Insitute for Mental Health Policy Research, CAMH, Toronto, Ontario, Canada.
Department of Family Medicine, 3710McMaster University, Hamilton, Ontario, Canada.
Can J Psychiatry. 2021 Apr;66(4):376-384. doi: 10.1177/0706743720953018. Epub 2020 Aug 28.
Individuals with schizophrenia are overrepresented in correctional facilities relative to their population-based prevalence. The purpose of this study was to determine the rate and predictors of reincarceration of individuals with schizophrenia after release from correctional facilities.
This was a retrospective cohort study that included all people released from Ontario's provincial correctional facilities from January 1 to December 31, 2010. Individuals with schizophrenia were identified using a population-based algorithm. The primary outcome was time to reincarceration. Covariates included sociodemographic characteristics (age, sex, neighborhood income quintile, urban/rural residence), health service utilization (primary care physician visits, psychiatrist visits, psychiatric and nonpsychiatric hospitalizations, emergency department visits), and other clinical comorbidity. Survival analysis was used to examine the association between schizophrenia and reincarceration.
Among 46,928 individuals, = 3,237 (7%) had a diagnosis of schizophrenia. Approximately 67.5% of these individuals were reincarcerated within 5 years following their first release in 2010, compared to 58.8% of individuals without schizophrenia. Individuals with schizophrenia were 40% (HR = 1.39, 95% CI, 1.33 to 1.45) more likely to be reincarcerated following release than the control group after adjusting for demographic characteristics. This association reduced to 8% (HR = 1.08, 95% CI,1.03 to 1.14) after adjusting for prior health service utilization, prior correctional involvement, and comorbidities.
Individuals with schizophrenia were more likely to experience reincarceration after release from correctional facilities. This risk is partly explained by prior correctional involvement, health service utilization, and comorbidities. Future research should focus on risk factors predicting the higher reincarceration rate and interventions to reduce correctional involvement.
与基于人群的患病率相比，精神分裂症患者在矫正机构中的比例过高。本研究旨在确定从安大略省矫正机构获释后精神分裂症患者再次入狱的比率和预测因素。
这是一项回顾性队列研究，纳入了 2010 年 1 月 1 日至 12 月 31 日从安大略省省级矫正机构获释的所有人员。使用基于人群的算法确定精神分裂症患者。主要结果是再次入狱的时间。协变量包括社会人口统计学特征（年龄、性别、邻里收入五分位数、城市/农村居住）、卫生服务利用（初级保健医生就诊、精神科医生就诊、精神科和非精神科住院、急诊就诊）和其他临床合并症。生存分析用于检查精神分裂症与再次入狱之间的关联。
在 46928 人中，有 3237 人（7%）被诊断患有精神分裂症。与没有精神分裂症的人相比，这些人中约有 67.5%在 2010 年首次获释后的 5 年内再次入狱，而精神分裂症患者再次入狱的可能性比对照组高 40%（HR=1.39，95%CI，1.33 至 1.45）。在调整人口统计学特征后，这一关联降低至 8%（HR=1.08，95%CI，1.03 至 1.14）。在调整先前的卫生服务利用、先前的矫正参与和合并症后，这一关联降低至 8%（HR=1.08，95%CI，1.03 至 1.14）。
与从矫正机构获释的对照组相比，精神分裂症患者再次入狱的可能性更大。这种风险部分是由先前的矫正参与、卫生服务利用和合并症解释的。未来的研究应集中在预测更高再入狱率的风险因素和减少矫正参与的干预措施上。
