Steadman Henry J, Osher Fred C, Robbins Pamela Clark, Case Brian, Samuels Steven
Policy Research Associates, Inc., 345 Delaware Ave., Delmar, NY 12054, USA.
Psychiatr Serv. 2009 Jun;60(6):761-5. doi: 10.1176/ps.2009.60.6.761.
This study estimated current prevalence rates of serious mental illness among adult male and female inmates in five jails during two time periods (four jails in each period).
During two data collection phases (2002-2003 and 2005-2006), recently admitted inmates at two jails in Maryland and three jails in New York were selected to receive the Structured Clinical Interview for DSM-IV (SCID). Selection was based on systematic sampling of data from a brief screen for symptoms of mental illness that was used at admission for all inmates. The SCID was administered to a total of 822 inmates-358 during phase I and 464 during phase II. To determine the current (past-month) prevalence of serious mental illness (defined as major depressive disorder; depressive disorder not otherwise specified; bipolar disorder I, II, and not otherwise specified; schizophrenia spectrum disorder; schizoaffective disorder; schizophreniform disorder; brief psychotic disorder; delusional disorder; and psychotic disorder not otherwise specified), interview data were weighted against strata constructed from the screening samples for male and female inmates by jail and study phase.
Across jails and study phases the rate of current serious mental illness for male inmates was 14.5% (asymmetric 95% confidence interval [CI]=11.0%-18.9%) and for female inmates it was 31.0% (asymmetric CI=21.7%-42.1%).
The estimates in this study have profound implications in terms of resource allocation for treatment in jails and in community-based settings for individuals with mental illness who are involved in the justice system.
本研究估计了两个时间段(每个时间段四个监狱)内五所监狱成年男性和女性囚犯中严重精神疾病的当前患病率。
在两个数据收集阶段(2002 - 2003年和2005 - 2006年),选取了马里兰州两所监狱和纽约州三所监狱中最近入狱的囚犯接受《精神疾病诊断与统计手册》第四版(DSM - IV)的结构化临床访谈(SCID)。选择基于对所有囚犯入院时使用的简短精神疾病症状筛查数据的系统抽样。SCID共对822名囚犯进行了访谈,第一阶段358名,第二阶段464名。为确定严重精神疾病(定义为重度抑郁症;未另行规定的抑郁症;双相I型、II型及未另行规定的双相情感障碍;精神分裂症谱系障碍;分裂情感性障碍;精神分裂症样障碍;短暂性精神病性障碍;妄想性障碍;以及未另行规定的精神病性障碍)的当前(过去一个月)患病率,访谈数据根据按监狱和研究阶段从男性和女性囚犯筛查样本构建的分层进行加权。
在各监狱和研究阶段,男性囚犯当前严重精神疾病的患病率为14.5%(不对称95%置信区间[CI]=11.0% - 18.9%),女性囚犯为31.0%(不对称CI = 21.7% - 42.1%)。
本研究中的估计对于监狱以及涉及司法系统的患有精神疾病的个人在社区环境中的治疗资源分配具有深远意义。