence of others); temporality (shorter time elapse between consecutive use of needles and syringes previously used by another) and source (hired rather than borrowed or bought). We conclude that syringe sharing is an integral part of drug use and drug injecting in prison. Many of those interviewed displayed a restricted understanding of what denotes syringe sharing. Our data reinforce the need for interventions and initiatives to be developed within prisons to deal with the considerable risk posed by continued injecting drug use.

Journal Article↗
PubMed1998

Methadone maintenance treatment reduces heroin injection in New South Wales prisons.

The purpose of this study was to examine whether methadone maintenance treatment reduces injecting risk behaviour (and therefore transmission of blood-borne viral infections) among prisoners in New South Wales (NSW), using comparison of retrospective reports of drug use in prisons for people who received standard drug treatment, time-limited methadone treatment and methadone maintenance treatment. The setting for the study was the NSW prison system. One hundred and eighty-five injecting drug users who had been recently released from NSW prisons were recruited in 1993. Self-reported drug use and injecting risk behaviour were compared in inmates who received standard drug treatment (counselling), time-limited methadone treatment and methadone maintenance treatment. HIV status was determined by serology. Intervention comprised high and low dose methadone treatment and counselling. The groups were similar in terms of most basic demographic characteristics but subjects who had been maintained on methadone reported a significantly lower prevalence of heroin injection, syringe sharing and scored lower on an HIV Risk-taking Behavioural Scale than subjects who received standard drug treatment and time-limited methadone treatment. This study suggests that methadone treatment is associated with reduced injecting risk behaviour in prison with adequate (greater than 60 mg) dose and duration in treatment. These treatment conditions are known to increase effectiveness in community-based methadone programmes. Prospective studies are required to evaluate the effectiveness of methadone programmes in the prevention of HIV and other blood-borne viral infections among IDU prisoners.

Journal Article↗
PubMed2002

Raising the "civilized minimum" of pain amelioration for prisoners to avoid cruel and unusual punishment.

This Article addresses the problems with our nation's cultural and legal prohibitions against certain pain management treatments. The practice of pain management has not kept pace with the many medical advances that have made it possible for physicians to ameliorate most pain. The Author notes that some patients are denied access to certain forms of treatments due to the mistaken belief that addiction may ensue. Additionally, some individuals are under-treated for their pain to a greater degree than are others. This is especially the case for our nation's prisoners. The Author contends that prisoners are frequently denied effective pain amelioration. He notes, however, that there has been improvement in medical treatment in general for prisoners due to court challenges based on the Eighth Amendment's prohibition against cruel and unusual punishment. Yet, due to the protection of qualified immunity given to jailers and prison health care providers, prisoners cannot bring a claim for negligence or medical malpractice, they must allege a violation of their constitutional rights, a significantly higher legal standard. Prisoners must meet a subjective test showing that there was a deliberate indifference to their medical needs that violates the protection of the Eighth Amendment. The Author concludes that because medical advances have made it possible to alleviate most pain suffering, withholding pain treatment or providing a less effective treatment is tantamount to inflicting pain and should be viewed as a violation of the Eighth Amendment.

Journal Article↗
PubMed1979

[Women in prison : A social inconvenance!].

The authors recall the origins of the two prisons for women in Quebec (Tanguay and Gomin) and of the one at Kingston in Ontario, They describe the sociological data of the prisoners and their need for institutional security. They then criticize the existing institutional programs and the high degree of security imposed on the prisoners, neither of which correspond to their actual needs. Why these deficiencies ? The prison authorities justify their lack of response by the fact that the out-of-province prisoners are dangerous and by the fact that their small number does not justify the heavy investments required to circumvent the problem. The authors finally describe the negative consequences of the internment on the prisoners and propose tentative solutions to the existing situation.

English Abstract↗
PubMed2007

Human herpesvirus 8 and human herpesvirus 2 infections in prison population.

Incarcerated persons have high rates of infectious diseases. Few data on the prevalence of sexually transmitted diseases in prisoners are available. This multi-center cross-sectional study enrolled 973 inmates from eight Italian prisons. Demographic and behavioral data were collected using an anonymous standardized questionnaire and antibodies to HIV, HCV, HBV, HSV-2, and HHV-8 were detected in a blood sample obtained from each person at the time of the enrollment in the study. Two hundred and two out of the 973 subjects (20.7%) had antibodies against HHV-8. HHV-8-seropositive subjects were more likely to be older than 30 years with a higher educational level. HHV-8 infection was associated significantly with HBV (P < 0.001) and HSV-2 (P = 0.004) seropositivity and with previous imprisonments. Multivariate analysis showed that HHV-8 infection in Italian inmates was associated with HBV (P < 0.001) and HSV-2 (P = 0.002) seropositivity otherwise among foreigners inmates HHV-8 was significantly associated with HBV infection (P = 0.05). One hundred and eighty-six (21.2%) prisoners had anti-HSV-2 antibodies. At multivariate analysis HSV-2-positivity was significantly associated with HIV (P < 0.001) and HHV-8 infections (P = 0.003), whereas it was inversely associated with HCV infection (0.004). A relatively high seroprevalence of HHV-8 and HSV-2 among Italian prison inmates was found. The association of HHV-8 and HSV-2 infections suggest sexual transmission of these viruses among Italian prison inmates.

