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PubMed2001

Anti-depressant prescribing patterns for prison inmates with depressive disorders.

BACKGROUND: Although prison inmates are reported to exhibit elevated rates of depressive disorders, little is known about anti-depressant prescribing patterns in correctional institutions. METHODS: The study population consisted of 5305 Texas Department of Criminal Justice (TDCJ) inmates who were diagnosed with one of three depressive disorders: major depression, dysthymia, and bipolar disorder (excluding those with manic episodes only). Information on medical conditions, sociodemographic factors, and pharmacotherapy was obtained from an institution-wide medical information system. RESULTS: In 1998, 78.2% of all inmates diagnosed with depressive disorders were treated with antidepressant medication. Of these, 47.3% were treated exclusively with tricyclic anti-depressants (TCA); 30.9% were treated with selective serotonin re-uptake inhibitors (SSRI); and 21.8% were not treated with any form of anti-depressant medication. Prescribing patterns varied substantially according to a number of sociodemographic factors under study. LIMITATIONS: Because the present study relied on retrospective, clinical data, the investigators had limited ability to assess: specific symptomatology for each diagnosed depressive condition under study; socio-economic status, pre-incarceration access to health care; and the overall reliability and validity of the data. CONCLUSION: The proportion of prison inmates with depressive disorders who receive appropriate medication management is substantially higher than that reported among similarly diagnosed nonincarcerated samples. It will be important, however, for future investigators to examine the sources of sociodemographic variation in treatment patterns found in the present study.

Adult↗

PubMed2004

[Primary HIV drug resistance in a prison population. REPRICOVA-2 Study].

INTRODUCTION: Currently, there are few reports on primary human immunodeficiency virus (HIV) drug resistance in the prison population. METHODS: This is a descriptive, one-day prevalence study to identify HIV drug-resistant mutations in chronically infected treatment-naïve prisoners. Systematic randomized sampling was performed and genotyping was done by automatic sequencing. RESULTS: A total of 90 patients were studied. Two samples were found to have nucleoside reverse transcriptase inhibitor (NRTI)-resistant mutations, four had non-nucleoside reverse transcriptase inhibitor (NNRTI)-resistant mutations and one had protease inhibitor (PI)-resistant mutations. CONCLUSIONS: There was a low rate of primary resistance in our series. Therefore, resistance testing is not required before prescribing initial antiretroviral therapy in these patients.

Adolescent↗

PubMedDate not supplied

[Comparison of knowledge and risk behavior regarding AIDS among HIV+ and HIV- inmates at the provincial prison of Granada].

We have studied at the Provincial Prison of Granada, during the months of July and August of 1993 the knowledges of the prison inmates about the transmission of the AIDS, measures of prevention, risk behaviors like not use of condoms, use of intravenous drugs and sharing syringes. In total, there were 75 human immunodeficiency virus infected (HIV+) and 78 not infected (HIV-). The percentage of correct answers about transmission were significant, similar to the other studies done population in general. For the risk behaviors among HIV+, only 34.7% of HIV+, reported the of condoms all the times with their partners. Within the HIV+ reported have used intravenous drugs, sometimes 85.3%, sharing syringes only 43% last time. These data suggest that it is necessary to update the in Jail Health Promotion Programmes, in particular stressing the use of condoms and the risk sharing syringes by the HIV+ inmates, and informing about the risk of i.v. drugs consumption in general.

Acquired Immunodeficiency Syndrome↗

PubMed2000

Predicting retention in a residential drug treatment alternative to prison program.

One hundred and fifty felony drug offenders diverted from prison to community-based, residential drug treatment alternative to prison program completed a comprehensive interview as part of a longitudinal study. Treatment completion predictors were sought examining intake data (demographics, family, social, employment, medical, psychological, criminal, sexual behavior, drug use and treatment histories). Logistic regression results found completers had more social conformity and close friends, and less need for employment counseling, felony drug convictions, drug dealing income, and unprotected sex than dropouts. Completers were also less likely to encounter recent problems with significant other, have a psychiatric history, experience gunshot or stabbing, and commenced heroin use at older ages than dropouts. However, completers reported higher alcohol use than counterparts. Further analyses explored subcategory models: "life choice" (substance use, criminal and sexual behavior), static (background and dispositional), and dynamic situational influences (employment, psychological state, recent and past encounters). Treatment implications considering findings are discussed.

