Taylor Pamela J, Walker Julian, Dunn Emma, Kissell Anna, Williams Amy, Amos Tim
Department of Psychological Medicine, School of Medicine, Cardiff University, Cardiff, Wales, UK.
Crim Behav Ment Health. 2010 Jul;20(3):215-31. doi: 10.1002/cbm.774.
Pre-trial prisoners have high rates of mental disorder, but to date, little is known about mental state change or stability among them.
The aim of this study was to describe mental state change over the first 4 weeks of imprisonment.
Two hundred and fifty-seven new pre-trial male prisoners consented to participate in a prospective interview study. Recruited men tended to be younger than non-recruited men, but otherwise similar. Mental state was assessed 1 and 4 weeks after reception, using the Comprehensive Psychopathological Rating Scale and two self-rating instruments [the 90-item symptom checklist (SCL-90); the Beck Depression Inventory].
After 4 weeks, 170 of the men were still in prison. In their demographics, previous offending, imprisonment, mental health histories or mental health ratings at initial interview, they did not differ from the 87 who were bailed, transferred, sentenced or had their case discontinued. The most sensitive of the rating schedules - the SCL-90 - identified only one new case among the 170 men, but the more illness-specific ratings suggested up to a 10% emergence of new cases by then. By contrast, while two-thirds of the men remained cases according to the SCL-90, about half of the men who had initial interview illness ratings were no longer 'cases'.
Measured in terms of 'caseness', distress is likely to be apparent on reception into prison and relatively resistant to change compared with symptoms of mental disorder per se. One-off screening at reception could be misleading. A limitation of our study is that we could measure mental state only twice. A third measure would have clarified whether, in such circumstances, the trend towards improvement is sustained, but brevity of residence in any one prison at this stage tends to preclude this.
审前被羁押者精神障碍发生率较高，但迄今为止，对于他们的精神状态变化或稳定性了解甚少。
本研究旨在描述入狱头4周内的精神状态变化。
257名新的审前男性被羁押者同意参与一项前瞻性访谈研究。招募的男性往往比未被招募的男性更年轻，但在其他方面相似。在接收后1周和4周时，使用综合精神病理学评定量表和两种自评工具[90项症状清单（SCL - 90）；贝克抑郁量表]对精神状态进行评估。
4周后，170名男性仍在狱中。在人口统计学特征、既往犯罪情况、监禁情况、心理健康史或初次访谈时的心理健康评定方面，他们与87名被保释、移送、判刑或案件终止的男性没有差异。评定量表中最敏感的——SCL - 90——在170名男性中仅识别出1例新病例，但更具疾病特异性的评定表明，到那时新病例出现率高达10%。相比之下，虽然根据SCL - 90，三分之二的男性仍是病例，但初次访谈时有疾病评定的男性中约有一半不再是“病例”。
以“病例状态”衡量，痛苦在入狱时可能很明显，并且与精神障碍症状本身相比，相对不易改变。入狱时的一次性筛查可能会产生误导。我们研究的一个局限性是我们只能测量两次精神状态。第三次测量本可澄清在这种情况下改善趋势是否持续，但现阶段在任何一所监狱中停留时间短暂往往排除了这种可能性。