Adult↗
PubMed2005

Gambling and problem gambling among recently sentenced women in new zealand prisons.

Ninety-four recently sentenced women prisoners were interviewed to assess aspects of their gambling involvement, problem gambling and relationships between gambling and criminal offending. A third of the women, on the basis of their SOGS-R scores, were assessed as lifetime probable pathological gamblers and just under a quarter were assessed as probable pathological gamblers during the 6 months prior to imprisonment. For women prisoners, a preference for non-casino gaming machines and housie were predictive of problem gambling. Relative to non-problem gamblers, problem gamblers experienced higher rates of childhood conduct disorder and current non-psychotic mental disorder. Just over a quarter of prisoners and a half of the problem gamblers had committed a crime to obtain money to gamble. Few women said their early offending or convictions related to gambling. It was concluded that most women were "criminals first and problem gamblers second" rather than people whose offending careers commenced as a consequence of problem gambling. However, the extent of problem gambling-related offending among the women prisoners highlights the potential for comprehensive assessment and treatment programs in prison to reduce recidivism and other adverse impacts of problem gambling and gambling-related offending.

Adult↗
PubMedDate not supplied

Conducting research as a visiting scientist in a women's prison.

Incarcerated populations have disparities in health risks and illness conditions meriting study, but the history of prison research is marred by unethical conduct. Ethical participation strategies are discussed in the context of studies implemented by the author in a state prison system. This study used ethnographic approaches, observed adherence to federal and institutional review board regulations and corrections department directives, and maintained continuous communication with vested interests to provide entry and long-term access for studies on female prisoners and their civilian infants. A culture clash between the punitive restrictive environment that serves the custody-control-care mission of corrections systems and the open inquiry environment needed for conduct of health research exists. Federal regulations protect prisoners as human subjects but additional vigilance and communication by researchers are required. Gaining and maintaining access to prison inmates for nursing research are leadership challenges that can be met within the caring and collaborative paradigm of nursing.

Female↗
PubMed2004

[Liaison psychiatry in the prison of Rottenburg (Germany)].

The aim of this study was to get an idea of the need of psychiatric therapy in a prison. We report on the period May 2000 to January 2002. 60 medical files with the sociodemographic variables and the psychiatric diagnosis were evaluated. 45 % of the examined prisoners had a diagnosis of drug- or alcohol dependency and 31.3 % had a diagnosis of a schizophrenia. In 26.7 % the therapy was successful and the prisoners improved. This results show a great need of psychiatric therapy in a prison. Also in a prison improvements in the course of psychic disturbances are possible.

Adult↗
PubMed1989

HIV counselling in prisons.

HIV presents particular problem in penal establishments: the nature of the population; conditions in prison; media attention and misinformation; the possibility of transmission within and beyond the prison population; the extra issues that apply to female prisoners. These are discussed in the context of prison policy regarding HIV and the broad strategic approach which is being adopted to manage the problem of HIV within penal institutions. Counselling has a key role in the overall strategy. Pre- and post-test counselling with prisoners is described and the particular problems presented by inmates are discussed and illustrated by reference to case histories. Developments in counselling provision for inmates are outlined.

AIDS Serodiagnosis↗
PubMed2006

Smoking and its correlates in an Australian prisoner population.

Despite evidence of high rates of smoking among prisoners, there has been limited research that describes smoking patterns and risk factors associated with smoking in this group. This study describes inmate smokers and identifies factors associated with smoking in prison, using a survey comprising a cross-sectional random sample of inmates stratified by sex, age and Aboriginality. A total of 914 adult inmates (747 men, 167 women) were recruited from 29 New South Wales (Australia) correctional centres. Information on the prevalence of smoking, smoking history, smoking behaviours and other risk factors were collected. Of the participants, 79% were current smokers (78% men, 83% women). Younger inmates were more likely than older inmates to smoke (86% vs. 64%). Most individuals smoked between 11 and 20 cigarettes a day and a median of 50 grams per week. In the previous year, over half (52%) of current smokers had attempted to quit or reduce the amount they smoked. At the time of the survey, 58% of smokers had plans to quit; 21% within 3 months. Independent predictors of current smoking in the multivariate analysis were past use of cannabis and a history of illicit drug use. The prevalence of smoking in prison is extraordinarily high and exceeds that of the general community. Despite this, the majority of prisoners report plans to quit. Readily available smoking cessation advice, support and treatment are needed to assist those wanting to quit in this stressful environment. As the prevalence of smoking within the general community declines, assisting cessation in groups containing a disproportionate number of smokers will become increasingly important. Despite high levels of tobacco dependence, many prisoners intend to quit and health planners and custodial authorities need to encourage and support inmates who do attempt to quit.

