Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 6.380
Filtrar
1.
Psychiatry Res ; 296: 113669, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33401092

RESUMO

This study aimed to analyze the possible impacts on the prison population's mental health in the context of the new COVID-19 pandemic. Qualitative study was carried out following a lexical and content analysis using the software IRaMuTeQ, version 0.7 alpha 2, in the speech of the short communication and headlines from newspapers. Three groups emerged from the analysis: "spatial conditions for infection" (39.2% of the text segments); "disease outbreaks in prisons" (30,4%) and "public responsibility" (30,4%). Precarious conditions of prisons, high rate of infections and psychiatric illnesses, and lack of government assistance are issues that should be given special attention in order to formulate health promotion and prevention policies focusing on mental health in prison population.


Assuntos
/epidemiologia , Transtornos Mentais/epidemiologia , Prisioneiros/estatística & dados numéricos , /prevenção & controle , Comorbidade , Estudos Transversais , Estudos de Avaliação como Assunto , Promoção da Saúde , Humanos , Transtornos Mentais/prevenção & controle , Transtornos Mentais/psicologia , Prisioneiros/psicologia , Assistência Pública , Fatores de Risco
2.
Soins Psychiatr ; 41(329): 37-44, 2020.
Artigo em Francês | MEDLINE | ID: mdl-33129405

RESUMO

To try to understand acting out, it depends of conciliation between the reality of the act and the psychic life. For that, it is necessary to listen the word of the criminal authors. What transgression represents for them? Based on clinical experience in a correctional center, this article takes a closer look about prisoner, incarcerated after having committed criminal acts. This clinical material could help to raise a new perspective around modern psychopathology. What is the act's difference between neurosis, perversion, borderline and psychosis? Our research will try to differentiate the psychic issues.


Assuntos
Encenação , Transtornos Psicóticos , Humanos , Prisioneiros/psicologia , Psicopatologia
3.
Obstet Gynecol ; 136(5): 1036-1039, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33030860

RESUMO

The population of women within carceral systems is growing rapidly. A portion of these individuals are pregnant and will deliver while incarcerated. Although shackling laws for pregnant persons have improved, incarcerated patients are forced to labor without the support of anyone but a carceral officer and their medical staff. We believe access to continuous labor support is critical for all pregnant persons. Carceral systems and their affiliated hospitals have the opportunity to change policies to reflect that continuous labor support is a basic human right and should be permitted for incarcerated pregnant persons in labor, either through a doula program or a selected person of choice.


Assuntos
Parto Obstétrico/ética , Trabalho de Parto/psicologia , Direitos do Paciente/legislação & jurisprudência , Assistência Perinatal/ética , Prisioneiros/psicologia , Entorno do Parto , Parto Obstétrico/legislação & jurisprudência , Feminino , Humanos , Assistência Perinatal/legislação & jurisprudência , Gravidez , Prisioneiros/legislação & jurisprudência
4.
PLoS One ; 15(10): e0238510, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33035215

RESUMO

We examine how solitary confinement correlates with self-reported adverse physical health outcomes, and how such outcomes extend the understanding of the health disparities associated with incarceration. Using a mixed methods approach, we find that solitary confinement is associated not just with mental, but also with physical health problems. Given the disproportionate use of solitary among incarcerated people of color, these symptoms are most likely to affect those populations. Drawing from a random sample of prisoners (n = 106) in long-term solitary confinement in the Washington State Department of Corrections in 2017, we conducted semi-structured, in-depth interviews; Brief Psychiatric Rating Scale (BPRS) assessments; and systematic reviews of medical and disciplinary files for these subjects. We also conducted a paper survey of the entire long-term solitary confinement population (n = 225 respondents) and analyzed administrative data for the entire population of prisoners in the state in 2017 (n = 17,943). Results reflect qualitative content and descriptive statistical analysis. BPRS scores reflect clinically significant somatic concerns in 15% of sample. Objective specification of medical conditions is generally elusive, but that, itself, is a highly informative finding. Using subjective reports, we specify and analyze a range of physical symptoms experienced in solitary confinement: (1) skin irritations and weight fluctuation associated with the restrictive conditions of solitary confinement; (2) un-treated and mis-treated chronic conditions associated with the restrictive policies of solitary confinement; (3) musculoskeletal pain exacerbated by both restrictive conditions and policies. Administrative data analyses reveal disproportionate rates of racial/ethnic minorities in solitary confinement. This analysis raises the stakes for future studies to evaluate comparative prevalence of objective medical diagnoses and potential causal mechanisms for the physical symptoms specified here, and for understanding differential use of solitary confinement and its medically harmful sequelae.


