High prevalence rates for multiple psychiatric conditions among inmates at French Guiana’s correctional facility: diagnostic and demographic factors associated with violent offending and previous incarceration

Abstract

BackgroundFrench Guiana has the highest incarceration rate among French territories, it is higher than that of Brazil, Colombia or Venezuela. It is well known that mental health problems are over-represented in correctional facilities. Our objectives were to describe the prevalence of various psychiatric conditions and to study factors associated with violence and repeated offenses among arriving detainees at the sole correctional facility of French Guiana.MethodsThe study was cross-sectional. All consenting new adult prisoners incarcerated between 18/09/2013 and 31/12/2014 at the penitentiary centre of French Guiana were included. The Mini International Neuropsychiatric Interview (MINI) was used to screen for psychiatric diagnoses. In addition sociodemographic data was collected.ResultsOverall 647 men and 60 women were included.The participation rate was 90%.Overall 72% of patients had at least one psychiatric diagnosis (Fig. 2). Twenty percent had three or more diagnoses. Violent index offences were not more frequent among those with a psychiatric diagnosis (crude odds ratio 1.3 (95%CI = 0.9–2), P = 0.11.Multivariate analysis showed that after adjusting for sex and age, psychosis, suicidality and post-traumatic stress disorder were independently associated with violent offences. Generalized anxiety disorder was less likely to be associated with incarceration for violent offences.Having a history of a previous incarceration was significantly associated with a psychiatric condition in general (any diagnosis) OR = 3 (95%CI = 2–4.3), P < 0.0001.Calculations of the population attributable risks showed that in the sample 31.4% of repeat incarcerations were attributable to antisocial personality disorder, 28.3% to substance addiction, 17.3% to alcohol addiction, 8.7% to depression and 7% to psychosis.ConclusionsThe very high prevalence of psychiatric disorders observed in our sample, and the relative lack of psychiatric facilities, suggest that part of the problem of very high incarceration rate may be explained by transinstitutionalization. Improving psychiatric care in prison and coordination with psychiatric care in the community after release is likely to be important.

Impulsive and premeditated aggression in male offenders with antisocial personality disorder

“…The prevalence of co-morbidity between ASPD and anxiety disorders reported in the literature is 50% [38,66,74]; a lower prevalence of anxiety disorders was observed in this study's population, and no difference was found between the two aggression groups.…”

“…In this study's sample, the prevalence of SUD co-morbidity with ASPD was high and comparable to other studies. Other authors have also reported a high prevalence of this co-morbidity, at 55% [65], 53% [38], 84.5% [66], and 90% [67]. The prevalence of SUDs in individuals with ASPD is up to five times higher than that in individuals without ASPD [68].…”

“…SUDs are highly comorbid with ASPD and are related to both aggression and criminal behaviour [38,39]. Although they represent two different nosological entities, some authors argue that SUDs may be part of the spectrum of antisocial behaviour [40].…”

Prevalence and predictors of penile nodules in French Guiana's sole prison facility

“…It is saturated and its overpopulation and poor living conditions have been repeatedly pointed out. [ 14 ] Mental health problems are more frequent in prisoners than in the general population [ 15 – 17 ]. French Guiana is a land of immigration and it is thus composed of a very diverse population.…”

First diagnosis of psychosis in the prison: results from a data-linkage study

“…High rates of psychosis and other mental disorders are common in prisoner populations worldwide. 1 A meta-analysis of 33 588 prisoners covering 24 countries reported a pooled prevalence of psychosis of 3.6% in men and 3.9% in women. 2 An Australian study reported that prisoners were 11.8 times more likely to report symptoms of psychosis than the general community.…”