National Department of Penitentiary Mental Health, National Direction of the First Level of Attention. Ministerio de Salud Pública de Ecuador, Av. Quitumbe Ñan y Av. Amaru Ñan. Plataforma Gubernamental de Desarrollo Social, 170146, Quito, Ecuador.
School of Medicine, Universidad Internacional del Ecuador, Av. Jorge Fernández s/n and Simon Bolívar, 170113, Quito, Ecuador.
BMC Psychiatry. 2019 Aug 7;19(1):248. doi: 10.1186/s12888-019-2227-z.
Major mental disorders in prison populations have been recognised as a long-term problem with an important impact on public health. Despite this, screening activities in prisons are still weak in Latin America. We proposed to estimate the prevalence of depression and psychosis and associated factors in the largest Ecuadorian prison for male inmates.
Cross-sectional study with 309 prisoners chosen at random between January and February 2017, who were administered two structured questionnaires. The first examined socio-demographic and occupational characteristics prior to incarceration and presence of social support networks; the second was the Mini International Neuropsychiatric Interview version in Spanish 5.0.0. We used maximum likelihood tests and multiple logistic regression to assess associations between depression, psychosis and study factors.
The prevalence of depression and psychosis were 50.2% (95% CI 44.6-55.8) and 25.9% (95% CI 21.0-30.8), respectively. The two conditions occurred together in 22.0% of the cases (95% CI 14.8-29.2), and depression or psychosis (D/P) was found in 54.0% (95% CI 48.4-59.6). Consuming drugs while in prison was found in 41.4% (95% CI 35.9-46.9). When age was considered among those consuming drugs, the prevalence of D/P were 72.2, 88.0, and 92.3%, respectively for the age-groups 18-29, 30-39 and 40 years or over (p-value < 0.001). Using a multivariate model, we found that not receiving visits (AOR 3.15 95%CI 1.42-6.96) and consuming drugs while in prison (AOR 5.85 95%CI 3.06-11.16) were associated with D/P, while the age effect disappears. Inmates who stopped drug consumption in prison or who had never consumed did not present any significant differences.
Depression and psychosis in prisoners are strongly affected by the absence of visitors and by consumption of drugs in prison. Greater presence of social support networks and preventive actions targeting drug abuse would contribute to improving the mental health of prison inmates.
监狱人群中的主要精神障碍已被视为一个长期存在的问题，对公共卫生有重要影响。尽管如此，拉丁美洲的监狱筛查活动仍然薄弱。我们旨在评估厄瓜多尔最大的男性囚犯监狱中抑郁和精神病的患病率及其相关因素。
2017 年 1 月至 2 月期间，我们采用横断面研究，随机选择 309 名囚犯，为其提供了两份结构化问卷。第一份问卷调查入狱前的社会人口学和职业特征以及社会支持网络的存在情况；第二份问卷是西班牙语 5.0.0 版的迷你国际神经精神访谈。我们使用最大似然检验和多因素逻辑回归来评估抑郁、精神病和研究因素之间的关联。
抑郁和精神病的患病率分别为 50.2%（95%CI 44.6-55.8）和 25.9%（95%CI 21.0-30.8）。两种情况同时存在的比例为 22.0%（95%CI 14.8-29.2），抑郁或精神病（D/P）的比例为 54.0%（95%CI 48.4-59.6）。入狱期间吸毒的比例为 41.4%（95%CI 35.9-46.9）。当考虑年龄因素时，18-29 岁、30-39 岁和 40 岁或以上年龄组中 D/P 的患病率分别为 72.2%、88.0%和 92.3%（p 值均<0.001）。使用多因素模型，我们发现未接受探访（AOR 3.15，95%CI 1.42-6.96）和入狱期间吸毒（AOR 5.85，95%CI 3.06-11.16）与 D/P 相关，而年龄因素的影响则消失。在狱中停止吸毒或从未吸毒的囚犯没有出现任何显著差异。
囚犯中的抑郁和精神病受探访缺失和狱中吸毒的严重影响。更多的社会支持网络和针对药物滥用的预防措施将有助于改善监狱囚犯的心理健康。