Assuntos
Avaliação do Impacto na Saúde , Prisioneiros/psicologia , Isolamento Social/psicologia , Adulto , Doença Crônica , Disparidades nos Níveis de Saúde , Humanos , Masculino , Grupos Minoritários , Saúde das Minorias , Dor Musculoesquelética/etiologia , Prisões , Autorrelato , Inquéritos e Questionários , Washington
5.
Cien Saude Colet ; 25(9): 3493-3502, 2020 Sep.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32876243

RESUMO

Prisional health is, in its essence, public health. The COVID-19 pandemic poses a great threat to the world and has shown that preventing the disease escalation in prisons integrates the novel corona virus clash in society in general. Up to this moment, the most effective known measure to curb the disease spread is social isolation. Nevertheless, in penal institutions, often overcrowded, social isolation becomes difficult to carry out and, when it happens, it takes the enclosed population to overisolation, with consequences to their mental health. Besides, prisoners suffer with clogged up environment, lack of materials for personal hygiene, poor basic sanitary conditions and difficulties in accessing health services. This paper deals with a narrative review on the pandemic effects in prisons and how government and civil society have organized themselves in order to reduce the disease consequences at those places. The text has been divided into three sections: the first with literature review on the current health theme; the second discusses how different countries have been dealing with the prison situation in the pandemic context, and, the last part focuses on how the Brazilian Penal System has reacted to the new disease.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Prisioneiros/estatística & dados numéricos , Prisões/estatística & dados numéricos , Brasil , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Assistência à Saúde/organização & administração , Acesso aos Serviços de Saúde , Humanos , Saúde Mental , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Prisioneiros/psicologia , Isolamento Social
6.
PLoS One ; 15(9): e0239046, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32941496

RESUMO

The increasing recidivism rate of sex offenders indicates potential problems in existing recidivism programs. The present study was conducted to determine whether the polygraph examination is a useful technique to obtain a sex offender's concealed past sexual history. We collected fifty-two sex offenders' data and analyzed it. Among the 52 participants, the court ordered 26 sex offenders to take the psychiatric evaluation and the polygraph test. The other half were prisoners at the hospital who were currently undergoing treatment. The participants in the polygraph group disclosed more deviant sexual behaviors and paraphilia interests/behaviors than the comparison group. Thus, the polygraph examination is a powerful tool that can encourage sex offenders to disclose hidden information to help create suitable psychological therapy programs for preventing recidivism in the future.


Assuntos
Detecção de Mentiras/psicologia , Reincidência/prevenção & controle , Delitos Sexuais/psicologia , Adulto , Criminosos/psicologia , Humanos , Masculino , Transtornos Parafílicos/diagnóstico , Transtornos Parafílicos/psicologia , Prisioneiros/psicologia , Comportamento Sexual/psicologia , Revelação da Verdade/ética
7.
Crim Behav Ment Health ; 30(5): 256-267, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32896935

RESUMO

Liaison and Diversion (L&D) has twin objectives: improving mental health outcomes and reducing re-offending. Early diversion from police custody seems promising, but evidence of benefit is required to sustain such programmes. To test the hypothesis that contact with L&D services while in police custody would lead to improved mental health outcomes and a reduction in type and level of offending, we used a pre-post service use design. National Health Service (NHS) records in two counties were searched for evidence that patients had been involved with L&D services while in police custody during the period July 2009-December 2017. We defined January 2009-July 2014 as the pre-intervention period and any time after contact as the post-intervention period. Data from the Police National Computer were gathered for each period for these individuals, to assess their pre-post L&D contact offending histories. NHS Trust data were similarly gathered to assess their pre-post use of mental health legislation. 4,462 individuals were identified who had used L&D services in police custody. There were statistically significant reductions in the amount of offending following contact with the L&D service (whether one or two contacts), regardless of offence type. Statistically significant reductions were also observed in use of the four most commonly used legislative powers for detaining patients in hospital on mental disorder grounds, regardless of offending status (prolific/non-prolific). Our results indicate positive associations between the L&D interventions and change in offending and use of compulsory hospital detention. Whilst our research does not allow a direct causal relationship to be established in either area, the findings go beyond other impact assessments of L&D which have either been with small samples or relied only on qualitative data or expert opinion.


