University of Pennsylvania, Philadelphia, PA 19104-6299, USA.
J Health Soc Behav. 2012;53(4):448-64. doi: 10.1177/0022146512453928.
Psychiatric disorders are unusually prevalent among current and former inmates, but it is not known what this relationship reflects. A putative causal relationship is contaminated by assorted influences, including childhood disadvantage, the early onset of most disorders, and the criminalization of substance use. Using the National Comorbidity Survey Replication (N = 5692), we examine the relationship between incarceration and psychiatric disorders after statistically adjusting for multidimensional influences. The results indicate that (1) some of the most common disorders found among former inmates emerge in childhood and adolescence and therefore predate incarceration; (2) the relationships between incarceration and disorders are smaller for current disorders than lifetime disorders, suggesting that the relationship between incarceration and disorders dissipates over time; and (3) early substance disorders anticipate later incarceration and other psychiatric disorders simultaneously, indicating selection. Yet the results also reveal robust and long-lasting relationships between incarceration and certain disorders, which are not inconsequential for being particular. Specifically, incarceration is related to subsequent mood disorders, related to feeling "down," including major depressive disorder, bipolar disorder, and dysthymia. These disorders, in turn, are strongly related to disability, more strongly than substance abuse disorders and impulse control disorders. Although often neglected as a health consequence of incarceration, mood disorders might explain some of the additional disability former inmates experience following release, elevating their relevance for those interested in prisoner reintegration.
精神障碍在现服刑犯人和刑满释放人员中异常普遍，但目前尚不清楚这种关系反映了什么。一个假定的因果关系受到各种因素的影响，包括儿童时期的不利因素、大多数障碍的早期发病和物质使用的犯罪化。我们使用全国共病调查再调查（N = 5692），在对多维影响进行统计调整后，研究监禁与精神障碍之间的关系。结果表明：（1）在以前的囚犯中发现的一些最常见的障碍出现在儿童和青少年时期，因此早于监禁；（2）监禁与障碍之间的关系对于当前障碍来说比终生障碍小，这表明监禁与障碍之间的关系随着时间的推移而消散；（3）早期的物质障碍同时预示着以后的监禁和其他精神障碍，表明选择。然而，结果也揭示了监禁与某些障碍之间存在牢固而持久的关系，这些关系虽然特殊，但并非不重要。具体来说，监禁与随后的情绪障碍有关，与“情绪低落”有关，包括重度抑郁症、双相情感障碍和心境恶劣。这些障碍反过来又与残疾密切相关，与物质滥用障碍和冲动控制障碍相比更为密切。尽管情绪障碍经常被忽视为监禁的健康后果，但它们可能解释了一些以前的囚犯在释放后经历的额外残疾，这增加了它们对那些对囚犯重新融入感兴趣的人的相关性。
