Troubles neurodéveloppementaux chez les détenus: comorbidité et associations combinées avec des symptômes psychiatriques et des troubles du comportement

Aperçu: G.M.

L'identification et la prise en charge des détenus ayant des troubles neurodéveloppementaux (TN) ont été insuffisamment abordées dans la littérature. Les chercheurs ont estimé la proportion de cas de trouble déficitaire de l'attention / hyperactivité (TDAH), de "trouble du spectre de l'autisme" (TSA) et de déficience intellectuelle (DI) en prison, leur comorbidité et leur association avec des comportements perturbateurs et des symptômes psychiatriques. De plus, ils ont examiné le rôle des TN coexistants sur les symptômes psychiatriques et les attitudes envers la violence.  

390 détenus ont subi une évaluation comprenant l'entrevue diagnostique pour le TDAH chez les adultes 2.0, le quotient autistique, le questionnaire de dépistage de l'incapacité, le bref inventaire des symptômes (BSI) et les mesures des comportements perturbateurs et des attitudes envers la violence. Le pourcentage de cas de TDAH, de TSA et d'ID était de 25%, 9% et 9%. Les détenus avec TDAH et ceux ayant une DI avaient des niveaux significativement plus élevés de comportements perturbateurs. Le groupe TDAH / TSA combiné avait des scores significativement plus élevés sur les symptômes de gravité globale que le TDAH ou TSA seulement.  

Pendant ce temps, le groupe combiné TDAH/ ID avait des scores significativement plus élevés de troubles du comportement que le groupe exclusivement TDAH.  

Ces résultats montrent l'étendue de la ND en prison, leurs interrelations et les associations avec d'autres problèmes de santé mentale.  

Les vulnérabilités conférées par les TN au sein du système de justice pénale devraient être traitées au moyen d'interventions et de stratégies préventives.

Psychiatry Res. 2017 Dec 15;261:109-115. doi: 10.1016/j.psychres.2017.12.036.

Neurodevelopmental disorders in prison inmates: comorbidity and combined associations with psychiatric symptoms and behavioural disturbance

Young S¹, González RA², Mullens H³, Mutch L⁴, Malet-Lambert I⁴, Gudjonsson GH⁵.

Author information

1

Centre for Mental Health, Division of Brain Sciences, Department of Medicine, Imperial College London, UK; Reykjavik University, Iceland. Electronic address: s.young@imperial.ac.uk.

2

Centre for Mental Health, Division of Brain Sciences, Department of Medicine, Imperial College London, UK; Child and Family Consultation Service, East London NHS Foundation Trust, UK.

3

Psychology Department, Bath University, UK.

4

Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.

5

Reykjavik University, Iceland; Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.

Abstract

The identification and management of inmates with neurodevelopmental disorders (ND) has been insufficiently addressed in the literature. We estimated the proportion of cases with Attention deficit/hyperactivity disorder (ADHD), Autism spectrum disorder (ASD) and Intellectual disability (ID) in prison, their comorbidity, and associations with disruptive behaviours and with psychiatric symptoms. Further, we examined the role of coexisting ND on psychiatric symptoms and attitudes toward violence. All 390 male inmates underwent an assessment that included the Diagnostic Interview for ADHD in Adults 2.0, the Autism Quotient, the Learning Disability Screening Questionnaire, the Brief Symptom Inventory (BSI), and measures of disruptive behaviours and attitudes towards violence. The percentage of cases with ADHD, ASD and ID were 25%, 9% and 9%. Inmates with ADHD and those with ID had significantly higher levels of disruptive behaviours. The combined ADHD/ASD group had significantly higher scores on global severity symptoms than either ADHD or ASD only. Meanwhile, the combined ADHD/ID group had significantly higher scores of behavioural disturbance than the ADHD-only group. Our findings show the extent of ND in prison, their inter-relations and associations with further mental health problems. Vulnerabilities conferred by ND within the criminal justice system should be addressed via interventions and preventative strategies.

PMID:29291476

DOI:10.1016/j.psychres.2017.12.036

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