Suicidal ideation in a United States jail: demographic and psychiatric correlates

Suicidal behavior is a significant problem in United States jails. Suicidal ideation (SI) is an established precursor to suicidal behavior in incarcerated populations. No studies to date have examined the prevalence of SI or its correlates in a mixed-gender U.S. jail sample. The purpose of the present study was to document rates of SI in a mixed-gender jail sample and examine socio-demographic and psychiatric correlates. This study of 511 jail inmates found that approximately 16% of participants reported clinically significant SI upon incarceration. White participants, suicide attempters, and those with a psychiatric diagnosis history endorsed greater SI. Reported SI did not differ by sex and was not correlated with age. Clinically, results indicate that screening for SI in jail samples is necessary to identify high-risk individuals for intervention to prevent suicidal behavior.     

Substance abuse and crime: A local jail assessment

Conclusion The clear picture of multiple arrests and conviction patterns emerged from the study which might indicate long term problems, perhaps with subcultural motivation. Many inmates indicated informally that the pressures to use drugs and alcohol “on the streets” are quite strong, and will be difficult to resist after release. Several of the older inmates who had been heavily addicted before their arrests volunteered to serve as counselors to explain the hazards of drug and alcohol abuse to younger inmates. Unfortunately, a significant number of these inmates also stated that they would probably continue to use drugs upon It would appear that we may expect these relationships to continue in the future, unless some dramatic efforts are made in the enforcement of drug laws, prevention of the gross availability of illegal drugs and legal alcohol, and in the effective rehabilitation of substance abusing offenders. Of particular importance (and difficulty) will be isolating and curbing those social forces which motivate persons to continue using drugs and alcohol in seemingly irrational quantities and combinations, even after arrest and incarceration for substance abuse related behavior.     

Mental health weapons prohibition: demographic and psychiatric factors in petitions for relief

Federal law and most states prohibit possession of firearms by individuals with a history of certain psychiatric diagnoses and/or treatment. In California, an involuntary 72-h hold can trigger a 5-year ban on firearm possession. Individuals so prohibited may petition for early termination of the ban. We report on the demographic and psychiatric characteristics of a sample of individuals petitioning for early relief in Los Angeles County, and on the results of their petitions. The majority of petitioners were Caucasian men over age 40. Sixteen percent of petitioners were employed in law enforcement or armed security, and all of their petitions were granted. Individuals for whom there was greater evidence of mental disorder were significantly less likely to petition successfully. The results are discussed in terms of the benefits of involving a forensic expert in the petition process, which is not presently required under California law.     

Substance use disorders in forensic psychiatric patients

There is a lack of detailed information on the role of substance use disorders (SUD) as a substantial factor in offences and treatment in forensic psychiatric patients. The aim of this study was to get a better understanding of these specifics. Clinical records of 193 male patients admitted to a Dutch forensic psychiatric hospital were scrutinized on anamnestic, diagnostic and risk assessment data. One of the central findings was that the prevalence of SUDs was high. Patients with an SUD had a more extensive criminal history, unstable and deviant lifestyle and higher risk of violent behavior than patients without a substance use disorder. No differences were found in duration of treatment, aggressive incidents and leave. Another important finding was that a distinction could be made between patients with substance use as a primary criminogenic risk factor and patients with substance use as a secondary risk factor. Although substance use is identified as a general risk factor, this study supports the idea of sub categorization of patients with an SUD and emphasizes the need for a different treatment approach. Further study is needed to identify specific treatment approaches, based on more differentiated profiles of these patients.     

Prevalence of delusional jealousy in psychiatric disorders

Delusional jealousy is a known risk factor for violence and homicide, but little is known about its prevalence in psychiatric disorders. We therefore reviewed retrospectively the psychopathological symptoms at admission and discharge, assessed with the AMDP system, of all patients admitted to the Psychiatric Hospital, University of Munich, Germany, from January 2000 through December 2008 (n=14,309). We identified 72 cases of delusional jealousy (0.5% of the whole sample). The prevalence was highest in schizophrenia and other psychoses (1.3%), and more of the patients with delusional jealousy were men (43 of 72, 59.7%). One-fifth (15 of 72, 20.8%) of the patients with delusional jealousy were aggressive at admission (vs. 6.2% of the total sample). We conclude that delusional jealousy is a comparatively rare phenomenon that is most frequent in schizophrenia and related psychoses. Quite a number of affected patients are aggressive, which may indicate a risk of future violence.     

Mental disorders and cognitive impairment in ageing offenders

The aim of our study was to identify psychiatric and cognitive disorders among older prison inmates and to investigate whether there is an association between mental disorders and cognitive impairment. 138 men aged 50 and over were recruited in seven French prisons (Group 1) and 138 men aged 50 and over were recruited from the general public (Group 2). Participants were assessed using the Mini International Neuropsychiatric Interview, the Mini Mental State Examination, and the Frontal Assessment Battery. The results reveal very significant differences in the incidence of mental disorders and in cognitive performance between the two groups. However, there does not appear to be a significant link between mental disorders and cognitive performance. We discuss the risk factors for mental disorders and cognitive impairment. We raise particularly the issue of depression, which is the most common pathology in this population and which is generally associated with the risk of suicide.     

Co-occurring psychiatric and substance use disorders among male detainees in Italy

This paper presents data on the prevalence of co-occurring substance use and psychiatric disorders among newly imprisoned males in Italy. Interviewers conducted semi-structured clinical interviews with n = 302 male detainees seven days after their admission to the prison of Perugia from August 2005 through July 2006. Over half of male detainees (54.3%) had either a substance use disorder or another psychiatric disorder. One of every five detainees (20.9%) had comorbid substance use and psychiatric disorders. Compared to detainees with psychiatric disorder only, substance use disorder only, or no disorder, detainees with comorbid substance use and psychiatric disorders were significantly more likely to have severe impairment in the areas of employment, substance abuse, family and social functioning, and psychiatric symptoms. Findings underscore the need for careful diagnostic screening at intake, access to treatment during detention, and an effective transition to services at the time of release.     

