A systematic review of the literature on mental disorder in prisoners, published in 2002, made no mention of post-traumatic stress disorder (PTSD), but indicators from other studies suggest that a history of serious and chronic trauma is common among offenders.
To conduct a systematic review of the literature with the specific questions: does any epidemiological study of sentenced prisoners include data on prevalence of PTSD while in prison? If so, what is the prevalence in this group?
Literature databases EMBASE, Medline, PsychInfo, PILOTS and SIGLE were searched. The Journal of Traumatic Stress was searched manually. Preliminary screening was conducted by reading abstracts of hundreds of papers. Ten exclusion criteria were then applied to the screened selection. Reference sections of all accessed papers were searched for any further studies.
One hundred and three potentially relevant papers were identified after preliminary screening. Four met all criteria for inclusion and suffered none of the exclusion criteria. PTSD rates ranged from 4% of the sample to 21%. Women were disproportionately affected.
All four papers suggested that the prevalence of PTSD among sentenced prisoners is higher than that in the general population, as reported elsewhere. Overall the findings suggest a likely need for PTSD treatment services for sentenced prisoners.
"Although there is now plentiful evidence of high rates of psychopathology among prisoners (Fazel and Seewald, 2012), there is little information available on some specific disorders, PTSD among them. Goff et al. (2007), in their systematic review, found that of 103 studies identified pertaining to mental health, only four examined PTSD; its prevalence ranged between 4% and 21%, but they did not analyse social or ethnic subgroups. Our aim, therefore, was to test for any relationship between PTSD and incarceration in a nationally representative sample of Black Americans. "
"Of these, many were found to be reluctant to give up cannabis because of its purported benefits for anxiety, insomnia, nightmares, and chronic pain, although they were otherwise motivated to give up alcohol and other illicit drugs. Studies in other correctional populations show a similar high prevalence of PTSD, PTSD-related sleep problems, chronic pain, and cannabis misuse,16–20 so it is likely that the challenge of managing these complex patients is relatively common. "
[Show abstract][Hide abstract] ABSTRACT: Nabilone is a synthetic cannabinoid that has shown promise for the treatment of posttraumatic stress disorder (PTSD)-related insomnia and nightmares as well as efficacy in the management of chronic pain. It has also been proposed for harm reduction in cannabis dependence. Its effectiveness for management of concurrent disorders in seriously mentally ill correctional populations has not been evaluated. This retrospective study of 104 male inmates with serious mental illness prescribed nabilone analyzes the indications, efficacy, and safety of its use. Medications discontinued with the initiation of nabilone were also reviewed. The results showed nabilone targeting a mean of 3.5 indications per patient, thus likely reducing polypharmacy risk. The mean final dosage was 4.0 mg. Results indicated significant improvement in PTSD-associated insomnia, nightmares, PTSD symptoms, and Global Assessment of Functioning and subjective improvement in chronic pain. Medications associated with greater risk for adverse effects or abuse than nabilone were often able to be discontinued with the initiation of nabilone, most often antipsychotics and sedative/hypnotics. There was no evidence of abuse within this high-risk population or reduction of efficacy when nabilone was given in powder form with water rather than as a capsule. This study supports the promise of nabilone as a safe, effective treatment for concurrent disorders in seriously mentally ill correctional populations. Prospective, randomized controlled trials are required to confirm our preliminary results. Follow-up in the community will be required to confirm effectiveness in harm reduction.
"In a systematic review and meta-analysis of 62 surveys of 23 000 prisoners, the prevalence of psychosis was around 4%, major depression 10–12%, and personality disorders 40–70% (Fazel, 2002). Post-traumatic stress disorder is also thought to affect up to a fifth of prisoners (Goff, 2007) and prisoners of both sexes report histories of severe trauma and abuse (Driessen, 2006). Women seem to have higher rates of most psychiatric disorders than do men (Binswanger, 2010). "
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