Comorbidity of severe psychiatric disorders and substance use disorders among women in jail.
01 May 2003-American Journal of Psychiatry (American Psychiatric Publishing)-Vol. 160, Iss: 5, pp 1007-1010
TL;DR: Because most detainees return to their communities in a few days, these findings have implications for treatment of high-risk women throughout the mental health system.
Abstract: OBJECTIVE: This article presents the prevalence, patterns, and sequences of severe psychiatric disorders and substance use disorders among female jail detainees. METHOD: Subjects were a randomly selected, stratified sample of 1,272 female arrestees awaiting trial at the Cook County Department of Corrections in Chicago. Independent clinical research interviewers administered the National Institute of Mental Health Diagnostic Interview Schedule Version III-R to assess comorbid psychiatric disorders and substance use disorders. RESULTS: Eight percent of the women had both a current severe mental disorder and a current substance use disorder. Nearly three-quarters of those with severe mental disorders also met criteria for one or more substance use disorders. CONCLUSIONS: Because most detainees return to their communities in a few days, these findings have implications for treatment of high-risk women throughout the mental health system.
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01 Nov 2009
TL;DR: It is tested whether significant differences in mental illness exist in a matched sample of Mental illness and the criminal justice system.
Abstract: We test whether significant differences in mental illness exist in a matched sample of Mental illness and the criminal justice system. In T. L. Scheid T. N. Brown (Eds.), A handbook for the study of mental health: Social contexts, theories. Find 9780521567633 A Handbook for the Study of Mental Health : Social Contexts, Theories, and Systems by Horwitz et al at over 30 bookstores. Buy, rent. A review of mental health problems in fathers following the birth of a child. for the study of mental health:Social contexts, theories, and systems (2nd ed., pp.
842 citations
TL;DR: The estimates in this study have profound implications in terms of resource allocation for treatment in jails and in community-based settings for individuals with mental illness who are involved in the justice system.
Abstract: Objective: This study estimated current prevalence rates of serious mental illness among adult male and female inmates in five jails during two time periods (four jails in each period). Methods: During two data collection phases (2002–2003 and 2005–2006), recently admitted inmates at two jails in Maryland and three jails in New York were selected to receive the Structured Clinical Interview for DSM-IV (SCID). Selection was based on systematic sampling of data from a brief screen for symptoms of mental illness that was used at admission for all inmates. The SCID was administered to a total of 822 inmates—358 during phase I and 464 during phase II. To determine the current (past-month) prevalence of serious mental illness (defined as major depressive disorder; depressive disorder not otherwise specified; bipolar disorder I, II, and not otherwise specified; schizophrenia spectrum disorder; schizoaffective disorder; schizophreniform disorder; brief psychotic disorder; delusional disorder; and psychotic disorder not otherwise specified), interview data were weighted against strata constructed from the screening samples for male and female inmates by jail and study phase. Results: Across jails and study phases the rate of current serious mental illness for male inmates was 14.5% (asymmetric 95% confidence interval [CI]=11.0%–18.9%) and for female inmates it was 31.0% (asymmetric CI=21.7%–42.1%). Conclusions: The estimates in this study have profound implications in terms of resource allocation for treatment in jails and in community-based settings for individuals with mental illness who are involved in the justice system. Psychiatric Services 60:761–765, 2009)
767 citations
TL;DR: Comorbid psychiatric disorders are a major health problem among detained youth and the odds of having comorbid disorders were higher than expected by chance for most demographic subgroups, except when base rates of disorders were already high or when cell sizes were small.
Abstract: Objective To estimate 6-month prevalence of comorbid psychiatric disorders among juvenile detainees by demographic subgroups (sex, race/ethnicity, and age). Design Epidemiologic study of juvenile detainees. Master's level clinical research interviewers administered the Diagnostic Interview Schedule for Children Version 2.3 to randomly selected detainees. Setting A large temporary detention center for juveniles in Cook County, Illinois (which includes Chicago and surrounding suburbs). Participants Randomly selected, stratified sample of 1829 African American, non-Hispanic white, and Hispanic youth (1172 males, 657 females, aged 10-18 years) arrested and newly detained. Main Outcome Measure Diagnostic Interview Schedule for Children. Results Significantly more females (56.5%) than males (45.9%) met criteria for 2 or more of the following disorders: major depressive, dysthymic, manic, psychotic, panic, separation anxiety, overanxious, generalized anxiety, obsessive-compulsive, attention-deficit/hyperactivity, conduct, oppositional defiant, alcohol, marijuana, and other substance; 17.3% of females and 20.4% of males had only one disorder. We also examined types of disorder: affective, anxiety, substance use, and attention-deficit/hyperactivity or behavioral. The odds of having comorbid disorders were higher than expected by chance for most demographic subgroups, except when base rates of disorders were already high or when cell sizes were small. Nearly 14% of females and 11% of males had both a major mental disorder (psychosis, manic episode, or major depressive episode) and a substance use disorder. Compared with participants with no major mental disorder (the residual category), those with a major mental disorder had significantly greater odds(1.8-4.1) of having substance use disorders. Nearly 30% of females and more than 20% of males with substance use disorders had major mental disorders. Rates of some types of comorbidity were higher among non-Hispanic whites and older adolescents. Conclusions Comorbid psychiatric disorders are a major health problem among detained youth. We recommend directions for research and discuss how to improve treatment and reduce health disparities in the juvenile justice and mental health systems.
