Swanson Jeffrey W, Stenger Madeline, Easter Michele M, Bareis Natalie, Chwastiak Lydia, Dixon Lisa B, Edlund Mark J, Graupensperger Scott, Guyer Heidi, Monroe-DeVita Maria, Olfson Mark, Stroup T Scott, Winans Katherine S, Swartz Marvin S
Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, United States of America.
Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, New York, New York, United States of America.
PLOS Ment Health. 2025 Apr;2(4). doi: 10.1371/journal.pmen.0000257. Epub 2025 Apr 9.
Large numbers of adults with mental disorders in the United States are incarcerated or otherwise involved with the criminal legal system. Evidence is lacking on prevalence of specific psychiatric diagnoses in this population. This article presents results from the Mental and Substance Use Disorders Prevalence Study (MDPS), a national epidemiological survey that assessed lifetime prevalence of schizophrenia-spectrum disorder, and past-year prevalence of bipolar 1, obsessive-compulsive, major depressive, generalized anxiety, and post-traumatic stress disorders using the Structured Clinical Interview for DSM-5 (SCID 5). Diagnoses and demographic characteristics are compared among three populations: (1) imprisoned adults (N=321), (2) adults not incarcerated but with justice involvement in the past year (N=269), and (3) adults with no criminal legal history in the past year (N=5,004). The weighted sample included households, prisons, hospitals, and homeless shelters. About 4 in 10 people with any past-year criminal legal involvement had at least one of these mental disorders. The cumulative prevalence of these disorders was highest among those in prison (41.8%; 95% Confidence Interval (CI): 33.1-50.9%), lower in the community resident population with criminal legal involvement (37.0%; 95% CI: 25.1-50.6%), and lowest among those with no criminal legal involvement in the past year (24.4%; 95% CI: 21.9-27.0%). Findings for schizophrenia-spectrum disorder followed this pattern: prevalence in prison was 6.3% (95% CI 2.7-14.0%), while among community residents with criminal legal involvement prevalence was 4.4% (95% CI: 1.9-10.0%), and among those with no criminal legal involvement it was 1.7% (95% CI: 1.2-2.4%).
在美国，大量患有精神障碍的成年人被监禁，或以其他方式与刑事司法系统有牵连。目前缺乏关于这一人群中特定精神疾病诊断患病率的证据。本文介绍了精神和物质使用障碍患病率研究（MDPS）的结果，这是一项全国性的流行病学调查，使用《精神疾病诊断与统计手册》第5版（DSM-5）的结构化临床访谈（SCID-5）评估精神分裂症谱系障碍的终生患病率，以及双相I型、强迫症、重度抑郁、广泛性焦虑和创伤后应激障碍的过去一年患病率。在三类人群中比较了诊断结果和人口统计学特征：（1）被监禁的成年人（N = 321），（2）未被监禁但在过去一年有司法牵连的成年人（N = 269），以及（3）在过去一年没有刑事司法历史的成年人（N = 5004）。加权样本包括家庭、监狱、医院和无家可归者收容所。在过去一年有任何刑事司法牵连的人中，约十分之四的人至少患有一种这些精神障碍。这些障碍的累积患病率在监狱服刑人员中最高（41.8%；95%置信区间（CI）：33.1-50.9%），在有刑事司法牵连的社区常住人口中较低（37.0%；95%CI：25.1-50.6%），在过去一年没有刑事司法牵连的人中最低（24.4%；95%CI：21.9-27.0%）。精神分裂症谱系障碍的调查结果也呈现出这种模式：监狱中的患病率为6.3%（95%CI 2.7-14.0%），而在有刑事司法牵连的社区居民中患病率为4.4%（95%CI：1.9-10.0%），在没有刑事司法牵连的人中患病率为1.7%（95%CI：1.2-2.4%）。