Assuntos
Criminosos/psicologia , Aplicação da Lei , Pessoas Mentalmente Doentes/psicologia , Polícia , Prisioneiros/psicologia , Adulto , Humanos , Estudos Longitudinais , Masculino , Transtornos Mentais/diagnóstico , Saúde Mental , Serviços de Saúde Mental , Transtornos Psicóticos , Medicina Estatal , Reino Unido
8.
Crim Behav Ment Health ; 30(5): 228-239, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32744391

RESUMO

BACKGROUND: The link between facial affect recognition and criminal justice involvement has been extensively researched, yet there are virtually no data on the capacity for facial affect recognition in post-incar+cerated individuals, and the results of many studies are limited due to a narrow focus on psychopathy rather than offence category. AIMS: To test the first hypothesis that individuals reporting a history of a violent offence would show a deficit in facial affect recognition and the second hypothesis that the violent offender's deficit would be exclusive to recognition of negative expressions, not affecting positive or neutral expressions. METHOD: Post-incarcerated individuals (N = 298) were recruited online through Qualtrics and completed questionnaires assessing their criminal justice background and demographics. They completed measures of facial affect recognition, anxiety and depression, and components of aggression. RESULTS: A logistic regression, including sex, ethnicity, age and years of education and depression/anxiety scores, indicated that committing a violent offence was independently associated with lower facial affect recognition scores as well as male gender and a trait-based propensity towards physical aggression, but no other co-variable. These data provided no evidence that this deficit was specific to negative emotions. CONCLUSIONS AND IMPLICATIONS FOR FUTURE RESEARCH/PRACTICE: Our study is one of the first to examine facial affect recognition in a post-incarcerated sample. It suggests that deficits in facial affect recognition, already well documented among violent prisoners, persist. While acknowledging that these may be relatively fixed characteristics, this study also suggests that, for these people, nothing happening during their imprisonment was touching this. Improving capacity in facial affect recognition should be considered as a target of intervention for violent offenders, developing or revising in-prison programmes as required.


Assuntos
Agressão/psicologia , Criminosos/psicologia , Emoções/fisiologia , Expressão Facial , Reconhecimento Facial/fisiologia , Prisioneiros/psicologia , Violência/psicologia , Adolescente , Adulto , Transtorno da Personalidade Antissocial/psicologia , Ansiedade/psicologia , Face , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Percepção Social , Voluntários
9.
Crim Behav Ment Health ; 30(5): 221-227, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32830392

RESUMO

BACKGROUND: Women with histories of childhood trauma tend to score higher on recidivism risk/needs assessment tools, such as the Level of Service Inventory-Revised: Screening Version (LSI-R: SV). These may affect their chance of leaving custody, but risk scores may be inflated by reliance on additional items which reflect other fixed childhood events. AIMS: We hypothesised that adverse childhood experiences (ACEs) would be related to immutable risk measures according to the LSI-R: SV, such as juvenile arrest history, rather than more mutable factors, such as criminal attitudes. METHODS: Two interviewer-administered questionnaires-one about ACEs and one about criminogenic risk and needs-were given to a cohort of women just after release from jail. Phi coefficients were used to test for associations between ? ACE scale scores and scores on the risk tool-the LSI-R: SV. RESULTS: ACE scale items were related to static risk item scores from the LSI-R: SV, but not to any of the dynamic risk items except psychological health. CONCLUSIONS: Risk reduction is an important task in the criminal justice system, for which systematic risk assessment is an integral part of decision making. Self-reported experience of psychological health apart, only fixed historical variables were related to estimated recidivism risk. There was no relationship between the mutable constructs of attitudes towards crime or employment status and estimated risk. This raises the question of whether the risk of recidivism is increased when there is a background of childhood trauma. Implications for using risk reduction tools to inform the need for trauma-informed correctional care are discussed. Longitudinal research assessing recidivism is needed to test this further.


