Eating disorders among patients incarcerated only for repeated shoplifting: a retrospective quasi-case-control study in a medical prison in Japan

Abstract

BackgroundShoplifting is a serious problem among patients with eating disorders. For more than a decade, we have treated many patients with eating disorders incarcerated in Hachioji Medical Prison only for repeated shoplifting.MethodsWe analyzed the prison records and medical records of female psychiatric patients transferred to Hachioji Medical Prison between 2002 and 2011. Based on the offense listed at the time of sentencing, we extracted a shoplifting group and a drug-offense group from among all patients with eating disorders. One patient from the former group who had used substances and two from the latter group who had never shoplifted were excluded from the study. The groups had 41 and 14 patients, respectively. A control group comprised patients with other mental disorders (n = 34). We compared eating disorder histories and subtypes, weight changes, comorbidities, life histories, past behavioral problems, and clinical behavioral problems among the three groups.ResultsThe shoplifting group exhibited less impulsive behavior, substance abuse, antisocial features, borderline personality disorder, and past bulimia than did the drug-offense and control groups. The shoplifting group had higher educational achievement and steadier employment; however, their eating disorder histories and interpersonal dysfunction were more severe, and they had a higher psychiatric treatment dropout rate. There were also significant relationships with low body weight, anorexia nervosa-restricting type, obsessive–compulsive behaviors, and obsessive–compulsive personality disorder in the shoplifting group. During the clinical course, food refusal, excessive exercise, food hoarding, and falsification of dietary intake amounts were more frequently observed in the shoplifting group. Conversely, drug requests and occurrences of self-harm were less frequent in the shoplifting group than in the drug-offense group.ConclusionsAlthough these results may be associated with specific characteristics of patients with eating disorders in the medical prison setting, we concluded that the repeated shoplifting by these patients is unrelated to antisocial or impulsive characteristics but is deeply rooted in these patients’ severe and undertreated eating disorder psychopathology. Strong supportive treatment should be considered for patients with eating disorders who develop shoplifting behaviors. Further research is required to elucidate the mechanisms responsible for the relationship between shoplifting and eating disorders.

Lifetime prevalence of non-suicidal self-injury in patients with eating disorders: a systematic review and meta-analysis

“…For example, in an AN sample studied by Favaro & Santonastaso (2000), skin cutting/burning and suicide attempts loaded on the same factor ('impulsive selfinjurious behaviour'), whereas substance abuse did not load on any of three factors ('impulsive self-injurious behaviour, 'compulsive self-injurious behaviour' and 'purging behaviour'). In addition, in a medical prison sample of females with ED in Japan, none of the patients who had been convicted for shoplifting had a history of conviction for other crimes, and none of the patients who had committed drug offences had an incarceration history for shoplifting (Asami et al 2014).…”

Treatment for female patients with eating disorders in the largest medical prison in Japan

“…Therefore, the majority of patients in the present study were patients in an anorexic state [25,28,29]. …”

“…Although this study has many overlaps with the content of our previous study in BMC Psychiatry [29], the purpose is to describe more features by citing other findings from the relevant literature.…”

“…Among the 67 patients aged under 62 years in this group, the most common convictions resulting in imprisonment were shoplifting (n = 44, 63%) and drug offences (n = 17, 24%) [29]. …”

“…Previous prosecution and/or incarceration for crimes other than shoplifting was also evident in many patients in the Drug group; many had experience working as prostitutes or night club hostesses (57%), few had experience of full-time work, and many also showed antisocial behaviors (79%) [29]. …”