Adult↗

PubMed2002

Evaluating component effects of a prison-based treatment continuum.

A continuum of correctional-based therapeutic community (TC) treatment programs for drug-involved offenders has been functioning for several years in Delaware. Previous evaluations have shown the efficacy of the full continuum for up to three years posttreatment, though there has been some question of the benefits of treatment within prison. The particular focus here is on the relative impact of the within-prison, transitional, and aftercare treatment components upon criminal recidivism and relapse to illicit drug use. The relative benefit of participation in each component is supported, over and above the effects of differences in demographics and histories of criminal behavior and illicit substance use. However, the residential transitional program effects are generally larger and more long lasting. Additionally, the two outcomes appear differentially sensitive to the degree of completion of the continuum.

Continuity of Patient Care↗

PubMed2002

A novel opioid maintenance program for prisoners: preliminary findings.

Effective postincarceration treatment for individuals with preincarceration heroin dependence is urgently needed because relapse typically follows release. This article presents first-year findings from a unique 2-year pilot study of opioid agonist maintenance treatment initiated in prison and continued in the community. Incarcerated males with preincarceration heroin dependence were randomly assigned to Levo-alpha-acetylmethadol (LAAM) maintenance or control conditions 3 months before release. Approximately 92% of eligible inmates volunteered to participate; 36 of 58 subjects who were eligible and randomly assigned to LAAM maintenance successfully initiated treatment. Twenty-eight of these continued on LAAM until release; 22 (78.6%) entered community-based maintenance treatment; and 11 (50%) remained in treatment at least 6 months postrelease. Changes in LAAM's labeling because of its association with cardiac arrhythmias now makes it a second-line treatment for heroin dependence, unsuitable for treatment initiation. Nonetheless, study findings may also be applicable to methadone maintenance treatment, suggesting such treatment may be a promising means of engaging prisoners with preincarceration heroin dependence into continuing treatment.

Adult↗

PubMed2003

Deception in prison assessment of substance abuse.

The relationship of The Paulhus Deception Scales (PDS; ) to the Texas Christian University Drug Screen I was investigated in participants screened for a voluntary in-prison substance abuse treatment program. Mean PDS scores for 35 female and 277 male prison inmates were significantly higher than the inmate norms in the test manual. All three PDS scale scores were negatively related to symptom endorsement and to the diagnosis of drug dependence. Almost 37% of participants produced protocols of questionable validity, with 22% faking-good and 14.7% faking-bad. However, over 90% of participants obtained scores that were not covered by the manual's profile typology. These findings underline the importance of deception to correctional assessment and the need for more information on the psychometrics and operating characteristics of the PDS in correctional settings.

Adult↗

PubMed2004

Treating drug using prison inmates with auricular acupuncture: a randomized controlled trial.

This study tested the viability of auricular acupuncture in prisons for alleviating inmates' symptoms of psychological and physical discomfort and reducing their drug use. The experimental NADA-Acudetox protocol was compared with a non-specific helix control protocol in a randomized trial. Over a period of 18 months, a 4-week, 14-session auricular acupuncture treatment program was offered in two prisons to 163 men and women with self-reported drug use. Among treatment completers, no differences by method were found in self-reported symptoms of discomfort. Drug use occurred in the NADA group but not in the helix group. In contrast, confidence in the NADA treatment increased over time while it decreased for the helix treatment. No significant negative side effects were observed for either method. Participants in both groups reported reduced symptoms of discomfort and improved nighttime sleep. Future research should compare auricular acupuncture to a non-invasive control in order to attempt to disentangle active effects from placebo.

Acupuncture, Ear↗

PubMedDate not supplied

Prisons and public health: emerging issues in HIV treatment adherence.