Mental health disorders and functioning of women in domestic violence shelters

This study investigates the presence of mental health symptoms and disorders reported by 74 women in a domestic violence shelter and the impact of those symptoms on function in work, school, and social encounters. Findings are compared to estimates of U.S. women generally, based on a national sample of over 65,000 women drawn from the 1995 National Health Interview Survey. The sheltered sample presents significantly higher rates of mental conditions and functional impairments affecting their work, school, and social functioning. These women are also less educated and poorer and use more health services than the U.S. population. Mental health conditions must be identified in shelters to improve functioning and facilitate independence from abusers.     

The forensic psychiatric evaluation of mental disorders in diabetic patients

The article deals with the results of investigation of psychic disturbances in 7 patients with diabetes mellitus. Psychic dysfunctions which are important for forensic psychiatric practice (depressions, transitory psychotic episodes at the background of hyperglycemia and pathologic states with consciousness disturbance, psychomotor excitement and incorrect behaviour in hypoglycemic states) were analysed. Characteristics were noted which contributed to diagnosing in patients with diabetes mellitus, the states of temporary morbid mental disorder and choosing correct expert conclusion in relation to persons who committed indictable actions.     

Pervasive developmental disorders, psychiatric comorbidities, and the law

Scattered reports propose that pervasive developmental disorders (PDDs) are risk factors for criminal behavior, yet the association between PDD and delinquent behavior is untrue for the majority of patients. However, individuals with PDDs may be at risk for legal trouble in the presence of comorbid psychopathology, and not solely on the basis of their developmental disability. This article analyzes theoretically the relationship between complex developmental disorders and delinquency with the hypothesis that the delinquent behaviors reported in it resulted from comorbid psychopathology and not as a direct consequence of a developmental disorder. A small series of patients diagnosed with a PDD and comorbid psychiatric illnesses whose admission to the hospital was precipitated by delinquent behavior is presented.     

Sociological, social psychological, and psychopathological correlates of substance use disorders in the U.S. jail population

The objective of this study was to examine sociological, social psychological, and psychopathological correlates of substance abuse disorders in a nationally representative sample of jail inmates. Criminal history and clinical factors most strongly differentiated convicted inmates with and without substance use disorders regardless of current index offense. Policy implications are discussed in terms of targeting antisocial attitudes and peer associations and more effective clinical treatments for substance use disorders among the inmate population. High rates of co-occurring depression symptoms and anger dyscontrol found among inmates with substance use disorders in this study underscore the need for assessment and evaluation of specialized programs for co-occurring disorders and anger management programs among U.S. inmates.     

Compliance and learning in an intervention program for partner-violent men

Although research has yielded mixed findings regarding the effectiveness of intervention programs for partner-violent men, it appears that greater participant compliance with such programs is associated with better outcomes. However, no research to date has jointly examined compliance with intervention programs and the extent to which partner-violent men learn specific information presented during the programs. The current study makes use of existing data to evaluate general and specific elements of partner-violent men's compliance with (i.e., active, appropriate participation in) an intervention program and recall of key points from the program. Results from a subsample of 22 men indicate that at program termination, those rated as having been "process conscious" during intervention group sessions, having self-disclosed during sessions, having evidenced awareness and use of techniques to avoid violence, and having used respectful language show greater recall of material taught in the program. This finding points to the potential benefit of taking steps to increase men's active participation in programs and of studying active engagement as a mediator of program effects on men's violence toward partners.     

Co-occurring serious mental illnesses and substance use disorders as predictors of assaultive infraction charges among adult male jail inmates

This study used self-report data from 4642 adult male jail inmates to test the hypothesis that inmates with co-occurring serious mental illnesses (SMIs) and substance use disorders (SUDs) (i.e. co-occurring disorders) would report having been officially charged for assaulting staff or inmates more often than inmates without co-occurring disorders. Negative binomial regression indicated that relative to inmates with neither SMI nor SUDs, assault charges were most likely to be reported by inmates with co-occurring SMI and substance abuse, co-occurring SMI and substance dependence, and only substance abuse, respectively (ps ≤ .01). Having been charged with assault was also strongly associated with assault victimization before and while incarcerated (ps ≤ .05). This article concludes with recommendations for jail policies and future research.     

Mental Capacity in Patients Involuntarily or Voluntarily Receiving Psychiatric Treatment for an Acute Mental Disorder

Despite the growing amount of data, much information is needed on patients' mental capacity to consent to psychiatric treatment for acute mental disorders. The present study was undertaken to compare differences in capacity to consent to psychiatric treatment in patients treated voluntarily and involuntarily and to investigate the role of psychiatric symptoms, competency, and cognitive functioning in determining voluntariness of hospital admission. Involuntary patients were interviewed with the MacArthur Competence Assessment Tool for Treatment (MacCAT‐T), the 24‐item Brief Psychiatric Rating Scale (BPRS), the Mini Mental State Examination (MMSE) and the Raven's Colored Progressive Matrices, and their data were compared with those for age‐ and sex‐matched voluntary patients. Involuntary patients performed worse in all MacCAT‐T subscales. Capacity to consent to treatment varied widely within each group. Overall, involuntary patients have worse consent‐related mental capacity than those treated voluntarily, despite capacity to consent to treatment showing a significant variability in both groups.