Plancke L, Gonfroy J, Lancelevée C, Danel T, Delaplace C, Fovet T, Thomas P, Amariei A
Fédération régionale de recherche en psychiatrie et santé mentale/Regional federation for research in psychiatry and mental health (F2RSM Psy), Hauts-de-France, Saint-André-lez-Lille, France; Université de Lille, Centre lillois d'études et de recherches sociologiques et économiques/The Lille center for sociological and economic research and studies (Clerse), Villeneuve-d'Ascq, France.
Fédération régionale de recherche en psychiatrie et santé mentale/Regional federation for research in psychiatry and mental health (F2RSM Psy), Hauts-de-France, Saint-André-lez-Lille, France.
Rev Epidemiol Sante Publique. 2020 Nov;68(6):367-373. doi: 10.1016/j.respe.2020.10.001. Epub 2020 Oct 29.
Compared to the general population, persons with mental disorders are overrepresented in prison. In a study carried out in Picardy (northern France) in 2017, a quarter of those entering prison had had contact with a psychiatric service prior to their incarceration. Since to our knowledge no work on this subject has been published in France, we conducted a retrospective study, the main objective of which was to propose an estimate measure of incarceration likelihood in people with mental disorders.
Using data from a psychiatric hospital discharge database (Recueil d'informations médicalisé en psychiatrie, RimP), we searched for patients aged 18 and older who had received psychiatric care (except for those who were incarcerated at baseline) at the Oise psychiatric hospital in 2015-2016 and identified those who had also been registered by the psychiatric care tool (DSP) in liaison with the same hospital. As a marker of incarceration, registration was the event to be investigated. Survival analyses (Kaplan-Meier), first simple and then stratified by age, gender, past history, main diagnosis and intensity of care outside of prison were carried out to calculate likelihood of incarceration. A multivariate Cox model was used in order to identify the factors associated with incarceration.
Among the 25,029 patients monitored in the Oise psychiatric hospital in 2015-2016, 126 had experienced incarceration during the 12 months following their inclusion in the study, i.e. an incarceration probability of 0.45% (95 % confidence interval: 0.37-0.55%). The incarcerated patients were younger (36.6 years in average versus 44.7-Pt-test<0.0001), more often male (96.8% versus 43.7% - P<0.0001), and had a more frequent history of detention (11.1% versus 0.6% - P <0.0001) and psychiatric care (20.6% versus 10.1% - P<0.0001) than the general population. The probability of incarceration at 12 months for the population followed in the psychiatry unit was 3.2 times higher than the detention rate of the general population in Oise over the same period.
Our study confirms the pronouncedly high incarceration rate of people with mental disorders. Scheduled to begin in 2020, coding in the RimP of a single nationwide patient identifier for all the procedures and stays described will allow the generalized measurement by means of the proposed indicator throughout France.
与普通人群相比，患有精神障碍的人在监狱中的比例过高。在2017年于皮卡第（法国北部）进行的一项研究中，四分之一进入监狱的人在入狱前曾与精神科服务机构有过接触。据我们所知，法国尚未发表过关于这一主题的研究，因此我们进行了一项回顾性研究，其主要目的是提出一种对精神障碍患者入狱可能性的估计方法。
利用一家精神病医院出院数据库（Recueil d'informations médicalisé en psychiatrie，RimP）的数据，我们在2015 - 2016年于瓦兹省精神病医院搜索了年龄在18岁及以上且接受过精神科护理的患者（基线时被监禁的患者除外），并确定了那些也在与同一家医院联络的精神科护理工具（DSP）中登记过的患者。作为监禁的标志，登记是要调查的事件。进行了生存分析（Kaplan - Meier法），首先是简单分析，然后按年龄、性别、既往史、主要诊断以及监狱外护理强度进行分层分析，以计算入狱可能性。使用多变量Cox模型来确定与入狱相关的因素。
在2015 - 2016年于瓦兹省精神病医院监测的25029名患者中，126人在纳入研究后的12个月内经历了监禁，即入狱概率为0.45%（95%置信区间：0.37 - 0.55%）。被监禁的患者更年轻（平均36.6岁，而总体为44.7岁 - Pt检验<0.0001），男性比例更高（96.8%对43.7% - P<0.0001），并且拘留史（11.1%对0.6% - P<0.0001）和精神科护理史（20.6%对10.1% - P<0.0001）比普通人群更频繁。精神科病房所跟踪人群在12个月时的入狱概率比同期瓦兹省普通人群的拘留率高3.2倍。
我们的研究证实了精神障碍患者明显过高的入狱率。计划于2020年开始，在RimP中对所有所述程序和住院情况使用单一的全国患者标识符进行编码，将使所提议的指标能够在全法国进行广泛测量。