Assuntos
Experiências Adversas da Infância , Crime/psicologia , Criminosos/psicologia , Prisioneiros/psicologia , Reincidência , Comportamento de Redução do Risco , Adolescente , Adulto , Criança , Crime/prevenção & controle , Feminino , Humanos , Masculino , Saúde Mental , Prisões , Medição de Risco , Inquéritos e Questionários
10.
Crim Behav Ment Health ; 30(5): 240-255, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32715530

RESUMO

Most studies of prisoners, the nature of their offending and any related characteristics have been conducted in rich Western countries. In Nigeria, prison conditions differ in many important respects, key among them that prisoners share large communal spaces much of the time-up to 50 men sleeping in the same space as well as spending the day together. Our aim was to compare levels of impulsivity, aggression and suicide-related behaviours between prisoners in one prison in Nigeria who had committed a homicide and those who had not, allowing for socio-demographic factors. A case-control study design was employed with 102 homicide and an equal number of non-homicide offenders. Each participant was interviewed using the Abbreviated Barratt Impulsiveness Scale for impulsivity, the Modified Overt Aggression Scale for aggression, the MINI International Neuropsychiatric Interview (Module C) for suicide-related behaviours, and a questionnaire for ascertaining socio-demographic characteristics. On bivariate analysis, motor impulsivity was higher among homicide offenders (p = .014) while non-planning was higher among non-homicide offenders (p = .006), but this relationship was affected by demographic variables. Physical aggression levels did not distinguish the two groups, but homicide offenders were less likely to record property-directed and auto-aggressive behaviours (p < .05). By contrast, on average, scores for suicide-related behaviours were lower among the homicide offenders (p = .001), with non-homicide offenders showing a mean score in the high-risk category (13.25; SD, 1.25). As motor impulsivity significantly differentiated the groups, this may be an important measure to add to any risk assessment battery when there are concerns about homicidal behaviours. In this sample, history of interpersonal aggression did not distinguish the groups. People with indications of self-harm or suicide-related behaviours may be at less risk of violence to others, but care should be taken in interpreting this finding as it is not entirely consistent with other findings.


Assuntos
Agressão/psicologia , Criminosos/psicologia , Comportamento Impulsivo , Prisioneiros/psicologia , Comportamento Autodestrutivo/psicologia , Suicídio/psicologia , Adulto , Estudos de Casos e Controles , Homicídio , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Escalas de Graduação Psiquiátrica , Inquéritos e Questionários , Violência/psicologia
11.
Nurs Outlook ; 68(5): 637-646, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32631795

RESUMO

BACKGROUND: Mind-body relaxation techniques are complementary or alternative to medication to manage high stress and anxiety levels in prisons. PURPOSE: To assess the motivation to attend and perceived benefits of a nurse-led group relaxation intervention in prison, investigate the experience of participants, prison officers, and health professionals, and identify improvements. METHOD: Exploratory study was conducted in a post-trial facility in Switzerland using a multiperspective convergent parallel mixed method drawing from participatory action research principles. FINDINGS: Reasons for attendance included back problems, mental tension, physical fitness, relaxation, and sleep problems. Perceived benefits comprised autonomy in self-practice, decreased physical tensions and anxiety, and improvement of sleep and physical fitness. Qualitative findings converged highlighting the importance of body-centering, relaxation as an alternative to medication, negative representations about relaxation sessions (useless, effeminate), and recommendations for improvement, including audio-visual support for self-practice. DISCUSSION: Long-standing mind-body relaxation interventions led by nurses in groups may offer participants a beneficial and operationally feasible complement to stress management in prisons.


Assuntos
Terapias Mente-Corpo , Motivação , Papel do Profissional de Enfermagem , Prisões , Adulto , Feminino , Pessoal de Saúde/psicologia , Humanos , Masculino , Prisioneiros/psicologia , Sono/fisiologia , Estresse Psicológico/psicologia , Suíça
12.
PLoS One ; 15(6): e0234697, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32603363

