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PubMedDate not supplied

Richard Pearson Strong and the iatrogenic plague disaster in Bilibid Prison, Manila, 1906.

In November 1906, Richard Pearson Strong, then head of the Philippine Biological Laboratory, inoculated 24 men--inmates of Manila's Bilibid Prison--with a cholera vaccine that somehow had been contaminated with plague organisms; 13 men died. The governor-general of the Philippines appointed a general committee to investigate the affair, and the U.S. Senate demanded information about the episode. Although the Senate, the secretary of war, and even the president were kept informed of developments, no mainland investigations ensued. The general committee concluded that Strong was negligent for not having locks on his incubators and for leaving a visiting physician alone in the laboratory, where he might have mixed up the cholera and plague cultures on the fateful day. The committee's charge was referred to the attorney general, who found Strong innocent of criminal negligence, whereupon the governor-general exonerated Strong. Strong was despondent over Bilibid but recovered and developed a noteworthy career in American tropical medicine. In retrospect, the disaster at Bilibid presents an epitome of the problems surrounding the use of prisoner-subjects without authorization and without their voluntary consent. Far ahead of its time, the general committee recognized and condemned the shortcomings and urged reform, pleas the government ignored. The Bilibid episode remains, however, as a cautionary tale for those engaged in clinical research.

Cholera Vaccines↗
PubMed1989

Temporal trends of human immunodeficiency virus type 1 (HIV-1) infection among inmates entering a statewide prison system, 1985-1987.

Acquired immune deficiency syndrome (AIDS) became the leading cause of death among Maryland State prisoners in 1985. To identify the prevalence, risk factors, and temporal trends for infection with the human immunodeficiency virus type 1 (HIV-1) in the statewide prison system, excess sera were obtained from incoming male inmates during specified periods between April and June 1985, 1986, and 1987. Correctional medical personnel also provided demographic variables of age, race, offense category, sentence, jurisidiction, and an indicator of intravenous drug use. Once rendered anonymous, specimens were assayed for antibody to HIV-1, using ELISA and Western blot techniques. For data from April to June 1985, 1986, and 1987, the crude prevalence of anti-HIV-1 was 7.1, 7.7, and 7.0%, respectively. Although one-third of incoming inmates were identified as intravenous drug users (IVDUs), the drug use variable was missing for 70% of the 1985 sample, and 40% of the 1986 sample. Several strategies were used to examined temporal trends in the context of missing data. Univariate analyses suggested no substantial change over time for either HIV-1 seroprevalence or risk of infection among IVDUs.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1988

Prison medicine.

Prisoners in U.S. correctional facilities constitute a unique patient population in need of health services. Physicians who provide medical services to inmates also must interact with prison officials. Drug withdrawal, self-destructive behavior and infectious diseases, including acquired immunodeficiency syndrome, are a few of the challenges to be met.

Acquired Immunodeficiency Syndrome↗
PubMed1986

The role of the psychiatrist in evaluating a prison mental health system in litigation.

Federal courts during the past 14 years have recognized that many prisons in the United States have provided constitutionally inadequate medical and psychiatric services. Our recent national survey indicates that at least 20 states have had at least one part of their correctional system included in a certified class action suit that alleged insufficient mental health services for inmates. This article reviews the role of the expert psychiatric witness during the phases of litigation that involve proposed remedial plans and compliance in implementing remedial plans. Available epidemiologic data about psychiatric disorders among prison inmates, standards for correctional mental health care, and various mental health system models are briefly reviewed. A comprehensive approach to evaluating proposed remedial plans and assessing issues of compliance with accepted plans is described. Special attention is directed toward psychiatric issues unique to a correctional system.

Forensic Psychiatry↗
PubMed1997

Treating prison inmates with co-occurring disorders: an integrative review of existing programs.

