Taggart Niamh, Kinner Stuart A, Young Jesse T
School of Population Health, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia.
School of Population Health, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Victoria 3052, Australia; Melbourne School of Population and Global Health, University of Melbourne, The University of Melbourne, Level 4, 207-221 Bouverie Street, Victoria 3010, Australia; Griffith Criminology Institute, Griffith University, Level 4, 176 Messines Ridge Road, Mount Gravatt, Queensland 4122, Australia.
Drug Alcohol Depend. 2025 Jul 1;272:112675. doi: 10.1016/j.drugalcdep.2025.112675. Epub 2025 Apr 22.
Incarcerated individuals experience mental illness (MI), substance use disorders (SUD), and their co-occurrence - dual diagnosis - at higher rates than the general population. By systematically reviewing the literature on dual diagnosis in custody, we aimed to (1) estimate the pooled prevalence of dual diagnosis among adults in custody, and (2) identify the psychosocial, health-related, and criminal justice correlates of dual diagnosis.
We searched CINAHL, CINCH, Embase, Medline, PsycINFO, and Web of Science for studies investigating dual diagnosis among adults in custody. We also conducted backward citation chaining of a previous systematic review of dual diagnosis in Australian prisons. We used random-effects meta-analysis to generate a pooled prevalence estimate of dual diagnosis and conducted a narrative synthesis of the identified correlates of dual diagnosis in the literature.
Twenty-five studies met the inclusion criteria; 20 had sufficient data for meta-analysis. The pooled prevalence estimate of dual diagnosis among adults in custody was 25.3 % [95 %CI: 18.6, 32.7]. Correlates of dual diagnosis included illicit substance use before 15 years old, living with someone who used substances before incarceration, violence victimisation, increased suicide risk, and a lifetime history of multiple convictions.
Our findings suggest that approximately one out of every four adults in custody have a dual diagnosis, highlighting the need for coordinated mental health and alcohol and other drug services for justice-involved individuals. It is crucial that correctional healthcare providers have the capacity and resources necessary to address the complex needs of adults with dual diagnosis in custody.
被监禁者患精神疾病（MI）、物质使用障碍（SUD）及其共病——双重诊断——的比例高于普通人群。通过系统回顾关于监禁中双重诊断的文献，我们旨在（1）估计被监禁成年人中双重诊断的合并患病率，以及（2）确定双重诊断的心理社会、健康相关和刑事司法相关因素。
我们在CINAHL、CINCH、Embase、Medline、PsycINFO和Web of Science中搜索了关于调查被监禁成年人双重诊断的研究。我们还对之前澳大利亚监狱双重诊断的系统评价进行了反向引文链分析。我们使用随机效应荟萃分析来生成双重诊断的合并患病率估计值，并对文献中确定的双重诊断相关因素进行叙述性综合分析。
25项研究符合纳入标准；20项有足够的数据进行荟萃分析。被监禁成年人中双重诊断的合并患病率估计为25.3%[95%CI：18.6，32.7]。双重诊断的相关因素包括15岁前使用非法物质、在入狱前与使用物质的人一起生活、遭受暴力侵害、自杀风险增加以及有多次定罪的终生史。
我们的研究结果表明，每四名被监禁成年人中约有一人有双重诊断，这凸显了为涉及司法的个人提供协调的心理健康以及酒精和其他药物服务的必要性。惩教医疗保健提供者有能力和资源来满足被监禁的患有双重诊断的成年人的复杂需求至关重要。
