In a comparison of assessment methods of severity of depressive illness, the Montgomery-Asberg Scale had, broadly, a performance equal to the Hamilton Scale. The Beck Depression Inventory, it subscale, and the Wakefield Inventory all had overall poor performances and should now be abandoned in research. The two-patient-rated scales were, overall, similar and fairly satisfactory measures. The comparisons were at points in severity of illness and not on change of severity.

Prisons have become the primary health care provider for some of the poorest and sickest women in the United States. By virtue of both biological sex and gender, incarcerated women have health needs different from those of their male counterparts. The purpose of this qualitative investigation was to understand better women's perceptions of how prison has affected their physical health. We conducted this investigation in a maximum-security women's prison in the United States using focus group methodology (12 focus groups, made up of 65 women). Women described several specific prison-based factors that affected their physical health: limited and complicated access to care; nutritional concerns; limited physical activity; and smoking in prison. We discuss these findings in relation to the gender-based health issues facing incarcerated women.

The majority of women who enter the criminal justice system, most of whom are poor and women of color, have suffered from significant lifetime trauma exposure that can lead to posttraumatic stress disorder (PTSD). It is essential to identify the prevalence of PTSD among this population in order to identify treatment needs. Most studies on PTSD among incarcerated women have focused on PTSD in jailed populations, including women awaiting trial. Using a cross-sectional study design, we estimated the prevalence of PTSD and comorbid physical and mental health conditions in 387 incarcerated women sentenced to a maximum-security prison in the United States. Almost half (44%) of our sample met the diagnostic criteria for PTSD. Women with moderate to severe PTSD symptoms were more likely to report several comorbid physical and mental health conditions than were women without PTSD. Women with the most severe symptoms were most likely to report receiving mental health treatment in prison; women with moderate to severe symptoms were less likely to report receiving similar mental health care. Our findings add support to the link between PTSD and comorbid physical and mental health conditions and suggest that many women with PTSD are not receiving mental health treatment that is likely to benefit them. Because prison has become the mental health safety net for some of the nation's most vulnerable women, it is imperative that prisons provide evidence-based PTSD treatment during incarceration.

Many women enter prison with significant mental health conditions. Without appropriate intervention during incarceration, there is the potential for these conditions to worsen during confinement. As a result, women, most of whom will eventually be released from prison, might return to their families and communities with even more complex mental health needs. We examined women's perceptions of how incarceration had affected their mental health. Our study approach included descriptive surveys and focus groups with women in prison. Our analysis revealed that women's mental health might worsen, might improve, or might remain the same as a result of incarceration. Women's accounts also provide evidence to support the need for all women's correctional institutions to adopt a trauma-informed approach to care of this vulnerable population.