Our findings indicate that psychiatric inpatients with criminal records should receive special attention with respect to all aspects of their health, not only within psychiatric services but also through more collaboration between the healthcare and judicial systems.
Women admitted to a psychiatric hospital have higher rates of imprisonment than the general population. Because admission predated imprisonment in most cases, this may be seen as an opportunity for early intervention to reduce later criminality.
IntroductionCriminality is common among patients with severe mental disorders and/or substance use disorders (SUDs).Aims/objectivesTo study the incidence of imprisonment among psychiatric inpatients along with their diagnoses patterns and survival.MethodsThis is a nationwide register based study of all psychiatric inpatients admitted in Iceland between 1983 and 2007. The database contained information on discharge diagnoses, imprisonment and cause of death when relevant. Cumulative incidence of imprisonment was calculated using the Kaplan-Meier method. Using a nested case-control (1:3) design, survival was analysed with Cox-proportional hazard ratio model. Controls were similar regarding age, year of admission and discharge diagnoses. All analyses were done separately for men and women.ResultsMen admitted at ages between 18 and 30 had 21% cumulative incidence of incarceration over a 20-year period. For women the corresponding figure was 6%. Most common discharge diagnoses of those serving a sentence in prison were SUD and/or personality disorder. Among men, adjusted hazard ratio (HR) for risk of death was 2.0 (95%-confidence interval (CI): 1.5–2.6) and for women 1.3 (95%-CI: 0.5–3.5).ConclusionsImprisonment is common among psychiatric inpatients. This group represents individuals with long-term problems and specific treatment needs. Mortality was significantly increased for men while there were to few women in the cohort to establish meaningful HR for risk of death.
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