Adult↗
PubMed2005

Hepatitis C virus infection among prisoners in the California state correctional system.

BACKGROUND: Incarcerated populations are at high risk for hepatitis C virus (HCV) infection, yet prisoners are not routinely screened or treated for HCV infection. Understanding the risk factors of HCV infection among prisoners could help improve HCV interventions. METHODS: Prevalence and risk of HCV infection among 469 prisoners entering California State correctional facilities were assessed using HCV antibody screening, HCV RNA measurement, and structured interviews. Multivariate logistic regression analysis was used to identify independent correlates of HCV infection. RESULTS: The prevalence of HCV infection was 34.3% overall (95% confidence interval [CI], 30%-38%) and was 65.7% among those with a history of injection drug use (IDU), compared with 10.2% among those with no history of IDU (odds ratio [OR], 17.24; 95% CI, 10.52-28.25). Significant differences in HCV antibody positivity were found in association with age at first detention but not with the nature of the crime. Independent correlates of HCV infection included age, history of IDU, cumulative time of incarceration, biological sex (OR for females subjects compared with males subjects, 0.35; 95% CI, 0.13-0.96), and a history of having sex with a male IDU (OR, 4.42; 95% CI, 1.46-13.37). We identified significant differences in risk factors between male and female subjects--notably, that the risk of HCV infection was significantly elevated among female non-IDUs who reported having sexual partners with a history of IDU. Among non-IDUs, correlates of HCV infection included history of receipt of blood products and cumulative years of incarceration. CONCLUSIONS: HCV infection is pervasive among the California prison population, including prisoners who are non-IDUs and women with high-risk sexual behavior. These results should promote consideration of routine HCV antibody screening and behavioral interventions among incarcerated men and women.

Adult↗
PubMed1994

Outbreak of multi-drug-resistant tuberculosis in a New York State prison, 1991.

In the summer of 1991, four inmates from prison A in Upstate New York died of multi-drug-resistant tuberculosis. To determine the extent of resistant tuberculosis at prison A and transmission patterns, the authors interviewed staff and reviewed medical records and inmate movement histories. Contact investigation results were examined to determine tuberculin skin test conversions and to estimate risk of infection and disease for inmates who were seropositive for human immunodeficiency virus (HIV). Eight HIV-positive inmates and one HIV-negative guard, who was immunocompromised with cancer, had multi-drug-resistant tuberculosis. Eight died, a median of 28 days after the first culture-positive specimen was collected. All isolates had identical seven-drug resistance and DNA fingerprint patterns. Of exposed inmates, 92 out of 306 (30%) had skin test conversions. HIV infection was not associated with becoming infected with drug-resistant tuberculosis (active disease or skin test conversion), but once infected, HIV-positive inmates were significantly more likely to develop disease than were HIV-negative inmates (p < 0.001). The source case transferred to prison A in February 1991, was ill with undiagnosed multi-drug-resistant tuberculosis, refused medical care, and lived in the general prison population, where he transmitted the disease to other inmates. Lapses in infection control and laboratory delays contributed to this outbreak. Prisons should fully implement infection control guidelines to prevent tuberculosis transmission.

Adult↗
PubMedDate not supplied

Hepatitis B vaccination practices in state and federal prisons.

OBJECTIVE: Incarcerated populations are a group at high risk for hepatitis B. About 30% of people experiencing acute hepatitis B virus infection (HBV) have a history of incarceration. Offering routine HBV vaccinations to incarcerated individuals could have a significant effect on public health. The objective of this study is to identify current vaccine practices and the perceived feasibility of routine vaccinations for hepatitis B within correctional settings. METHOD: The authors surveyed the medical directors of state correctional facilities in all 50 states and the federal prison system regarding current HBV vaccine practices. Surveys were faxed or mailed between July 1 and September 1, 2000. RESULTS: Thirty-five states and the federal system responded (response rate = 70.6%). These systems account for 77% of all inmates in federal or state prisons and jails. Two states give hepatitis B vaccine routinely, nine states offer no hepatitis B vaccine, and 26 states and the Federal Bureau of Prisons offer hepatitis vaccine to some inmates. Most states do not spend enough money to vaccinate even those prisoners at highest risk. Under the Vaccine for Children program, 19,520 youths could receive vaccine immediately. According to the respondents, if vaccine were available at no-cost, 25 states and the Federal Bureau of Prisons would routinely offer vaccination to all inmates. CONCLUSIONS: Most correctional systems do not routinely offer vaccine to their incarcerated populations, but would if funds were available. There exists now a unique public health opportunity to prevent a significant proportion of new hepatitis B infections.