Correctional facilities in the United States are faced with challenges in providing appropriate and timely HIV treatment to incarcerated HIV-infected inmates. Prison and jails, due to their structure, operation, and staff, may present many barriers to HIV treatment and adherence to complicated and expensive HIV treatment regimens. Changes and modifications of prison health care delivery are required to accommodate the needs of HIV-infected inmates. Approaches to improving correctional HIV care and treatment include training health care personnel, prevention education for inmates, increasing access to voluntary HIV testing, comprehensive treatment planning, and continuity of care. Policy changes for correctional systems include adopting current HIV care standards and immediate evaluation for and access to HIV treatment upon entry into the institution. These changes can have a significant impact on the quality of care for inmates, ultimately improving their quality of life and reducing the morbidity and mortality of HIV disease for incarcerated populations.

Allied Health Personnel↗

PubMedDate not supplied

Women prisoners and HIV/AIDS.

In the last decade, both the number of female inmates and the average length of their sentences have increased dramatically. A by-product of the recent "confinement era" within criminal justice is the influx of ill and generally unhealthy female offenders into this nation's correctional institutions. As women in prison have different treatment needs and problems than their male counterparts, there is a need for gender-appropriate programs. The impact of such inmates on correctional health care services represents a potentially critical issue confronting correctional managers and correctional health service administrators. This article highlights the need for correctional policy to address the health care needs of women prisoners with HIV/AIDS.

Acquired Immunodeficiency Syndrome↗

PubMed1986

Clinical psychiatric illness in prisoners of war of the Japanese: forty years after release.

Clinical psychiatric and medical assessments were carried out on a randomly selected sample of Australian prisoners of war captured by the Japanese in 1942 and a sample of combatants from Pacific theatres of war who were not captured. Prisoners of war had significantly more anxiety and depressive 'neuroses' and more major affective illness, although the latter finding was not statistically significant. The two groups did not differ in the risk of alcohol abuse and dependence.

Alcoholism↗

PubMed2006

Prevalence of hepatitis C in a German prison for young men in relation to country of birth.

A high prevalence of hepatitis C (HCV) virus infection of up to 80% has been reported for injecting drug users (IDUs) in prison communities. However, there are only very limited data available on the prevalence and course of HCV in young offenders. We performed a study on hepatitis C markers in the largest German Young Offenders' Institution (YOI), a prison for men (aged 16-24 years). In 2002, all 1176 incoming offenders were asked to participate in the study of whom >95% agreed. Ninety-seven inmates (8.6%) tested positive for anti-HCV or HCV RNA, 79% of whom were viraemic. None of the patients had evidence of cirrhosis at presentation. Interestingly, six individuals (6%) tested positive for HCV RNA in the absence of anti-HCV antibodies, four of whom cleared HCV spontaneously during follow-up without either clinical signs of acute hepatitis or developing HCV antibodies. Hepatitis C markers were significantly more prevalent among immigrants from the former Soviet Union (NIS) than among German inmates (31% vs. 6% respectively, P<0.0001). HIV co-infection was found in five individuals, all of whom were German. In contrast, hepatitis B surface antigen (HBsAg) was detected in five NIS immigrants, one Lebanese and one German inmate. HCV genotypes 2 and 3 were more prevalent in immigrants than in German inmates, while biochemical parameters did not differ significantly between the two groups. In conclusion, the prevalence of hepatitis C was relatively low among inmates of German YOIs although there were significant differences in relation to the country of birth. Our data highlight the need for educational programmes for young offenders in order to prevent the further spread of HCV.

Adolescent↗

PubMed1999

Method used to identify previously undiagnosed infections in the HIV outbreak at Glenochil prison.

Four years after the occurrence of an outbreak of hepatitis B and HIV infection among injecting drug user inmates at Her Majesty's Prison Glenochil in Scotland, a study design was developed to complete the epidemiological account of the HIV outbreak. Our aim was to identify potential cases of (1) HIV transmission not diagnosed during the original outbreak investigation and (2) the source(s) of the outbreak. Scotland's HIV positive case register was searched for matches to a soundexed list of 636 Glenochil inmates imprisoned during January-June 1993. Eight HIV infections that may have been acquired in Glenochil and four possible sources of the outbreak were identified. The second stage of follow-up molecular epidemiological techniques used on stored sera samples from identified individuals is described in the companion paper. Without breach of medical or prisoner confidentiality, indirect and anonymous follow-up has proved possible for the Glenochil inmates.