RESUMO

Assisted HIV partner notification services provide a safe and effective way for people living with HIV (PLHIV) to inform their partners about the possibility of exposure and to offer them testing, treatment, and support. This study examined whether or not PLHIV in prison might be willing to participate in assisted HIV partner notification services and their reasons for and against disclosing their HIV-positive status to their partners. PLHIV (n = 150) recruited from Jakarta's two largest all-male prisons completed an interviewer-administered questionnaire collecting demographic and risk behavior data, and attitudes toward HIV disclosure and partner services. Among those who were sexually active and/or injecting drugs before incarceration, two-thirds (66.4%, 91/137) endorsed provider referral as an acceptable way to notify their sex partners, and nearly three quarters (72.4%, 89/123) endorsed provider referral to notify their drug-injecting partners. Only a quarter (25.1%) of participants reported that their main sex partner had ever received an HIV test. Participants with anticipated stigma were less likely to endorse provider referral for sex partners (adjusted odds ratio [aOR] = 0.58, 95% CI: 0.35, 0.96) and drug-injecting partners (aOR = 0.54, 95% CI: 0.29, 1.00). Relationship closeness was associated with higher odds of endorsing provider referral for drug-injecting partners (aOR = 2.08, 95% CI: 1.25, 3.45). Protecting partners from infection and a moral duty to inform were main reasons to disclose, while stigma and privacy concerns were main reasons not to disclose. Most incarcerated PLHIV have at-risk partners in the community who they would be willing to notify if provided with assistance. Assisted partner notification for prison populations offers a promising public health approach to accelerate diagnosis, treatment, and prevention of HIV infection in the community, particularly among women.


Assuntos
Infecções por HIV/epidemiologia , Aceitação pelo Paciente de Cuidados de Saúde , Prisioneiros , Prisões , Parceiros Sexuais , Inquéritos e Questionários , Adulto , Objetivos , Infecções por HIV/psicologia , Humanos , Indonésia , Masculino , Prisioneiros/psicologia , Encaminhamento e Consulta , Assunção de Riscos , Parceiros Sexuais/psicologia
14.
Lancet Psychiatry ; 7(8): 682-691, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32711709

RESUMO

BACKGROUND: Self-harm is a leading cause of morbidity in prisoners. Although a wide range of risk factors for self-harm in prisoners has been identified, the strength and consistency of effect sizes is uncertain. We aimed to synthesise evidence and assess the risk factors associated with self-harm inside prison. METHODS: In this systematic review and meta-analysis, we searched four electronic databases (PubMed, Embase, Web of Science, and PsycINFO) for observational studies on risk factors for self-harm in prisoners published from database inception to Oct 31, 2019, supplemented through correspondence with authors of studies. We included primary studies involving adults sampled from general prison populations who self-harmed in prison and a comparison group without self-harm in prison. We excluded studies with qualitative or ecological designs, those that reported on lifetime measures of self-harm or on selected samples of prisoners, and those with a comparison group that was not appropriate or not based on general prison populations. Data were extracted from the articles and requested from study authors. Our primary outcome was the risk of self-harm for risk factors in prisoners. We pooled effect sizes as odds ratios (OR) using random effects models for each risk factor examined in at least three distinct samples. We assessed study quality on the basis of the Newcastle-Ottawa Scale and examined between-study heterogeneity. The study protocol was registered with PROSPERO, CRD42018087915. FINDINGS: We identified 35 independent studies from 20 countries comprising a total of 663 735 prisoners, of whom 24 978 (3·8%) had self-harmed in prison. Across the 40 risk factors examined, the strongest associations with self-harm in prison were found for suicide-related antecedents, including current or recent suicidal ideation (OR 13·8, 95% CI 8·6-22·1; I2=49%), lifetime history of suicidal ideation (8·9, 6·1-13·0; I2=56%), and previous self-harm (6·6, 5·3-8·3; I2=55%). Any current psychiatric diagnosis was also strongly associated with self-harm (8·1, 7·0-9·4; I2=0%), particularly major depression (9·3, 2·9-29·5; I2=91%) and borderline personality disorder (9·2, 3·7-22·5; I2=81%). Prison-specific environmental risk factors for self-harm included solitary confinement (5·6, 2·7-11·6; I2=98%), disciplinary infractions (3·5, 1·2-9·7; I2=99%), and experiencing sexual or physical victimisation while in prison (3·2, 2·1-4·8; I2=44%). Sociodemographic (OR range 1·5-2·5) and criminological (1·8-2·3) factors were only modestly associated with self-harm in prison. We did not find clear evidence of publication bias. INTERPRETATION: The wide range of risk factors across clinical and custody-related domains underscores the need for a comprehensive, prison-wide approach towards preventing self-harm in prison. This approach should incorporate both population and targeted strategies, with multiagency collaboration between the services for mental health, social care, and criminal justice having a key role. FUNDING: Wellcome Trust.