The tremendous growth in state and federal correctional populations has focused greater attention on the needs of mentally ill and substance abusing inmates. Although an estimated 3-11% of prison inmates have co-occurring mental health (psychotic and major mood) disorders and substance abuse disorders, few treatment programs are described in the literature and there is little available information regarding effective treatment strategies for this population. The current study provides an integrative review of seven 'dual diagnosis' treatment programs that recently have been developed in state and federal prisons. Many of these have evolved from existing substance abuse treatment programs and approaches. Key program components include an extended assessment period, orientation/motivational activities, psychoeducational groups, cognitive-behavioral interventions such as restructuring of 'criminal thinking errors', self-help groups, medication monitoring, relapse prevention, and transition into institution or community-based aftercare facilities. Many programs use therapeutic community approaches that are modified to provide (a) greater individual counseling and support, (b) less confrontation, (c) smaller staff caseloads, and (d) cross-training of staff. Research is underway in three of the seven sites to examine the effectiveness of these new programs.

Adult↗
PubMed1976

Personality deviancy and prison incarceration.

This investigation was designed to study personality differences among prison inmates that could be attributed to the number of felony offenses and the length of incarceration. MMPI profiles of 93 inmates of a medium security prison were obtained and analyzed. Special attention was directed to the five MMPI variables K, D, PD, SC, and MA. These five variables taken collectively successfully differentiated first offenders from repeaters and short-term from long-term inmates. The results support the hypothesis that increased incarceration has a harmful effect upon personality.

Antisocial Personality Disorder↗
PubMed1979

Longitudinal post-validation of the MMPI Escape (EC) and Prison Adjustment (AP) scales.

Conducted a longitudinal 3-year post-validation study of the MMPI Escape (Ec) and Prison Adjustment (Ap) scale score of 301 male felon inmates convicted of major type crimes and serving sentences of 5 years or more within the North Carolina Correctional System. Examination of the escape and infraction records of these inmates in relationship to their Ec and Ap scale scores demonstrated that the two scales were still effective classification instruments in predicting escape from within prison units that provided inner and perimeter security and in predicting the committing of major rule infractions irrespective of the degree of custodial control. Caution was expressed concerning the use of the Ec and Ap scale scores without supportive date from their classification procedures.

Criminal Psychology↗
PubMed1993

Prevalence and incidence of hepatitis C virus infection among male prison inmates in Maryland.

To identify incidence of antibody to hepatitis C virus among 265 male prison inmates, we assayed paired serum specimens obtained at intake in 1985-1986 with follow-up specimens in 1987. Intake prevalence was 38 percent. Seroincidence was 1.1/100 person years in prison. This finding might reflect saturation of high-risk subgroups or possibly reduced frequency of exposures following incarceration.

Adult↗
PubMed1994

Suicide in prison: a study of France from 1852 to 1913.

Prison suicide rates in France from 1852 to 1913 were strongly correlated with the overall male suicide rate in France. Measures of domestic social integration were associated with both of these suicide rates, but were less successful in accounting for the prison suicide rate than the overall male suicide rate.

France↗
PubMedDate not supplied

Deliberate ingestion of foreign bodies by institutionalised psychiatric hospital patients and prison inmates.

Deliberate and recurrent foreign body ingestion is a common problem among institutionalised patients. We review our experience with 36 cases of deliberate foreign body ingestion by prisoners or psychiatric patients, thirty of whom were institutionalised at the time of ingestion. Symptoms were frequently severe in the prison inmate group but, in contrast, psychiatric patients presented with few, if any, symptoms. A majority of objects pass spontaneously or remain in situ without complication. Twenty-four patients were discharged following initial evaluation and without specific treatment. Eight of these were reviewed electively and discharged within one week. Twelve patients were admitted for observation, seven of whom were discharged within 48 hrs. Upper gastrointestinal endoscopy was performed in four patients and an intragastric foreign body identified in two cases. Laparotomy was performed in two cases for unresolving mechanical intestinal obstruction. Management should be conservative when possible, with surgery indicated only for complications.

