La santé mentale chez les jeunes adultes en prison: l'importance des troubles du comportement au début de l'enfance

Aperçu: G.M.

Le fardeau psychiatrique pour la santé des prisonniers est important. Cependant, il existe un manque d'études de haute qualité sur les troubles psychiatriques chez les jeunes adultes présentant un risque élevé de récidive.La recherche vise à enquêter sur la prévalence des troubles psychiatriques et l'utilisation des services de santé mentale chez les jeunes délinquants violents masculins et l'impact du trouble de comportement à l'enfance (COCD).

Le groupe COCD était surreprésenté dans la plupart des catégories cliniques et avait des probabilités  cinq fois plus élevées (OR = 5.1, 95% IC 2.0-12.8) de se voir diagnostiquer un trouble psychotique, trois fois plus élevées (OR = 3.2, IC 95% 1.2-8.5) d'avoir un trouble de l'usage de substances et deux fois plus élevées d'avoir un trouble de l'humeur (OR = 2,3, IC 95% 1,3-4,0) ou un trouble anxieux (OR = 2,0, IC 95% 1.1-3,5). 

BJPsych Open. 2017 Mar 23;3(2):78-84. doi: 10.1192/bjpo.bp.116.003889. eCollection 2017.

Mental health among young adults in prison: the importance of childhood-onset conduct disorder

Hofvander B¹, Anckarsäter H², Wallinius M³, Billstedt E⁴.

Author information

1

, PhD, Department of Clinical Sciences, Lund, Child and Adolescent Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden; Division of Forensic Psychiatry, Region Skåne, Kristianstad, Sweden; Department of Psychiatry, Autism Research Centre, University of Cambridge, Cambridge, UK.

2

, MD, Department of Forensic Psychiatry, Centre of Ethics, Law and Mental Health, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.

3

, PhD, Department of Clinical Sciences, Lund, Child and Adolescent Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden; Regional Forensic Psychiatric Clinic, Växjö, Sweden.

4

, PhD, Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.

Abstract

BACKGROUND:

The psychiatric health burden of prisoners is substantial. However, there is a lack of high-quality studies of psychiatric disorders among young adults with a high risk of reoffending.

AIMS:

To investigate the lifetime prevalence of psychiatric disorders and use of mental health services among young male violent offenders and the impact of childhood-onset conduct disorder (COCD).

METHOD:

A nationally representative cohort (n = 270, age 18-25) of male offenders was followed back in medical records and clinically assessed by gold standard methods. Lifetime prevalences are presented together with odds ratios (ORs) as risk estimates in relation to COCD.

RESULTS:

Previous use of psychiatric services among the participants was high but their lifetime psychiatric morbidity was even higher, with 93% meeting criteria for at least one Axis I disorder. The COCD group was overrepresented in most clinical categories and carried five times higher odds (OR = 5.1, 95% CI 2.0-12.8) of a psychotic disorder, three times higher odds (OR = 3.2, 95% CI 1.2-8.5) of a substance use disorder and two times higher odds of a mood disorder (OR = 2.3, 95% CI 1.3-4.0) or anxiety disorder (OR = 2.0, 95% CI 1.1-3.5).

CONCLUSIONS:

The mental health burden is substantial among young violent offenders, and COCD is an important indicator of future mental health problems which must be a priority for public health efforts.

DECLARATION OF INTEREST:

None.

COPYRIGHT AND USAGE:

© The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.

PMID: 28357134

PMCID: PMC5362727

DOI: 10.1192/bjpo.bp.116.003889