The prevalence of mental disorders in prisoners in the city of Salvador, Bahia, Brazil

The number of individuals affected by serious psychiatric disorders in Brazilian prisons is unknown. This cross-sectional study was conducted in prison complexes within the city of Salvador, Bahia, Brazil. The sample consisted of 497 prisoners, and the outcome measure was the Brazilian Portuguese version of the Mini International Neuropsychiatric Interview. The prevalence rates found in the closed and semi-open prison systems, respectively, were as follows: depression 17.6% and 18.8%; bipolar mood disorder 5.2% and 10.1%; anxiety disorders 6.9% and 14.4%; borderline personality disorder 19.7% and 34.8%; antisocial personality disorder 26.9% and 24.2%; alcohol addiction 26.6% and 35.3%; drug addiction 27.9% and 32.4%; psychosis 1.4% and 12.6%; attention deficit/hyperactivity disorder (ADHD) in childhood 10.3% and 22.2%; and ADHD in adulthood 4.1% and 5.3%. This study revealed higher rates of substance-related disorders and lower rates of psychotic and mood disorders compared to other prevalence studies carried out in prison populations.     

Attention deficit hyperactivity disorder does not predict criminal recidivism in young adult offenders: Results from a prospective study

As the state of research on the relationship between attention deficit hyperactivity disorder (ADHD) and recidivism can be considered controversial, our prospective study investigated whether ADHD predicts recidivism in a sample of 283 male, German, young adult prisoners. Currently existing ADHD symptoms and symptoms that were present in childhood were screened according to the DSM-IV checklist criteria. Information on general and violent recidivism was gathered using government records with a follow-up period of up to five years. The prevalence of adult ADHD was six times greater than in the general population, and the number of participants who retrospectively met the criteria for a diagnosis with ADHD in childhood was ten times greater than found in community samples. Survival analyses did not identify ADHD as a predictor of recidivism. Controlling for conduct disorder, substance dependence, and other relevant variables did not alter results. However, among individuals who were released from prison and then reconvicted for a new crime, offenders diagnosed with ADHD were found to reoffend sooner after release. These findings stress the necessity of differentiating between risk factors for delinquency and risk factors for recidivism.     

Psychopathy among prisoners in England and Wales

Most research into psychopathy among prisoners is based on selected samples. It remains unclear whether prevalences are lower among European populations. This study aimed to measure the prevalence of psychopathy, and the distribution and correlates of psychopathic traits in a representative national sample of prisoners. Psychopathy was measured using the revised Psychopathy Checklist (PCL-R) in a second stage, cross-sectional survey of prisoners in England and Wales in 1997 (n = 496). Poisson regression analysis was carried out to examine independent associations between correlates and PCL-R total and factor scores. The prevalence of categorically diagnosed psychopathy at a cut off of 30 was 7.7% (95%CI 5.2–10.9) in men and 1.9% (95%CI 0.2–6.9) in women. Psychopathic traits were less prevalent among women. They were correlated with younger age, repeated imprisonment, detention in higher security, disciplinary infractions, antisocial, narcissistic, histrionic, and schizoid personality disorders, and substance misuse, but not neurotic disorders or schizophrenia. The study concluded that psychopathy and psychopathic traits are prevalent among male prisoners in England and Wales but lower than in most previous studies using selected samples. However, most correlates with psychopathic traits were similar to other studies. Psychopathy identifies the extreme of a spectrum of social and behavioral problems among prisoners.     

The prevalence of intellectual disabilities among 12,000 prisoners - a systematic review

There are 9 million prisoners worldwide, but it is uncertain what proportion have intellectual disabilities. Such prisoners have been identified as a vulnerable group at risk of victimization and mental illness. Psychiatric surveys based on interviews of unselected prison populations were sought, involving diagnoses of intellectual disabilities. The search was performed by computer-assisted searches, scanning of relevant reference lists, hand-searching of journals, and correspondence with authors of relevant reports. Prevalence rates of intellectual disabilities by gender and other potentially relevant study characteristics were abstracted from publications, supplemented by information from authors of reports. Ten relevant surveys from four different countries were identified that included a total of 11,969 prisoners (mean age: 29 years; 92% male; 23% violent offenders). No formal calculation of a summary estimate of prevalence was undertaken due to substantial heterogeneity. The results suggest that typically 0.5-1.5% of prisoners were diagnosed with intellectual disabilities (range 0% to 2.8% across studies). We conclude that the number of prisoners with intellectual disabilities is considerable and discuss implications for policy and practice.     