Adolescent↗
PubMed2006

Estimating the cost-effectiveness of detecting cases of chronic hepatitis C infection on reception into prison.

BACKGROUND: In England and Wales where less than 1% of the population are Injecting drug users (IDUs), 97% of HCV reports are attributed to injecting drug use. As over 60% of the IDU population will have been imprisoned by the age of 30 years, prison may provide a good location in which to offer HCV screening and treatment. The aim of this work is to examine the cost effectiveness of a number of alternative HCV case-finding strategies on prison reception METHODS: A decision analysis model embedded in a model of the flow of IDUs through prison was used to estimate the cost effectiveness of a number of alternative case-finding strategies. The model estimates the average cost of identifying a new case of HCV from the perspective of the health care provider and how these estimates may evolve over time. RESULTS: The results suggest that administering verbal screening for a past positive HCV test and for ever having engaged in illicit drug use prior to the administering of ELISA and PCR tests can have a significant impact on the cost effectiveness of HCV case-finding strategies on prison reception; the discounted cost in 2017 being pound2,102 per new HCV case detected compared to pound3,107 when no verbal screening is employed. CONCLUSION: The work here demonstrates the importance of targeting those individuals that have ever engaged in illicit drug use for HCV testing in prisons, these individuals can then be targeted for future intervention measures such as treatment or monitored to prevent future transmission.

Adult↗
PubMed2003

Psychiatric treatment in prison: a missed opportunity?

National Health Service Executive guidelines require psychiatric services to maintain links with prisoners previously subject to the Care Programme Approach (CPA) and to participate in discharge planning. We are unaware of previous studies assessing the involvement of general psychiatric services with patients in prison or prisoners' perceptions of their needs. Consecutive referrals to a prison psychiatric liaison service over a three-month period were screened for previous psychiatric contact. Half of those interviewed reported previous psychiatric contact. Two-thirds were in contact with services at the time of detention. One-third believed services knew of their imprisonment. Ninety-three per cent believed they would require psychiatric support after release. Few patients received input from general psychiatric services during imprisonment despite a high level of perceived need. Improved liaison would help facilitate both care in prison and discharge planning in the spirit of CPA and the government directive.

Criminal Psychology↗
PubMed2002

Expansion of long-term care in the prison system: an aging inmate population poses policy and programmatic questions.

Throughout the United States, departments of corrections are experiencing increases in their inmate populations. More specifically, the number of aging inmates is increasing and will continue to grow as younger prisoners who have long sentences with no possibility of parole age in prison. In addition, the number of younger inmates with illnesses such as AIDS has increased. Although long-term care can be required by individuals of any age, the need for such assistance tends to increase with age. Long-term care, therefore, can be seen as an issue confronting prisons with aging inmate populations. Yet, little is known about the nature or extent of the need. This paper focuses on older inmates and includes reasons for the increased need for long-term care in the prison setting. The standard for prison health care, the long-term-care status of older inmates, and examples of long-term-care services and facilities are described. Key questions related to furnishing long-term care to an older incarcerated population are identified. Recommendations are presented for both corrections and long-term-care providers and policymakers as they develop strategies to address this challenge.

Aged↗
PubMed2006

[Forensic psychiatry ethics: expert and clinical practices and research on prisoners].

OBJECTIVE: Review the most relevant ethical issues of the tripartite aspects on which forensic psychiatry is based: expert activity, treatment of the mentally ill in prisons, and research on prisoner subjects. RESULTS AND DISCUSSION: The principles of General Medical Ethics and those of Forensic Medical Ethics are discriminated and confronted and the steps the psychiatrist should take both as an expert and as a clinician to follow the ethical principles of his profession are indicated. A succinct résumé of the research on prisoners is offered and the basic principles, which, if respected, would keep a balance between the need for carrying out research in prisonal environments and the safeguard of prisoners' rights are suggested. CONCLUSION: It is fundamental for the forensic psychiatrist the knowledge and implementation of the ethical principles that govern his practice so that he will effectively respect the basic rights of the individuals he treats or researches with.

Brazil↗