549 citations
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TL;DR: This article concludes with a strong recommendation for the mandatory electronic recording of interrogations and considers other possibilities for the reform of interrogation practices and the protection of vulnerable suspect populations.
Abstract: Recent DNA exonerations have shed light on the problem that people sometimes confess to crimes they did not commit. Drawing on police practices, laws concerning the admissibility of confession evidence, core principles of psychology, and forensic studies involving multiple methodologies, this White Paper summarizes what is known about police-induced confessions. In this review, we identify suspect characteristics (e.g., adolescence; intellectual disability; mental illness; and certain personality traits), interrogation tactics (e.g., excessive interrogation time; presentations of false evidence; and minimization), and the phenomenology of innocence (e.g., the tendency to waive Miranda rights) that influence confessions as well as their effects on judges and juries. This article concludes with a strong recommendation for the mandatory electronic recording of interrogations and considers other possibilities for the reform of interrogation practices and the protection of vulnerable suspect populations.
455 citations
TL;DR: A review of police-induced confessions can be found in this paper, where the authors identify suspect characteristics (e.g., adolescence, intellectual disability, mental illness, and certain personality traits) and interrogation tactics (i.e., excessive interrogation time, presentations of false evidence, and minimization) that influence confessions as well as their effects on judges and juries.
Abstract: Recent DNA exonerations have shed light on the problem that people sometimes confess to crimes they did not commit. Drawing on police practices, laws concerning the admissibility of confession evidence, core principles of psychology, and forensic studies involving multiple methodologies, this White Paper summarizes what is known about police-induced confessions. In this review, we identify suspect characteristics (e.g., adolescence; intellectual disability; mental illness; and certain personality traits), interrogation tactics (e.g., excessive interrogation time; presentations of false evidence; and minimization), and the phenomenology of innocence (e.g., the tendency to waive Miranda rights) that influence confessions as well as their effects on judges and juries. This article concludes with a strong recommendation for the mandatory electronic recording of interrogations and considers other possibilities for the reform of interrogation practices and the protection of vulnerable suspect populations.
403 citations
References
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TL;DR: In this article, a new interview schedule allows lay interviewers or clinicians to make psychiatric diagnoses according to DSM-III criteria, Feighner criteria, and Research Diagnostic Criteria.
Abstract: • A new interview schedule allows lay interviewers or clinicians to make psychiatric diagnoses according to DSM-III criteria, Feighner criteria, and Research Diagnostic Criteria. It is being used in a set of epidemiological studies sponsored by the National Institute of Mental Health Center for Epidemiological Studies. Its accuracy has been evaluated in a test-retest design comparing independent administrations by psychiatrists and lay interviewers to 216 subjects (inpatients, outpatients, ex-patients, and nonpatients).
4,884 citations
TL;DR: The results show that alcohol abuse and dependence are often associated with other lifetime NCS/DSM-III-R disorders and suggest that, at least in recent cohorts, the alcohol use disorders are usually temporally secondary.
Abstract: Objective: To study patterns of co-occurrence of lifetimeDSM-III-Ralcohol disorders in a household sample. Methods: Data came from the National Comorbidity Survey (NCS), a nationally representative household survey. Diagnoses were based on a modified version of the Composite International Diagnostic Interview. Results: Respondents with lifetimeNCS/DSM-III-Ralcohol abuse or dependence had a high probability of carrying at least 1 other lifetimeNCS/DSM-III-Rdiagnosis. Retrospective reports have suggested that most lifetime co-occurring alcohol disorders begin at a later age than at least 1 other NCS/DSM-III-Rdisorder. Earlier disorders are generally stronger predictors of alcohol dependence than alcohol abuse and stronger among women than men. Lifetime co-occurrence is positively, but weakly, associated with the persistence of alcohol abuse among men and of alcohol dependence among both men and women. Conclusions: Caution is needed in interpreting the results due to the fact that diagnoses were made by nonclinicians and results are based on retrospective reports of the age at onset. Within the context of these limitations, though, these results show that alcohol abuse and dependence are often associated with other lifetimeDSM-III-Rdisorders and suggest that, at least in recent cohorts, the alcohol use disorders are usually temporally secondary. Prospective data and data based on clinically confirmed diagnoses are needed to verify these findings.
1,947 citations
"Comorbidity of severe psychiatric d..." refers background in this paper
...Epidemiologic studies of men in jail (4), persons with high arrest rates (5), and women in the general population with severe mental disorders (6) suggest that comorbidity of substance use disorders and other psychiatric disorders is common among women in jail....