The Relationship Between Gambling Severity and Risk of Criminal Recidivism

Individuals involved with the criminal justice system have the highest prevalence of gambling disorder. Yet, this is an understudied area, especially in relation to postrelease functioning and recidivism risk. Participants (N = 100) were recruited from a local nonprofit organization and a federal probation office. Participants completed both self‐report and interviewer‐administered questionnaires assessing past‐year and lifetime gambling behaviors and problems, legal history, health, and risk of recidivism. Past‐year (8%) and lifetime (18%) rates of gambling disorder among the current sample are significantly greater than those of the general population and similar to rates found in incarcerated populations. Furthermore, 13% of individuals reported a direct relationship between their gambling and crime, and analyses revealed that increased gambling severity was a significant predictor of increased recidivism risk. Results suggest the need for screening and intervention efforts and call for policy reform among incarcerated and ex‐offender populations.     

Prevalence of mental disorders and deliberate self-harm in Greek male prisoners

The aim of this survey was to determine the prevalence of current and lifetime mental disorder and deliberate self-harm among male prisoners in Greece. The subjects were 80 randomly selected remanded and sentenced prisoners in a Greek prison. They were assessed for mental disorder including suicidality and substance misuse using the Mini International Neuropsychiatric Interview (MINI). We also collected information regarding contact with psychiatric services, previous deliberate self-harm as well as physical health and conducted a brief assessment of their intellectual functioning. Mental disorder was diagnosed in 63 (78.7%) prisoners. The main diagnoses were: anxiety disorder, 30 (37.5%); major depression, 22 (27.5%); antisocial personality disorder, 30 (37.5%); alcohol dependence, 21 (26.3%) and opiate dependence 22 (27.5%) and schizophrenic or bipolar disorder 9 (11.2%). Deliberate self-harm prior to and during imprisonment was reported by 15% and 2.5% of prisoners, respectively, and 12 prisoners (15%) had IQ below 75. This survey identified a significant level of need for specialist mental health services in prison. Further studies are required to assess the specific needs of those patients who are too unwell to remain in prison, the need for specific treatments for substance misuse and improved assessment/treatment of common psychiatric disorders.     

Topological Variability of Fingerprint Ridge Density in a Sub‐Saharan Population Sample for Application in Personal Identification

Variability in ridge density in a sub‐Saharan population sample was studied by counting ridges in three fingerprint areas (two distal regions, radial and ulnar, and one proximal region) on the epidermal surface of the distal phalanx. Study material was obtained from the fingerprint impressions of 100 male sub‐Saharan subjects aged between 18‐ and 48‐years old. The results were compared with those obtained from a Spanish population sample. Sub‐Saharan males presented lower ridge density than Spanish males in the distal regions (radial and ulnar) of all fingers, whereas differences in the proximal region were only observed on some fingers. Using the differences observed between these populations, the likelihood ratio for inferring membership of one of the populations from a fingerprint of unknown origin was calculated; therefore, a ridge density of 14 or less for both areas (ulnar and radial), support an origin sub‐Saharan versus Spanish population.     

Identification of Risk Factors for Self‐Injurious Behavior in Male Prisoners*

Abstract: Male prisoners with (n = 132) and without (n = 132) histories of engaging in self‐injurious behavior (SIB) were matched on conviction prefix and custody level. Conditional logistic regression revealed that a combination of risk factors from domains defined by developmental, offense history, mental health, and institutional functioning factors correctly classified 93% of the prisoners in the sample (ROC AUC = 0.89, S.E. = 0.005, p < 0.0001). Model specificity was 92.6% and sensitivity was 95.3%. False positive and false negative rates were 2.3% and 3.4%, respectively. Implications for the assessment of prisoners at risk for SIB as well as suggested future directions for SIB prisoner research are discussed.     

Total Body Mass Estimation from Anthropometric Measurements in Modern Young Adult U.S. Populations with Healthy Body Fat Percentages (NHANES III)

This study presents a method by which to estimate total body mass in modern young adult U.S. populations who self‐identified as non‐Hispanic U.S. White, non‐Hispanic U.S. Black, and Mexican American with anthropometric measurements from the Third National Health and Nutrition Examination Survey (NHANES III) 1988–1994 dataset (N = 2532). Correlations of stature and bi‐iliac breadth with total body mass were stronger among males (r = 0.717–0.774) than among females (r = 0.549–0.661), yet these results were more accurate assessments of total body mass than existing techniques. This study also examined additional anthropometric measurements to estimate total body mass using an information‐theoretic approach demonstrating that some error in the stature–bi‐iliac breadth method is attributed to a nonsupported model with multimodel inference. The limitations of the current total body mass technique are discussed as well as the need for future studies to validate the method.     

