Relevance of psychogeriatrics in the prison setting: a systematic review.

INTRODUCTION: The aging of the world population is reflected in the penitentiary setting, with a progressive increase of elderly inmates. These prisoners present complex clinical processes with multiple comorbidities, and require a specialized approach. However, resources have not yet been adapted to the unique characteristics of this vulnerable subpopulation. The aim of this review is to highlight the relevance of psychogeriatrics in prison, detecting the most prevalent diseases and outlining the needs of elderly inmates. MATERIAL AND METHOD: Narrative review through databases of those studies that analyze psychopathologies among inmates over 50. RESULTS: Elderly inmates present a high prevalence of substance use (especially alcohol), affective symptoms (depression) and cognitive deterioration. A significant presence of personality disorders, anxiety, post-traumatic disorders, psychotic disorders, and physical comorbidities is also observed, with rates higher than among young convicts and the general geriatric population. There is a higher prevalence for any diagnosis amongst women, mainly for affective disorders. DISCUSSION: Prisoners over 50 have a different profile from other prison population. They suffer from more physical and mental illnesses, and so require specific health and social approaches. It would be advisable to adapt clinical care by optimizing resources, developing prison psychogeriatrics and establishing specific assessment and treatment methods.

Relevancia de la psicogeriatría en el entorno penitenciario: una revisión sistemática / Relevance of psychogeriatrics in the prison setting: a systematic review

Introducción: El envejecimiento de la población mundial tiene su reflejo en el entorno penitenciario, con un incremento progresivo de los internos de edad avanzada. Los reclusos mayores presentan cuadros clínicos complejos, con múltiples comorbilidades, requiriendo un abordaje especializado. Aun así, los dispositivos todavía no se han adaptado a las peculiaridades deesta subpoblación vulnerable. El objetivo del trabajo es determinar la relevancia de la psicogeriatría en prisión, detectando lasenfermedades más prevalentes y perfilando las necesidades de los internos de edad avanzada.Material y método: Revisión sistemática a través de bases de datos de aquellos estudios que analizan la psicopatología existenteentre reclusos mayores de 50 años.Resultados: Los internos de avanzada edad presentan una prevalencia elevada de abuso de sustancias (especialmente alcohol),cuadros afectivos (depresión) y deterioro cognitivo. Asimismo, también se observa una presencia relevante de trastornos depersonalidad, de ansiedad y postraumáticos, trastornos psicóticos y comorbilidades físicas, con tasas superiores a los penadosjóvenes y a la población general geriátrica. En mujeres, existe una mayor prevalencia para cualquier diagnóstico, principalmentecuadros afectivos.Discusión: Los presos mayores de 50 años tienen un perfil diferente al resto de población penitenciaria. Padecen más enfermedades físicas y mentales, por lo que requieren un abordaje sanitario y social específico. Sería recomendable adaptar la atenciónclínica mediante la optimización de recursos, desarrollando la psicogeriatría penitenciaria y estableciendo métodos específicos de evaluación y tratamiento. (AU)

Introduction: The aging of the world population is reflected in the penitentiary setting, with a progressive increase of elderlyinmates. These prisoners present complex clinical processes with multiple comorbidities, requiring a specialized approach.Still, the devices have not yet adapted to the peculiarities of this vulnerable subpopulation. The aim of this review is tohighlight the relevance of psychogeriatrics in prison, detecting the most prevalent diseases and outlining the needs of elderlyinmates.Material and method: Narrative review through databases of those studies that analyze the psychopathology existing amonginmates over 50.Results: Elderly inmates present a high prevalence of substance abuse (especially alcohol), affective symptoms (depression) andcognitive deterioration. Likewise, is observed a significant presence of personality disorders, anxiety, post-traumatic disorders,psychotic disorders, and physical comorbidities, with rates higher than young convicts and the general geriatric population. Inwoman exists a higher prevalence for any diagnosis, mainly for affective conditions. Discussion: Prisoners over 50 have a different profile from the rest of the prison population. They suffer more physical and mental illnesses, so they require specific health and social approach. It would be advisable to adapt clinicalcare by optimizing resources, developing prison psychogeriatrics and establishing specific assessment and treatment methods. (AU)