Department of Forensic Psychiatry and Psychotherapy, Ulm University, Ulm, Germany.
Department of Forensic Psychiatry, Psychiatric Services Graubuenden, Cazis.
Curr Opin Psychiatry. 2019 Jul;32(4):342-347. doi: 10.1097/YCO.0000000000000504.
In prisons, resources for psychiatric care are limited, but the population is at high risk for mental disorders. This article aims to review recent findings and developments and to focus on the changing needs of prisoners and consequences for treatment.
The evidence for high general prevalence rates of mental disorders in prison populations can be considered as robust worldwide. Recent meta-analyses focused on specific prevalence rates and found that complex disorders, such as attention deficit hyperactivity disorder and posttraumatic stress disorder, are also more common in prison populations. Interest is growing in studying subgroups with special needs, for example, women and older prisoners. Furthermore, a large amount of research deals with suicide and self-harm, especially risk factors and assessments. Promising results have been obtained for treatment outcome in substance use disorders. Psychological therapies, however, have not yet been proven to have sustaining effects.
Considering the growing amount of research on prison inmates' mental health issues and heterogeneous needs, future studies should aim to consolidate previous findings and develop special diagnostic and therapeutic standards for mental healthcare in prisons that consider ethical aspects and human and financial resources.
在监狱中，精神科护理资源有限，但囚犯群体患精神障碍的风险很高。本文旨在综述最新发现和进展，并重点关注囚犯需求的变化及其对治疗的影响。
有充分证据表明，监狱囚犯群体的精神障碍普遍高发。最近的一些荟萃分析集中于特定的流行率，发现复杂障碍，如注意缺陷多动障碍和创伤后应激障碍，在监狱囚犯中也更为常见。人们对研究有特殊需求的亚组越来越感兴趣，例如女性和老年囚犯。此外，大量研究涉及自杀和自残问题，特别是风险因素和评估。在物质使用障碍的治疗效果方面取得了可喜的成果。然而，心理疗法尚未被证明具有持续效果。
考虑到越来越多的关于囚犯心理健康问题和异质需求的研究，未来的研究应旨在巩固以往的发现，并为监狱中的精神保健制定特殊的诊断和治疗标准，这些标准应考虑到伦理方面以及人力和财力资源。