Diagnostic Value of PSA and AP Tests for the Detection of Spermatozoa in Postmortem Swabs from the Genital and Anal Region in Males

The aim of this study was to clarify whether positive results for prostate‐specific antigen (PSA) and acid phosphatase (AP) occur in postmortem swabs from the genito‐anal region in males (n = 80; 4 regions) and females (n = 20; 3 regions) and to calculate the positive predictive value (PPV) concerning the presence of spermatozoa. In male subjects, the highest incidence of positive test results was found in urethral swabs (PSA 76%, AP 71%) and the lowest frequencies appeared in perianal and rectal swabs (15–20%). Microscopic evaluation for spermatozoa was positive between 39% in urethral swabs and 1% in rectal swabs. PPV regarding positive identification of spermatozoa was 33.3% for PSA and 31.5% for AP. The combination of both tests yielded a PPV of 38.2%. In female cases, no spermatozoa were identified, and one case was PSA‐ and AP‐positive in perianal swabs. Our findings indicate that PSA and AP tests are of limited value for the postmortem detection of spermatozoa in male subjects.     

Chronic Offenders or Socially Disadvantaged Youth? Institutionalized Males as Missing Cases in School‐based Delinquency Research

Previous criminological studies comparing institutional youth populations with community samples have for the most part focused on youths institutionalized primarily as a result of involvements in delinquency. The present study compares levels of social disadvantage and criminal involvement within a nationally representative sample of Swedish schoolboys with those of a national population of institutionalized males that includes both serious young offenders and youths institutionalized for other reasons. Whilst at the aggregate level, mean levels of offending are higher within the institutional sample, the institutional population includes youths from across the entire range of levels of offending. Levels of social disadvantage are substantially elevated among the institutionalized males by comparison with the school sample. The study notes that institutionalized samples, where these include both young offenders and youths institutionalized for other reasons, may provide a fruitful ground for life‐course research into the way involvements in crime interact with other indicators of social disadvantage to affect the likelihood of continued marginalization into adulthood.     

Syphilis—Cardiovascular Manifestations of the Great Imitator

Rates of syphilis are beginning to once again increase, with the World Health Organization estimating that in recent years there were 12 million new cases of syphilis each year; in 2002, syphilis was responsible for 0.3% of deaths globally. At‐risk groups include young males (20–29 years), prisoners, and sex workers. Increased rates in young females have elevated the numbers of congenital cases. Review of the University of Adelaide Pathology Archive revealed four cases with significant pathology, which included cardiac gummas and aortic arch aneurysms. These cases demonstrate the cardiovascular characteristics of untreated syphilis in the tertiary stage. Cases with such advanced pathology will only occur where diagnoses have not been made, and/or standard antibiotic therapy has not been implemented in the early stage of disease.     

Prevalence of probable attention-deficit/hyperactivity disorder in inmates and its relationship with recidivism

The aim of the current study was to determine the prevalence of probable attention-deficit/hyperactivity disorder (ADHD) in prisoners and to assess the relationship between ADHD and recidivism. We studied 356 inmates, who were evaluated using the Wender Utah Rating Scale and Adult ADHD Self-Report Scale. Type of crime and other crime-related data were compared between inmates with and without ADHD. The group with probable ADHD had a higher average number of convictions compared to the group without ADHD. The probable ADHD group also demonstrated higher incidence of extortion crime, drug trade, disciplinary action at school, and military service than the group without ADHD. Linear regression analysis revealed that the presence of probable ADHD was effective on the number of convictions. The findings of our study support that the presence of probable ADHD carries a potential risk of being prone to certain crimes and demonstrate a correlation between the presence of probable ADHD and early involvement in crime and the number of convictions.     

Fatal Oral Methylphenidate Intoxication with Postmortem Concentrations

Methylphenidate (MPD) is a widely prescribed stimulant used primarily for the treatment for attention‐deficit/hyperactivity disorder (ADHD). Suicide attempts involving MPD ingestion have been well described; however, deaths attributed solely to MPD ingestion have not been reported. A 62‐year‐old woman was found dead on her floor. The only discrepancy in among her medication quantities was that >three hundred 10 mg MPD tablets were missing. Analysis utilizing gas chromatography–mass spectrometry revealed elevated postmortem MPD peripheral and central blood, liver and vitreous humor concentrations. Considering both the central blood to peripheral blood ratio (0.89) and the liver to peripheral blood ratio (3.3), MPD does not appear subject to significant postmortem redistribution. With no other identifiable cause of death, we report what appears to be the first isolated MPD ingestion associated with a fatality.     

