Yee Natalia, Browne Christie, Chemjong Prabin, Korobanova Daria, Dean Kimberlie
Justice Health and Forensic Mental Health Network, Roundhouse, Long Bay Complex, PO Box 150, Matraville, NSW, 2036, Australia.
Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia.
Soc Psychiatry Psychiatr Epidemiol. 2025 Feb;60(2):363-373. doi: 10.1007/s00127-024-02733-y. Epub 2024 Jul 30.
Despite the high rates of psychotic disorders amongst people in prison, current prison mental health screening approaches have not included assessment of the full psychosis spectrum to capture those at-risk of an emerging psychosis as well as those with established illness nor assessed the concurrent validity of psychosis symptom screening.
Using a clinical staging approach to establish the prevalence of Ultra High Risk (UHR), first episode of psychosis (FEP) and established psychosis (EP) groups, 291 adults entering custody in two prison reception centres in NSW completed a two-stage (screening and validation) interview process. The Comprehensive Assessment of At-Risk Mental States (CAARMS) was used to determine the clinical stages of psychosis and concurrent validity of symptom screening in identifying individuals on the psychosis spectrum was formally assessed.
Amongst men and women entering prison, almost one quarter (24.1%) met UHR criteria, 5.1% met the FEP threshold and 10.6% had an established psychosis. Those on the psychosis spectrum reported greater disadvantage across sociodemographic and justice factors. The presence of perceptual disturbance and paranoid beliefs emerged as the two best screening items for identifying those with an underlying psychosis spectrum illness.
The prevalence of psychosis spectrum illness, including the UHR state, amongst those entering prison is high. Current prison mental health approaches should include screening for the presence of perceptual disturbances and paranoid beliefs to improve the detection of psychosis spectrum illness.
尽管监狱中的人群患有精神障碍的比例很高，但目前监狱心理健康筛查方法并未涵盖对整个精神病谱系的评估，以识别有新发精神病风险的人群以及已确诊患病的人群，也未评估精神病症状筛查的同时效度。
采用临床分期方法确定超高风险（UHR）、首次发作精神病（FEP）和确诊精神病（EP）组的患病率，新南威尔士州两个监狱接待中心的291名成年入狱者完成了两阶段（筛查和验证）访谈过程。使用高危精神状态综合评估（CAARMS）来确定精神病的临床阶段，并正式评估症状筛查在识别精神病谱系个体方面的同时效度。
在入狱的男性和女性中，近四分之一（24.1%）符合UHR标准，5.1%符合FEP阈值，10.6%患有确诊精神病。处于精神病谱系的人在社会人口统计学和司法因素方面面临更大的不利处境。知觉障碍和偏执信念的存在成为识别潜在精神病谱系疾病患者的两个最佳筛查项目。
入狱者中包括UHR状态在内的精神病谱系疾病患病率很高。目前的监狱心理健康方法应包括筛查知觉障碍和偏执信念的存在情况，以改善对精神病谱系疾病的检测。