Adolescent↗
PubMed2004

Psychometric and psychopathological characterization of young male prison inmates with and without attention deficit/hyperactivity disorder.

There is considerable evidence that attention deficit/hyperactivity disorder (ADHD) is associated with conduct problems, social maladaptation and delinquent behavior. The "Ottweiler Study" was performed to elaborate the prevalence of ADHD and comorbid disorders in 129 young adult detainees of the juvenile prison of Ottweiler (Germany) according to DSM-IV and ICD-10 criteria. Here we report psychopathological characteristics of 28 inmates, who fulfilled the diagnostic criteria for persisting ADHD, and 37 individuals with neither a history nor current ADHD symptoms. Childhood ADHD symptoms but no current ADHD were present in 64 individuals. The Wender-Reimherr Interview (WRI) based on the Utah criteria for adult ADHD, the NEO-five factor personality inventory (NEO-FFI) and the youth self report/young adult self report (YSR/YASR) according to Achenbach were used for the assessment of psychopathology and the description of behavioral problems. Regarding WRI and YSR/YASR we found a significant increase of emotional and internalizing problems in the ADHD group compared to delinquents without ADHD or ADHD history. ADHD delinquents scored higher on the personality dimension neuroticism, and showed lower scores on the dimensions agreeableness and consciousness. Using discriminant analysis, high scores on the WRI subscales disorganization and attention difficulties and NEO-FFI neuroticism were the best predictors of ADHD diagnosis. The results support prior findings of high ADHD prevalence in prison inmates and suggest that emotional and internalizing abnormalities are prominent problems in this population. Further studies are needed to elucidate the role of ADHD as an independent factor for life-persistent criminality, since specific treatment may help to ameliorate the legal prognosis.

Adolescent↗
PubMed1991

Hospital management of voluntary total fasting among political prisoners.

In 1989 20 political detainees, held without trial for up to 32 months, were admitted, on hunger strike, to the Johannesburg Hospital, South Africa. Most were held under the regulations of the State of Emergency (since revoked) and 5 were held incommunicado under section 29 of the Internal Security Act (still in force). Guidelines for ethical management were based on the Declaration of Tokyo, which included the understanding that such detentions constituted mental torture. Conditions of detention in hospital were complicated by police interference in medical and nursing care, and by the chaining of some prisoners to their beds. Doctors are in a unique position to protest against inhuman treatment of prisoners, and should use this authority.

Adolescent↗
PubMed1993

Hepatitis B vaccination in prisons: the Catalonian experience.

A pilot programme of hepatitis B vaccination was set up in three prisons to assess the feasibility and results of this method of reaching a high-risk population. Hepatitis B vaccine was offered to all inmates who lacked serological markers for hepatitis B virus. The antibody response was assessed in those who received two or three doses of vaccine. Candidates for vaccination were 41% of 1755 imprisoned men (20% of intravenous drug users (IVDU) and 63% of non-IVDU), but complete vaccination could be given to only 33% of candidates. A further 29% received two doses. Seroconversion to anti-HBs (titres > 10 IU l-1) occurred in 33% of vaccinees after two doses and in 76% after three doses. The overall rate of susceptible inmates who became protected for hepatitis B was 34%. The seroconversion rate was higher when the interval between the first two doses was shorter than 3 weeks (91%), than in cases with an interval of 3-6 weeks (79%) or longer than 6 weeks (33%). Age greater than 35 years and history of IVDU were associated with a lower response to the vaccine, while anti-HIV seropositivity did not influence the response. In conclusion, vaccination of prisoners susceptible to HBV may achieve protection in at least a third of cases. Shortening intervals between the priming doses of vaccine may improve compliance and increases the response.

Adolescent↗
PubMedDate not supplied

Drug abuse treatment in prisons and jails.