Assuntos
Prisioneiros/psicologia , Comportamento Autodestrutivo/psicologia , Tentativa de Suicídio/prevenção & controle , Transtorno da Personalidade Borderline/psicologia , Estudos de Casos e Controles , Vítimas de Crime/psicologia , Direito Penal/organização & administração , Transtorno Depressivo Maior/psicologia , Estudos de Avaliação como Assunto , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Saúde Mental/normas , Estudos Observacionais como Assunto , Prisioneiros/estatística & dados numéricos , Fatores de Risco , Comportamento Autodestrutivo/mortalidade , Ideação Suicida , Tentativa de Suicídio/estatística & dados numéricos
15.
Crim Behav Ment Health ; 30(2-3): 141-150, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32483870

RESUMO

Dialectical behaviour therapy (DBT) is a therapy model incorporating elements of Eastern philosophies and cognitive behavioural principles. Originally designed for people struggling with chronic suicidality and borderline personality disorder (BPD), it has been adapted to treat complex, multi-diagnostic presentations, such as those in forensic mental health settings. To date, there has been little evaluation when the primary diagnosis is of psychosis. To explore the effectiveness of DBT, with patients, with multiple comorbidities, including psychosis, in a forensic psychiatric inpatient setting. A descriptive outcome study with a cohort of offender-patients in one specialist forensic mental health unit. Before and after treatment change scores were compared on anger, aggression, hopefulness, coping abilities, emotional intelligence, insight and subjective symptom severity scales, as well as staff-rated risk, and length of stay. Nine men and five women residents in one Canadian secure hospital completed a standard DBT programme, and self-ratings, over about 1 year. Scale scores indicated significantly increased insight and acknowledgment of problems. Apparently increased anger and vengeance scores were clinically associated. Independent staff ratings indicated reductions in risk and most patients achieved early release. This study provides support for extension of the use of DBT to offender-patients with psychosis among the complex mix in their presentation. It suggests that a randomised controlled trial with cost-benefit analysis is warranted, as well as further work, to promote understanding of mechanisms of effectiveness.


Assuntos
Transtorno da Personalidade Borderline/terapia , Criminosos/psicologia , Terapia do Comportamento Dialético/métodos , Psiquiatria Legal/métodos , Prisioneiros/psicologia , Violência/prevenção & controle , Adaptação Psicológica , Adulto , Agressão , Ira , Transtorno da Personalidade Borderline/diagnóstico , Transtorno da Personalidade Borderline/psicologia , Canadá , Inteligência Emocional , Emoções , Feminino , Esperança , Humanos , Masculino , Pessoa de Meia-Idade , Inventário de Personalidade , Transtornos Psicóticos , Estudos Retrospectivos , Inquéritos e Questionários , Resultado do Tratamento
16.
Encephale ; 46(3S): S60-S65, 2020 Jun.
Artigo em Francês | MEDLINE | ID: mdl-32475693