Learning disabilities and delinquency: a study of Israeli prison inmates

Research consistently illustrates that several intellectual disabilities--namely, learning disabilities (LD), low intelligence, challenging behavior, and inadequate adaptive behavior, as well as attention deficit hyperactivity disorder (ADHD)--are considered risk factors for antisocial and criminal behavior. Although much attention has been paid to the relationship of LD, ADHD, and criminal behavior, three research topics have been overlooked: the frequency of LD with ADHD among inmates, the relationship between LD and/or ADHD and level of education among prisoners, and the connection between LD and/or ADHD and age of criminal onset. The present study examined the frequency of LD and ADHD in a sample of Israeli-born prisoners, in addition to the frequency of each category by itself, and it investigated the relationship of LD and/or ADHD, school dropout age, and onset of criminal activity.     

The mental health needs of incarcerated youth in British Columbia, Canada

The purpose of the study was to identify the current prevalence of mental disorders and mental health needs among incarcerated male and female youths in Canada, and to present these data in the context of rates found in other jurisdictions. One hundred forty male and 65 female incarcerated young offenders in British Columbia were screened with the Massachusetts Youth Screening Instrument Version 2 (MAYSI-2); provisional psychiatric diagnoses were assessed with the Diagnostic Interview Schedule for Children Version IV (DISC-IV); abuse history and aggressive symptoms of Conduct Disorder (CD) were coded from file information. Nearly all youths (91.9% of males and 100% of females) met the criteria for at least one mental disorder. Substance abuse and dependence disorders were highly prevalent (85.5% of males and 100% of females). Aggressive forms of CD were common (72.9% of males and 84.3% of females), as were exposure to physical abuse (60.8% of males and 54.3% of females) and sexual abuse (21.2% of males and 42.4% of females). Female youths had significantly higher odds of presenting with: (1) substance abuse/dependence disorders; (2) current suicide ideation; (3) sexual abuse; (4) PTSD; (5) symptoms of depression and anxiety; (6) Oppositional Defiant Disorder; and (7) multiple mental disorder diagnoses. Male youths had significantly higher odds of presenting with aggressive symptoms of CD. Overall, rates of mental disorder among this sample of serious and violent young offenders were higher than rates previously reported for incarcerated youths — both in Canada and in other jurisdictions.     

Myocardial Bridging: A Meta‐Analysis of Prevalence

The main objective of this article was to analyze prevalence data about myocardial bridging (MB) in published studies. To this purpose, we performed a meta‐analysis of studies published in English literature that contained data about the prevalence of MB and its anatomical characteristics. The overall prevalence was 19% (CI: 17–21%); autopsy studies revealed an overall prevalence of 42% (CI: 30–55%), CT studies 22% (CI: 18–25%), and coronary angiography 6% (CI: 5–8%). Most bridges were located on the left anterior descending artery (82% overall, 63% on autopsy studies), had a mean thickness of 2.47 mm and a mean length of 19.3 mm. In conclusion, autopsy studies should be the gold standard in evaluating the actual prevalence of myocardial bridges, while in vivo high‐resolution CT scanning should be preferred to coronary angiography studies.     

Psychiatric morbidity among Finnish prisoners with special reference to socio-demographic factors: results of the Health Survey of Finnish Prisoners (Wattu Project)

The present study is part of the Health Survey of Finnish Prisoners (Wattu Project). The project dealt with a sample of 1099 Finnish prisoners, of which 82% participated in the study. Because of the representativeness of the sample the results can be generalized to all Finnish prisoners. The methods used consisted of questionnaires, interviews, a clinical examination by prison physicians and gathering of register data. The total prevalence rate of psychiatric cases was 56%. This is much higher than the rate for the Finnish population in general. The high number of mental disorders was due to alcoholism (43%) and personality disorders (18%). These disorders became even more prevalent as the number of prison sentences increased. There was no difference between the prisoners and the general population in the prevalence of psychoses and neuroses. Alcoholism is the most important mental disorder in Finnish prisoners, while drug abuse is rarely found among them in comparison to prisoners in many other countries.