Acknowledging the fact that the criminal justice system is currently awash with drug abusers and that prison drug abuse treatment has had a varied history in the United States, this article explores possible directions for the future of drug abuse treatment in prisons and jails. The current status of drug abuse treatment is reviewed, and selected treatment approaches are high-lighted. In addition, evaluation issues are presented, and special issues are reviewed including case management, community follow-up, and methodological considerations. Finally, recommendations are suggested for treatment, research, evaluation, demonstrations, management information, community linkage, training, and technical assistance.

Combined Modality Therapy↗
PubMed2005

Community reintegration of prisoners with mental illness: a social investment perspective.

Responding effectively and efficiently to the needs of persons with mental illness returning to the community from prison requires identifying their differences in need and placement difficulties upon return and targeting reintegration investments to reflect these differences. This paper has three parts. The first part profiles the male special needs population in New Jersey prisons. These profiles describe behavioral health and criminal justice characteristics of 2715 male inmates with mental health problems, and are used to identify the scope and nature of the public's investment opportunity. The next part describes the costs associated with possible "investments." The special needs population is classified by need and placement difficulty, and then matched to reentry and community-based treatment programs. Costs are estimated for reentry planning and community-based treatment for the first year post-release. The third part recommends an investment strategy and a set of operational changes that might minimize the loss and maximize the return on the public's investment dollar in mental health.

Adult↗
PubMed2004

A preliminary study identifying risk factors in drop-out from a prison therapeutic community.

Three different groups of therapy leavers and current residents (total n = 80) from Dovegate Prison's Therapeutic Community (TC) were compared on various demographic, criminogenic and psychometric attributes. Statistically significant findings distinguished the leaver groups from current residents and differentiated between type of leavers. Those leavers judged as unsuitable for therapy were characterised by high scores of Psychopathy, Neuroticism, Criminality, Addiction, Venturesomeness, and Avoidant and Schizoid Personality Disorders. Those leavers who had elected to leave the TC were more likely to have a sexual index offence, significant scores on the Multiphasic Sex Inventory, and Paranoid and Depressive Personality Disorders. Logistic Regression analysis confirmed that particular personality disorders were predictive of therapy leaver group membership. Paranoid Personality Disorder was identified as a predictor of all types of drop-out. These findings provide a psychological profile of the different types of residents who have left a prison therapeutic community and can be used to support and inform selection and assessment practices.

Adult↗
PubMed2005

Treatment during transition from prison to community and subsequent illicit drug use.

This study examined the effects of postrelease transitional therapeutic community treatment on the drug use and employment rates of drug involved prisoners in the Delaware corrections system followed for up to 5 years after release. A comparison group received standard postrelease supervision. Abstinence rates were 32.2% in the treatment group and 9.9% in the no-treatment group, and the treatment group had a higher overall proportion of time free of drug use. Time to relapse was a mean of 28.8 months in the treatment group versus 13.2 months in the no-treatment group. Relapse was defined as any use of any drug and was confirmed by urinalysis. Positive effects were seen even for those who did not complete treatment. The treatment group had a significantly higher rate of employment after leaving work release (54.6%) than did the no-treatment group (45.4%). Treatment during the transitional period between prison and community showed substantial and persistent benefits even for a cohort marked with extensive criminal history, low rates of marital bonds, and substantial unemployment.

Adult↗
PubMed2004

Hepatitis B vaccination in prison with a 3-week schedule is more efficient than the standard 6-month schedule.

A randomized study of injecting drug users in a Danish prison comparing vaccination at 0, 1 and 3 weeks with the 0, 1 and 6 months schedule (20microg Engerix B i.m.) was conducted. Due to a low participation rate, a second nonrandomized study was conducted in Estonia where all prisoners were vaccinated with the short schedule. In the randomized study, the compliance with three doses was 63% (12/19) in the 3-week schedule compared to 20% (3/15) in the 6-month schedule (P = 0.017). In the nonrandomized study, the compliance was 81% (457/566) and the seroprotection rate at month 7 was 67% (97/145), resulting in protection of 54% of the population at risk. This was significantly higher than the estimated 34-42% protection that would have been achieved with the 6-month schedule.

Adult↗