Mendes dos Santos Maíra, Quintana Maria Ines, Moreira Fernanda Gonçalves, Taborda José Geraldo Vernet, Mari Jair de Jesus, Andreoli Sérgio Baxter
Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil; Program in Public Health, Universidade Catolica de Santos, Santos, São Paulo, Brazil.
Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil.
PLoS One. 2014 Nov 19;9(11):e113066. doi: 10.1371/journal.pone.0113066. eCollection 2014.
To analyze the association between drug (DAD) and alcohol (AAD) abuse and dependency and criminal and clinical background by gender of prisoners in São Paulo, Brazil.
Cross-sectional study, random sample stratified by administrative district, from which prisons and prisoners were selected via random, multistage sampling. Psychiatric diagnoses were made with the CIDI 2.1. Lifetime prevalence and 95% CI were calculated and adjusted via analysis of complex samples. Multinomial logistic regression analysis was carried out with four categories of dependent variables: presence AAD; presence DAD; presence of another mental disorder; no mental disorders. For female alcohol and drug abuse and dependency (ADAD) were combined into a single category.
The sample was composed by 1809 interviewed prisoners (1192 men and 617 women). Prevalence of DAD and AAD was 25.2% and 15.6%, respectively, among female prisoners, and 26.5% and 18.5% among males. Male prisoners with DAD were more likely to have a criminal record as an adolescent (OR 2.17), to be a repeat offender (OR 2.85), and to have committed a property crime (OR 2.18). Prisoners with AAD were repeat offenders (OR 2.18). Among female prisoners, ADAD was associated with repeat offenses (OR 3.39), a criminal record as an adolescent (OR 9.24), a clinical or infectious condition (OR 5.09), another health problem (OR 3.04), and violent crime (OR 2.5).
The study confirmed an association between drug-use disorders and the criminal and clinical background in the study population. Prisoners with such disorders were more likely to be repeat offenders and to have a criminal record as adolescents. Among female prisoners disorders were also associated with violent crime and health problems, while among males they were associated with property crime. These patterns in clinical and criminal backgrounds illustrate the need for social rehabilitation programs and specific medical treatment for prison populations.
分析巴西圣保罗州囚犯中药物滥用与依赖（DAD）和酒精滥用与依赖（AAD）与犯罪及临床背景之间按性别划分的关联。
横断面研究，按行政区分层随机抽样，通过随机、多阶段抽样选择监狱和囚犯。使用CIDI 2.1进行精神科诊断。计算终生患病率及95%置信区间，并通过复杂样本分析进行调整。对四类因变量进行多项逻辑回归分析：存在AAD；存在DAD；存在其他精神障碍；无精神障碍。女性酒精和药物滥用与依赖（ADAD）合并为单一类别。
样本包括1809名接受访谈的囚犯（1192名男性和617名女性）。女性囚犯中DAD和AAD的患病率分别为25.2%和15.6%，男性分别为26.5%和18.5%。患有DAD的男性囚犯更有可能在青少年时期有犯罪记录（比值比2.17）、是惯犯（比值比2.85）以及实施财产犯罪（比值比2.18）。患有AAD的囚犯是惯犯（比值比2.18）。在女性囚犯中，ADAD与惯犯（比值比3.39）、青少年时期的犯罪记录（比值比9.24）、临床或感染性疾病（比值比5.09）、其他健康问题（比值比3.04）以及暴力犯罪（比值比2.5）相关。
该研究证实了研究人群中药物使用障碍与犯罪及临床背景之间的关联。患有此类障碍的囚犯更有可能是惯犯且在青少年时期有犯罪记录。在女性囚犯中，这些障碍还与暴力犯罪和健康问题相关，而在男性中则与财产犯罪相关。临床和犯罪背景中的这些模式表明需要为监狱人群制定社会康复计划和特定的医疗治疗。