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TL;DR: The positive associations between psychiatric comorbidity and severity of substance use and other psychosocial problems were most consistent among those with antisocial personality.
Abstract: Background: Major studies of psychiatric comorbidity in opioid abusers reported rates of comorbidity that far exceeded general population estimates. These studies were published more than a decade ago and reported on few women and few substance use diagnoses. Methods: Psychiatric and substance use comorbidity was assessed in 716 opioid abusers seeking methadone maintenance. Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition diagnostic assessment was conducted 1 month after admission. Rates of psychiatric and substance use disorder were compared by gender, and associations were assessed between psychiatric comorbidity and dimensional indexes of substance use severity, psychosocial impairment, and personality traits. Results: Psychiatric comorbidity was documented in 47% of the sample (47% women and 48% men). Antisocial personality disorder (25.1%) and major depression (15.8%) were the most common diagnoses. Patients had at least 2 substance use diagnoses, most often opioid and cocaine dependence. Demographics, substance use history, and personality variables discriminated between patients with vs without comorbidity. Psychiatric comorbidity also was associated with a more severe substance use disorder. Conclusions: Psychiatric comorbidity, especially personality and mood disorder, was common in men and women. The positive associations between psychiatric comorbidity and severity of substance use and other psychosocial problems were most consistent among those with antisocial personality.
739 citations
"Comorbidity of severe psychiatric d..." refers background in this paper
...Epidemiologic studies of men in jail (4), persons with high arrest rates (5), and women in the general population with severe mental disorders (6) suggest that comorbidity of substance use disorders and other psychiatric disorders is common among women in jail....
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TL;DR: Substantial psychiatric morbidity among female jail detainees is suggested, except for schizophrenia, which was arrested for nonviolent crimes.
Abstract: Background: There are little epidemiologic data on psychiatric disorders of women in jails. Accurate data on female jail detainees are critical because of their increasing numbers and their unique treatment needs. Methods: Using the Diagnostic Interview Schedule, independent interviewers assessed a randomly selected, stratified sample of 1272 female jail detainees awaiting trial in Chicago, Ill. We tabulated lifetime and 6-month prevalence rates of disorders by race or ethnicity (African American, non-Hispanic white, Hispanic), age, and education and compared the jail rates with general population rates for women in the Epidemiologic Catchment Area program. We also examined whether or not psychiatric disorder was associated with the severity of the detainee's current arrest charges. Results: Over 80% of the sample met criteria for one or more lifetime psychiatric disorders; 70% were symptomatic within 6 months of the interview. The most common disorders were drug abuse or dependence, alcohol abuse or dependence, and post-traumatic stress disorder. Major depressive episode was the most prevalent major mental disorder. Rates were generally highest among non-Hispanic whites and among older detainees. Rates for all disorders were significantly higher than general population rates, except for schizophrenia. Most detainees with psychiatric disorders were arrested for nonviolent crimes. Conclusion: These results suggest substantial psychiatric morbidity among female jail detainees.
702 citations
"Comorbidity of severe psychiatric d..." refers background or methods in this paper
...The Cook County Department of Corrections receives approximately 6,400 female admissions per year; its population is similar to that of jails nationwide, composed disproportionately of racial/ethnic minorities (2)....
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...Additional information on methods is available elsewhere (2)....
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...On the basis of our prior analyses of these data (2), we presumed a design effect of 1....
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...Nearly one-fifth of the women in jail have severe psychiatric disorders (2), double the rate among women in the general population and higher than the rate among male detainees (3)....
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TL;DR: It is demonstrated that most subjects with a severe mental disorder also meet criteria for a substance abuse or antisocial personality disorder, and these findings suggest several changes in public policy regarding health care delivery in correctional settings and for the general population.
Abstract: Studies have demonstrated that police often arrest the mentally ill when treatment alternatives would be preferable but are unavailable. Thus, jails may contain disproportionate numbers of severely mentally ill persons who have co-occurring disorders. Data on the co-occurrence of severe mental disorder, substance abuse, and antisocial personality disorders were gathered from 728 randomly selected male urban jail detainees. Using difference of proportions tests and loglinear analysis, the authors demonstrated that most subjects with a severe mental disorder (schizophrenia or a major affective disorder) also meet criteria for a substance abuse or antisocial personality disorder. These findings suggest several changes in public policy regarding health care delivery in correctional settings and for the general population.
496 citations
"Comorbidity of severe psychiatric d..." refers background in this paper
...org they receive fewer outpatient and residential services (15); with fewer treatments available, persons with comorbidity may be more vulnerable to arrest (4)....
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...Epidemiologic studies of men in jail (4), persons with high arrest rates (5), and women in the general population with severe mental disorders (6) suggest that comorbidity of substance use disorders and other psychiatric disorders is common among women in jail....
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...of comorbid alcohol use disorder than men in jail (4)....
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