Adult↗

PubMed2004

Forecasting recidivism in mentally ill offenders released from prison.

Little research has focused on assessing the risk of mentally ill offenders (MIOs) released from state prisons. Here we report findings for 333 mentally ill offenders released from Washington State prisons. Logistic regression identified sets of variables that forecasted felony and violent reconviction as accurately as state-of-the-art risk assessment instruments. Sums of simple recoded versions of these variables predicted reoffense as well as complex logistic regression equations. Five of these 9 variables were found to be relative protective factors. Findings are discussed in terms of the value of stock correctional variables in forecasting risk, the need to base actuarial risk assessments on local data, the importance of protective factors in assessing MIO risk, and the need for dynamic, situational, and clinical variables that can further sharpen predictive accuracy of emergent risk in the community.

Adult↗

PubMed2003

Suicide outside of prison settings among males under investigation for sex offenses in Ireland during 1990 to 1999.

Thirty-two cases of suicide outside prison were identified among 7008 Irish men under investigation for sexual offenses between 1990 and 1999. Previously this risk category has not been identified. Risk ratios of 1/1644 for those accused of offenses against adults, and 1/24 for those accused of offending against minors, respectively, were estimated based on the conservative estimates found here. The increase in the base rate of suicide in Ireland during the study period is an insufficient explanation. The frequency is comparable to prison suicides for the period, and the population of risk may overlap. The incidence increases over the study period. It outpaces increases in prosecutions and may reflect responses to the changing social environment of these investigations. These men use community psychiatric services that may need to become aware of the increased risk of suicide they pose.

Adult↗

PubMed1992

Problem solving and suicidality among prison inmates: another look at state versus trait.

This research examines the relationships between means-ends problem solving and suicidality among adult male prison inmates in light of new evidence based on inpatient and college student populations suggesting that state, rather than trait, vulnerabilities may be responsible for problem-solving deficits and differences. Using the Means-Ends Problem-Solving Procedure (MEPS) with 93 state prison inmates, we found that among inmates with a history of parasuicide, current suicidality did not affect problem-solving performance. We further found that among nonsuicidal inmates, parasuicide history had no effect on problem solving or affect-suicidality measures. Although these results support new research suggesting that trait problem-solving deficits are not causally linked to suicidality, they raise questions about the potentially unique relationships among suicidality, problem solving, depression, and hopelessness in incarcerated populations.

Adult↗

PubMed1976

Autonomic responses to modeled distress in prison psychopaths.

The present experiment was designed to study the physiological basis of the proposition that psychopaths are indifferent to the feelings of others. Young male subjects from a prison population were divided into groups according to their Minnesota Multiphasic Personality Inventory (MMPI) Pd score and then subdivided on the basis of MMPI Welsh Anxiety Scale (WAS) scores. Subjects in each group observed a model exhibiting either mild or severe distress to electric shock. Heart rate and skin conductance were measured over 15 trials in each subject. We hypothesized that the different clinical groups would exhibit different physiological emotional response patterns. The results showed that low-Pd subjects were more autonomically responsive to an emotional stimulus (modeled distress) than high-Pd subjects from the same prison population. Moreover, high-WAS subjects were more responsive than low-WAS subjects. The level of distress exhibited by the model had no effect.

Antisocial Personality Disorder↗

PubMed2005

Vulnerability of older adults to deception in prison and nonprison contexts.

Media reports frequently depict older adults as victims of deception. The public perceives these stories as particularly salient because older adults are seen as fragile victims taken advantage of because of trusting behaviors. This developmental investigation of deception detection examines older and younger adults interacting in 2 contexts, prison and the "free world," to discover whether older adults are vulnerable to deception. Younger prisoners were found to be lie biased. Older adults were better able to discriminate lies than younger adults, and this effect was localized primarily to older female adults. Findings indicate that discriminability strongly increases from younger to older age for women, whereas men do not show an improvement, as age increases, in making decisions about statement veracity.

Adult↗