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康涅狄格州监狱中在入狱时未被认定为患有严重精神疾病的囚犯的当前及终生精神疾病情况。

Current and lifetime psychiatric illness among inmates not identified as acutely mentally ill at intake in Connecticut's jails.

作者信息

Trestman Robert L, Ford Julian, Zhang Wanli, Wiesbrock Valerie

机构信息

Center for Correctional Mental Health Services Research, University of Connecticut Health Center, Farmington, CT 06030-5386, USA.

出版信息

J Am Acad Psychiatry Law. 2007;35(4):490-500.

Abstract

This study presents estimates of current and lifetime psychiatric illness among inmates not identified as acutely mentally ill at intake into all five of Connecticut's adult jails (four male facilities and one female facility). Diagnoses were assessed with the Structured Clinical Interview for DSM-IV (SCID), Clinician-Administered PTSD Scale, and the Global Assessment of Functioning (GAF) and are reported by gender and race/ethnicity. The results showed that more than two of three inmates met the criteria for at least one lifetime psychiatric disorder, almost half for an anxiety disorder, and more than one-third for an affective disorder. Overall, estimates of psychiatric morbidity in the women were higher than those in the men, with the exception of antisocial personality disorder (ASPD). Of particular note, borderline personality disorder was diagnosed in 23.2 percent of women and 12.9 percent of men. An allegation of a violent offense was not associated with the presence of mental illness or with a specific diagnosis. Lifetime history of any mental illness was associated with significantly reduced scores (range, 12-15 points reduction) on the Global Assessment of Functioning. The study showed that current and lifetime psychiatric morbidity are elevated among newly incarcerated adults who do not exhibit obvious signs of severe mental illness and are associated with functional impairment. While such disorders do not necessarily require treatment, unrecognized mental illness may place offenders at greater risk while incarcerated than offenders without mental illness. This study reinforces the need for appropriate screening and referral for treatment at intake into jail.

摘要

本研究呈现了康涅狄格州所有五所成人监狱(四所男性监狱和一所女性监狱)中,在入狱时未被认定为患有严重精神疾病的囚犯当前和终生精神疾病的估计情况。使用《精神疾病诊断与统计手册》第四版结构化临床访谈(SCID)、临床医生管理的创伤后应激障碍量表和功能总体评定量表(GAF)对诊断进行评估,并按性别和种族/族裔进行报告。结果显示,三分之二以上的囚犯符合至少一种终生精神障碍的标准,近一半符合焦虑症标准,超过三分之一符合情感障碍标准。总体而言,除反社会人格障碍(ASPD)外,女性的精神疾病发病率估计高于男性。特别值得注意的是,边缘性人格障碍在23.2%的女性和12.9%的男性中被诊断出来。暴力犯罪指控与精神疾病的存在或特定诊断无关。任何精神疾病的终生病史与功能总体评定量表得分显著降低(降低幅度为12 - 15分)相关。该研究表明,在新入狱的成年人中,当前和终生精神疾病发病率升高,这些人没有明显的严重精神疾病迹象,且与功能损害有关。虽然这些疾病不一定需要治疗,但未被识别的精神疾病可能使罪犯在监禁期间比没有精神疾病的罪犯面临更大风险。本研究强调了在入狱时进行适当筛查和转介治疗的必要性。

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