Sahajian F, Lamothe P, Fabry J, Vanhems P
Service médico-psychologique régional (SMPR) des prisons de Lyon, antenne toxicomanies, centre hospitalier le Vinatier, Bron, France.
Rev Epidemiol Sante Publique. 2012 Oct;60(5):371-81. doi: 10.1016/j.respe.2012.02.010. Epub 2012 Sep 13.
In France, recent data on the consumption of psychoactive substances (PASs) among women entering prison are virtually nonexistent. The objective of this study was to describe the characteristics of female entrants at Montluc prison in Lyon (France) and to estimate their PAS consumption.
Between June 1, 2004 and December 31, 2008, of 841 women entering the Lyon correctional facility, 535 had an entrance interview, conducted by a nurse, during which a questionnaire was systematically proposed; 306 detainees did not have this interview and could not be included in the study because of an immediate transfer to another prison or emergency hospitalization. Socioeconomic and incarceration characteristics, PAS consumption, as well as consumption level (occasional, regular, abusive or dependence) and psychological distress of the 535 interviewed detainees were systematically noted. This psychological distress was defined by the presence in the entrant talks or behavior suggesting clinical symptoms such as anxiety, depression, delusion, delirium, and mood or behavior disorders. Descriptive analysis was undertaken with the Chi(2) test and Fisher's exact test for differences between the proportions observed.
The average age of the 534 responding detainees was 31.5 years; 59.2% had had no ongoing professional activity in the 12 months prior to incarceration, and 21.6% had already been imprisoned before; 37.5% of the entrants reported dependence on tobacco and 13.7% on alcohol; 6.6% reported regular, abusive use or dependence on cannabis, 20.4% on psychotropic medications, and 7.7% on other drugs (heroin, cocaine, synthetic drugs) in the 6 months preceding their incarceration; 39.2% of the consumers at risk reported using at least two substances; 7.1% of detainees were on opioid substitution treatment. A multiple correspondence factor analysis was used to note specific characteristics of three groups of PAS consumers.
More frequent among young women detainees, overall PAS consumption was quite close to that of male entrants, was greater than in the general female population, and was very often accompanied by psychological distress. Effective screening upon entry into detention should be carried out so that female consumers can be offered psychological and/or psychiatric care adapted to a prison environment.
在法国，几乎没有关于入狱女性使用精神活性物质（PASs）的最新数据。本研究的目的是描述法国里昂蒙特吕克监狱女性新入狱者的特征，并估计她们对PASs的使用情况。
在2004年6月1日至2008年12月31日期间，841名进入里昂惩教设施的女性中，535人接受了护士进行的入狱面谈，面谈期间系统地提出了一份问卷；306名被拘留者未接受此面谈，由于被立即转移到另一所监狱或紧急住院治疗，无法纳入本研究。系统记录了535名接受面谈的被拘留者的社会经济和监禁特征、PASs使用情况，以及使用水平（偶尔、经常、滥用或依赖）和心理困扰情况。这种心理困扰是根据新入狱者谈话或行为中出现的表明焦虑、抑郁、妄想、谵妄以及情绪或行为障碍等临床症状来定义的。采用卡方检验和Fisher精确检验对观察到的比例差异进行描述性分析。
534名做出回应的被拘留者的平均年龄为31.5岁；59.2%的人在入狱前12个月没有持续的职业活动，21.6%的人曾有过入狱经历；37.5%的新入狱者报告对烟草有依赖，13.7%的人对酒精有依赖；6.6%的人报告在入狱前6个月经常、滥用或依赖大麻，20.4%的人依赖精神药物，7.7%的人依赖其他药物（海洛因、可卡因、合成毒品）；39.2%有使用风险的使用者报告使用至少两种物质；7.1%的被拘留者接受阿片类药物替代治疗。采用多重对应因子分析来记录三组PAS使用者的具体特征。
PASs的总体使用情况在年轻女性被拘留者中更为常见，与男性新入狱者的情况相当接近，高于一般女性人群，并且经常伴有心理困扰。在入狱时应进行有效的筛查，以便为女性使用者提供适合监狱环境的心理和/或精神护理。