RESUMO

OBJECTIVE: The impact of the Covid-19 pandemic on the 11 million people currently incarcerated worldwide is the subject of many concerns. Prisons and jails are filled with people suffering from many preexisting medical conditions increasing the risk of complications. Detainees' access to medical services is already limited and overcrowding poses a threat of massive contagion. Beyond the health impact of the crisis, the tightening of prison conditions worries. On March 16, 2020, in France, the lockdown measures have been accompanied by specific provisions for prisons: all facilities have suspended visitations, group activities and external interventions. Over 10,000 prisoners have been released to reduce the prison population and the risk of virus propagation. These adjustments had major consequences on the healthcare system in French prisons. The objectives of this article are to describe the reorganization of the three levels of psychiatric care for inmates in France in the context of Covid-19 pandemic and to have a look at the impact of lockdown measures and early releases on mental health of prisoners. METHODS: This work is based on a survey conducted in April 2020 in France among psychiatric healthcare providers working in 42 ambulatory units for inmates and in the 9 full-time inpatient psychiatric wards exclusively for inmates called "UHSAs" (which stands for "unités hospitalières spécialement aménagées", and can be translated as "specially equipped hospital units"). A review of the international literature on mental healthcare system for inmates during the Covid-19 epidemic has also been performed. RESULTS: The Covid-19 epidemic has been rather contained during the period of confinement in French prisons but the impact of confinement measures on the prison population is significant. The three levels of psychiatric care for inmates have implemented specific measures to ensure continuity of care, to support detainees during Coronavirus lockdown and to prevent an infection's spread. Among the most important are: limitation of medical consultations to serious and urgent cases, creation of "Covid units", cancellation of voluntary psychiatric hospitalizations, reinforcement of preventive hygiene measures and reshuffling of medical staff. Prolonged confinement has consequences on mental health of detainees. Currently, mental health workers are facing multiple clinical situations such as forced drug and substance withdrawal (linked to difficulties in supplying psychoactive substances), symptoms of anxiety (due to concerns for their own and their relatives' well-being) and decompensation among patients with severe psychiatric conditions. Early releases from prison may also raise some issues. People recently released from prison are identified as at high risk of death by suicide and drug overdose. The lack of time to provide the necessary link between health services within prisons and health structures outside could have serious consequences, emphasizing the well-known "revolving prison doors" effect. DISCUSSION: The current lockdown measures applied in French jails and prisons point out the disparities between psychiatric care for inmates and psychiatric care for general population. Giving the high vulnerability of prison population, public health authorities should pay more attention to health care in prisons.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Serviços de Saúde Mental/organização & administração , Pandemias , Pneumonia Viral , Prisioneiros/psicologia , Prisões , Adulto , Assistência Ambulatorial/organização & administração , Assistência Ambulatorial/estatística & dados numéricos , Infecções por Coronavirus/prevenção & controle , Assistência à Saúde , Feminino , França/epidemiologia , Pesquisas sobre Serviços de Saúde , Acesso aos Serviços de Saúde , Unidades Hospitalares/organização & administração , Humanos , Controle de Infecções/métodos , Masculino , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Serviços de Saúde Mental/estatística & dados numéricos , Pandemias/prevenção & controle , Isolamento de Pacientes , Pneumonia Viral/prevenção & controle , Prisioneiros/estatística & dados numéricos , Unidade Hospitalar de Psiquiatria/organização & administração , Quarentena
17.
PLoS One ; 15(6): e0233842, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32479552

RESUMO

In the United States (U.S.), the HIV infection rate is disproportionately high among incarcerated individuals. HIV-infected individuals typically receive antiretroviral therapy (ART) to suppress HIV and reduce the threat of transmission. Although HIV-infected individuals are generally ART-adherent while incarcerated, the public health benefits experienced during incarceration are often lost as HIV-infected individuals struggle to maintain optimal adherence post-incarceration. While the importance of maintaining adherence in the post-incarceration period has been acknowledged, research on barriers to ART adherence during this period is limited. To better understand post-release barriers to ART adherence, we conducted in-depth interviews with 20 HIV-infected formerly incarcerated individuals in New York City; we also followed up with 18 (90%) participants after three months to explore whether their adherence challenges changed over time. Viral load testing results from their most recent physician visit were also recorded at each interview. Interviews were transcribed using transcription software and reviewed for accuracy by a researcher. Thematic coding based on discussion guide prompts were then used to identify commonly mentioned barriers to adherence. The results identified four overarching themes that affected study participants' efforts to adhere to their ART regimen: medication burden, forgetfulness, mental health and emotional difficulties, and perceived conflict between substance use and medication adherence. These barriers were the most commonly cited and largely persisted at three-month follow-up. The results suggest that interventions addressing these challenges are essential for promoting ART adherence among HIV-infected formerly incarcerated individuals. Effective interventions may include mobile-based text messaging reminders and those that facilitate patient-provider communication. Additionally, interventions or programs that integrate substance use and mental health treatment into HIV-related care, along with other types of behavioral health support, may also be beneficial for this population. Such interventions should be a routine part of discharge planning and support for incarcerated individuals returning to the community.


Assuntos
Terapia Antirretroviral de Alta Atividade/psicologia , Infecções por HIV/tratamento farmacológico , Adesão à Medicação/psicologia , Prisioneiros/psicologia , Adolescente , Adulto , Idoso , Fármacos Anti-HIV/administração & dosagem , Fármacos Anti-HIV/uso terapêutico , Emoções , Feminino , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Cidade de Nova Iorque
18.
Psychol Trauma ; 12(S1): S233-S235, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32551768

RESUMO

This paper explores parallels between experiences of confinement due to pandemic-related restrictions and confinement as a result of legal incarceration. We compare experiences of social isolation, lack of choice, and reduced access to resources while also acknowledging the existence of significant differences between the two situations. We describe the ways in which experiences of confinement as part of COVID-19 regulations can provide the general public with insight into difficulties associated with incarceration and the negative effect it can have on psychological health. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Sintomas Comportamentais/psicologia , Infecções por Coronavirus , Empatia , Controle de Infecções , Pandemias , Pneumonia Viral , Prisioneiros/psicologia , Isolamento Social , Adulto , Sintomas Comportamentais/etiologia , Humanos , Relações Interpessoais , Apoio Social
19.
Artigo em Inglês | MEDLINE | ID: mdl-32545743

RESUMO

Prison could be considered a prolonged stressful situation that can trigger not only a dysregulation of sleep patterns but can also bring out psychiatric illness, such as anxiety and depression symptoms. Our study is aimed at exploring sleep quality and sleep habits in an Italian prison ward with three different security levels, and to attempt to clarify how anxiety state and the total time spent in prison can moderate insomnia complaints. There were 129 participants divided into three groups who enrolled in this study: 50 were in the medium-security prison ward (Group 1), 58 were in the high-security prison ward (Group 2) and 21 were in the medium-security following a protocol of detention with reduced custodial measures (Group 3). All participants filled in a set of questionnaires that included the Beck Depression Inventory (BDI-2), the State-Trait Anxiety Inventory (STAI), the Pittsburgh Sleep Quality Index (PSQI), and the Insomnia Severity Index (ISI). Based on their responses, we observed that all participants showed poor sleep quality and insomnia, mild to moderate depressive symptoms that tended to a higher severity in Groups 1 and 3, and the presence of clinically significant anxiety symptoms, mainly in Groups 1 and 3. Our study shows that increased anxiety state-level and the presence of mood alteration corresponds to an increase in both poor sleep quality and, more specifically, insomnia complaints. Finally, we propose that TiP (total time in prison) could have an interesting and stabilizing paradox-function on anxiety state and insomnia.


Assuntos
Ansiedade , Prisioneiros , Distúrbios do Início e da Manutenção do Sono , Adulto , Depressão , Humanos , Itália , Saúde Mental , Pessoa de Meia-Idade , Prisioneiros/psicologia , Sono
20.
BMC Psychiatry ; 20(1): 332, 2020 06 24.
Artigo em Inglês | MEDLINE | ID: mdl-32580785

RESUMO

BACKGROUND: Borderline personality disorder (BPD) is caused by a variety of biological and environmental factors. Accumulating evidence suggests that childhood maltreatment is a risk environmental factor in the development of BPD, but research on the genetic pathology of BPD is still in its early stages, and very little is known about the oxytocin receptor (OXTR) gene. The purpose of this study is to further explore the interactive effects between OXTR gene polymorphisms and childhood maltreatment on BPD risk. METHODS: Among the 1804 Chinese Han male inmates, 765 inmates who had BPD or antisocial personality disorder (ASPD) or highly impulsive or violent crime were considered as high-risk inmates and included in this study. Childhood maltreatment, BPD, antisocial personality disorder (ASPD) and impulsivity were measured by self-reported questionnaires. Peripheral venous blood was collected for the genotype test. RESULTS: Analyses revealed that the BP group (inmates with BPD features) had higher rs53576 AA genotype frequency and rs237987 AA genotype frequency than the non-BP group, while the statistical significances were lost after Bonferroni correction. Total childhood maltreatment score, emotional abuse and neglect could positively predict BPD risk. Among the high-risk samples, rs53576 GG genotype carriers had higher BPD scores at higher levels of physical abuse and sexual abuse and had lower BPD scores at lower levels of physical abuse and sexual abuse. CONCLUSIONS: The findings suggest that the interaction between OXTR gene variations and childhood maltreatment is an important mechanism for the development of BPD. The moderating role of the OXTR gene provides evidence for gene plasticity.


Assuntos
Transtorno da Personalidade Borderline/epidemiologia , Transtorno da Personalidade Borderline/genética , Maus-Tratos Infantis/estatística & dados numéricos , Prisioneiros/psicologia , Prisioneiros/estatística & dados numéricos , Receptores de Ocitocina/genética , Adulto , Criança , Maus-Tratos Infantis/psicologia , China/epidemiologia , Humanos , Masculino , Polimorfismo Genético
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA