1
|
Zhang Y, Coid J. Childhood Adversity Determines the Syndemic Effects of Violence, Substance Misuse, and Sexual Behavior on Psychotic Spectrum Disorder Among Men. Schizophr Bull 2024; 50:684-694. [PMID: 38019938 PMCID: PMC11059794 DOI: 10.1093/schbul/sbad165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
BACKGROUND AND HYPOTHESIS Childhood adversity (CA) increases the risk for several adult psychiatric conditions. It is unclear why some exposed individuals experience psychotic symptoms and others do not. We investigated whether a syndemic explained a psychotic outcome determined by CA. STUDY DESIGN We used self-reported cross-sectional data from 7461 British men surveyed in different population subgroups. Latent class analysis (LCA) identified categorical psychopathological outcomes. LCs were tested by interaction analysis between syndemic factors derived from confirmatory factor analysis according to CA experiences. Pathway analysis using partial least squares path modeling. RESULTS A 4-class model with excellent fit identified an LC characterized by both psychotic and anxiety symptoms (class 4). A syndemic model of joint effects, adducing a 3-component latent variable of substance misuse (SM), high-risk sexual behavior (SH), violence and criminality (VC) showed synergy between components and explained the psychotic outcome (class 4). We found significant interactions between factor scores on the multiplicative scale, specific only to class 4 (psychosis), including SM × SH, SH × VC, and SM × VC (OR > 1, P < .05); and on the additive scale SM × SH (relative excess risk due to interaction >0, P < .05), but only for men who experienced CA. CONCLUSION Multiplicative synergistic interactions between SM, SH, and VC constituted a mechanism determining a psychotic outcome, but not for anxiety disorder, mixed anxiety disorder/depression, or depressive disorder. This was specific to men who had experienced CA along direct and syndemic pathways. Population interventions should target SM and VC in adulthood but prioritize primary prevention strategies for CA.
Collapse
Affiliation(s)
- Yamin Zhang
- Department of Neurobiology, Affiliated Mental Health Center & Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Major Ppsychiatric Ddisorder Workgroup, Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-machine Integration, State Key Laboratory of Brain-machine Intelligence, Zhejiang University, Hangzhou, China
| | - Jeremy Coid
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| |
Collapse
|
2
|
Brooker C, Sirdifield C, Parkhouse T. Identifying mental illness and monitoring mental health in probation service settings. EUROPEAN JOURNAL OF PROBATION 2022; 14:179-203. [PMID: 36794232 PMCID: PMC7614176 DOI: 10.1177/20662203221140646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
There is a need to improve a) identification and monitoring of people with mental illness on probation and b) understanding of the impact of interventions on mental health outcomes for the probation population. If data were routinely collected using validated screening tools and shared between agencies, this could inform practice and commissioning decisions, and ultimately it could improve health outcomes for people under supervision. The literature was reviewed to identify brief screening tools and outcome measures that have been used in prevalence and outcome studies conducted with adults on probation in Europe. This paper shares findings from the UK-based studies in which 20 brief screening tools and measures were identified. Recommendations are made based on this literature regarding suitable tools for use in probation to routinely identify a need for contact with mental health and/or substance misuse services and to measure change in mental health outcomes.
Collapse
Affiliation(s)
- Charlie Brooker
- Centre for Sociology and Criminology, Royal Holloway University of London, Egham, UK
| | - Coral Sirdifield
- School of Health and Social Care, University of Lincoln, Lincoln, UK
| | - Thomas Parkhouse
- School of Health and Social Care, University of Lincoln, Lincoln, UK
| |
Collapse
|
3
|
Bebbington PE, McManus S, Coid JW, Garside R, Brugha T. The mental health of ex-prisoners: analysis of the 2014 English National Survey of Psychiatric Morbidity. Soc Psychiatry Psychiatr Epidemiol 2021; 56:2083-2093. [PMID: 33751153 PMCID: PMC8519824 DOI: 10.1007/s00127-021-02066-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 03/10/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE Prisoners experience extremely high rates of psychiatric disturbance. However, ex-prisoners have never previously been identified in representative population surveys to establish how far this excess persists after release. Our purpose was to provide the first community-based estimate of ex-prisoners' mental health in England using the data from the 2014 Adult Psychiatric Morbidity Survey (APMS). METHODS APMS 2014 provides cross-sectional data from a random sample (N = 7546) of England's household population aged 16 or above. Standardised instruments categorised psychiatric disorders and social circumstances. Participants who had been in prison were compared with the rest of the sample. RESULTS One participant in seventy had been in prison (1.4%; 95% CI 1.1-1.7; n = 103). Ex-prisoners suffered an excess of current psychiatric problems, including common mental disorders (CMDs), psychosis, post-traumatic disorder, substance dependence, and suicide attempts. They were more likely to screen positive for attention-deficit/hyperactivity disorder and autistic traits, to have low verbal IQ, and to lack qualifications. They disclosed higher rates of childhood adversity, including physical and sexual abuse and local authority care. The odds (1.88; 95% CI 1.02-3.47) of CMDs were nearly doubled in ex-prisoners, even after adjusting for trauma and current socioeconomic adversity. CONCLUSIONS Prison experience is a marker of enduring psychiatric vulnerability, identifying an important target population for intervention and support. Moreover, the psychiatric attributes of ex-prisoners provide the context for recidivism. Without effective liaison between the criminal justice system and mental health services, the vulnerability of ex-prisoners to relapse and to reoffending will continue, with consequent personal and societal costs.
Collapse
Affiliation(s)
- Paul E Bebbington
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK.
| | - Sally McManus
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK
- National Centre for Social Research, London, UK
- Violence and Society Centre, City, University of London, London, UK
| | - Jeremy W Coid
- Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary, University of London, London, UK
| | | | - Terry Brugha
- Department of Health Sciences, Leicester University, Leicester, UK
| |
Collapse
|
4
|
Coid J, Gonzalez Rodriguez R, Kallis C, Zhang Y, Bhui K, De Stavola B, Bebbington P, Ullrich S. Ethnic disparities in psychotic experiences explained by area-level syndemic effects. Br J Psychiatry 2020; 217:555-561. [PMID: 31662125 PMCID: PMC7525103 DOI: 10.1192/bjp.2019.203] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Ethnic inequalities in health outcomes are often explained by socioeconomic status and concentrated poverty. However, ethnic disparities in psychotic experiences are not completely attenuated by these factors. AIMS We investigated whether disparities are better explained by interactions between individual risk factors and place-based clustering of disadvantage, termed a syndemic. METHOD We performed a cross-sectional survey of 3750 UK men, aged 18-34 years, oversampling Black and minority ethnic (BME) men nationally, together with men residing in London Borough of Hackney. Participants completed questionnaires covering psychiatric symptoms, substance misuse, crime and violence, and risky sexual health behaviours. We included five psychotic experiences and a categorical measure of psychosis based on the Psychosis Screening Questionnaire. RESULTS At national level, more Black men reported psychotic experiences but disparities disappeared following statistical adjustment for social position. However, large disparities for psychotic experiences in Hackney were not attenuated by adjustment for social factors in Black men (adjusted odds ratio, 3.24; 95% CI 2.14-4.91; P < 0.002), but were for South Asian men. A syndemic model of joint effects, adducing a four-component latent variable (psychotic experiences and anxiety, substance dependence, high-risk sexual behaviour and violence and criminality) showed synergy between components and explained persistent disparities in psychotic experiences. A further interaction confirmed area-level effects (Black ethnicity × Hackney residence, 0.834; P < 0.001). CONCLUSIONS Syndemic effects result in higher rates of non-affective psychosis among BME persons in certain inner-urban settings. Further research should investigate how syndemics raise levels of psychotic experiences and related health conditions in Black men in specific places with multiple deprivations.
Collapse
Affiliation(s)
- Jeremy Coid
- Professor of Epidemiology in Psychiatry, Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, China; and Wolfson Institute of Preventive Medicine, Queen Mary University of London, UK,Correspondence: Professor Jeremy Coid, Mental Health Center, West China Hospital of Sichuan University, No. 28 Dianxin South Street, Chengdu, Sichuan610041, China.
| | - Rafael Gonzalez Rodriguez
- Post-doctoral Researcher, Wolfson Institute of Preventive Medicine, Queen Mary University of London, UK
| | - Constantinos Kallis
- Senior Lecturer in Medical Statistics, Wolfson Institute of Preventive Medicine, Queen Mary University of London, UK
| | - Yamin Zhang
- Post-doctoral Researcher, Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, China
| | - Kamaldeep Bhui
- Professor of Psychiatry, Wolfson Institute of Preventive Medicine, Queen Mary University of London, UK
| | - Bianca De Stavola
- Professor of Medical Statistics, Institute of Child Health, University College London, UK
| | - Paul Bebbington
- Professor of Psychiatry, Department of Mental Health Sciences, University College London, UK
| | - Simone Ullrich
- Lecturer in Forensic Mental Health, Wolfson Institute of Preventive Medicine, Queen Mary University of London, UK
| |
Collapse
|
5
|
Denzel AD, Harte JM, van den Bergh M, Scherder EJA. Ethnic variations regarding clinical profiles and symptom representation in prisoners with psychotic disorders. BJPsych Open 2018; 4:18-28. [PMID: 29388907 PMCID: PMC6020278 DOI: 10.1192/bjo.2017.3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Black and minority ethnic (BME) groups are known to have higher prevalences of psychotic disorders and are over-represented in western penitentiaries and forensic psychiatric institutions. Research from regular mental healthcare settings suggests that they could show different and more severe psychotic symptoms. Aims To explore ethnic variations in severity of symptomatology of BME and non-BME detainees with psychotic disorders. METHOD In this study, 824 patients with psychotic disorders from seven different ethnic groups, imprisoned in a penitentiary psychiatric centre in the Netherlands, were compared on symptom severity and symptom representation using the BPRS-E clinical interview. Data were analysed by means of a multilevel analysis. RESULTS BME patients with psychotic disorders are over-represented in forensic psychiatry, and symptom profiles of prisoners with psychotic disorders vary by ethnicity. Additionally, severity levels of overall psychopathology differ between ethnic groups: patients with an ethnic majority status show more severe levels of psychopathology compared with BME patients. CONCLUSIONS There are differences in symptom severity and symptom profiles between BME patients and non-BME patients. Disregarding these differences could have an adverse effect on the outcome of the treatment. Possible explanations and clinical impact are discussed. Declaration of interest None.
Collapse
Affiliation(s)
- A Dorina Denzel
- Department of Clinical Neuropsychology,VU University,Amsterdam,van der Boechorststraat 1,1081 BT Amsterdam,the Netherlands
| | - Joke M Harte
- Netherlands Institute for the Study of Crime and Law Enforcement,(NSCR);Department of Criminology,VU University Amsterdam,de Boelelaan 1105,Initium (1A-46),1081 HV Amsterdam,the Netherlands
| | - Mattis van den Bergh
- Department of Methodology and Statistics,Tilburg University,P.O. Box 90153,5000 LE Tilburg,the Netherlands
| | - Erik J A Scherder
- Professor,Department of Clinical Neuropsychology,VU University,Amsterdam,van der Boechorststraat 1,1081 BT Amsterdam,the Netherlands
| |
Collapse
|
6
|
Coid JW, Ullrich S, Kallis C, Freestone M, Gonzalez R, Bui L, Igoumenou A, Constantinou A, Fenton N, Marsh W, Yang M, DeStavola B, Hu J, Shaw J, Doyle M, Archer-Power L, Davoren M, Osumili B, McCrone P, Barrett K, Hindle D, Bebbington P. Improving risk management for violence in mental health services: a multimethods approach. PROGRAMME GRANTS FOR APPLIED RESEARCH 2016. [DOI: 10.3310/pgfar04160] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BackgroundMental health professionals increasingly carry out risk assessments to prevent future violence by their patients. However, there are problems with accuracy and these assessments do not always translate into successful risk management.ObjectivesOur aim was to improve the accuracy of assessment and identify risk factors that are causal to be targeted by clinicians to ensure good risk management. Our objectives were to investigate key risks at the population level, construct new static and dynamic instruments, test validity and construct new models of risk management using Bayesian networks.Methods and resultsWe utilised existing data sets from two national and commissioned a survey to identify risk factors at the population level. We confirmed that certain mental health factors previously thought to convey risk were important in future assessments and excluded others from subsequent parts of the study. Using a first-episode psychosis cohort, we constructed a risk assessment instrument for men and women and showed important sex differences in pathways to violence. We included a 1-year follow-up of patients discharged from medium secure services and validated a previously developed risk assessment guide, the Medium Security Recidivism Assessment Guide (MSRAG). We found that it is essential to combine ratings from static instruments such as the MSRAG with dynamic risk factors. Static levels of risk have important modifying effects on dynamic risk factors for their effects on violence and we further demonstrated this using a sample of released prisoners to construct risk assessment instruments for violence, robbery, drugs and acquisitive convictions. We constructed a preliminary instrument including dynamic risk measures and validated this in a second large data set of released prisoners. Finally, we incorporated findings from the follow-up of psychiatric patients discharged from medium secure services and two samples of released prisoners to construct Bayesian models to guide clinicians in risk management.ConclusionsRisk factors for violence identified at the population level, including paranoid delusions and anxiety disorder, should be integrated in risk assessments together with established high-risk psychiatric morbidity such as substance misuse and antisocial personality disorder. The incorporation of dynamic factors resulted in improved accuracy, especially when combined in assessments using actuarial measures to obtain levels of risk using static factors. It is important to continue developing dynamic risk and protective measures with the aim of identifying factors that are causally related to violence. Only causal factors should be targeted in violence prevention interventions. Bayesian networks show considerable promise in developing software for clinicians to identify targets for intervention in the field. The Bayesian models developed in this programme are at the prototypical stage and require further programmer development into applications for use on tablets. These should be further tested in the field and then compared with structured professional judgement in a randomised controlled trial in terms of their effectiveness in preventing future violence.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.
Collapse
Affiliation(s)
- Jeremy W Coid
- Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Simone Ullrich
- Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Constantinos Kallis
- Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Mark Freestone
- Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Rafael Gonzalez
- Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Laura Bui
- Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Artemis Igoumenou
- Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Anthony Constantinou
- School of Electronic Engineering and Computer Science, Risk and Information Management, Queen Mary University of London, London, UK
| | - Norman Fenton
- School of Electronic Engineering and Computer Science, Risk and Information Management, Queen Mary University of London, London, UK
| | - William Marsh
- School of Electronic Engineering and Computer Science, Risk and Information Management, Queen Mary University of London, London, UK
| | - Min Yang
- West China Research Centre for Rural Health Development, Sichuan University, Chengdu, China
| | - Bianca DeStavola
- Centre for Statistical Methodology, London School of Hygiene and Tropical Medicine, London, UK
| | - Junmei Hu
- Basic and Forensic Medicine, Sichuan University, Chengdu, China
| | - Jenny Shaw
- Institute of Brain Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - Mike Doyle
- Institute of Brain Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - Laura Archer-Power
- Institute of Brain Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - Mary Davoren
- Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Beatrice Osumili
- Health Services and Population Research, Institute of Psychiatry, King’s College London, UK
| | - Paul McCrone
- Health Services and Population Research, Institute of Psychiatry, King’s College London, UK
| | | | | | - Paul Bebbington
- Department of Mental Health Sciences, University College London, London, UK
| |
Collapse
|
7
|
Slade K, Samele C, Valmaggia L, Forrester A. Pathways through the criminal justice system for prisoners with acute and serious mental illness. J Forensic Leg Med 2016; 44:162-168. [PMID: 27810587 DOI: 10.1016/j.jflm.2016.10.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 08/17/2016] [Accepted: 10/17/2016] [Indexed: 11/24/2022]
Abstract
PURPOSE To evaluate pathways through the criminal justice system for 63 prisoners under the care of prison mental health services. RESULTS A small number (3%) were acutely mentally ill at prison reception, which may reflect the successful operation of liaison and diversion services at earlier stages in the pathway. However, a third (33%) went onto display acute symptoms at later stages. Cases displaying suicide risk at arrest, with a history of in-patient care, were at increased risk of acute deterioration in the first weeks of imprisonment, with a general absence of health assessments for these cases prior to their imprisonment. Inconsistencies in the transfer of mental health information to health files may result in at-risk cases being overlooked, and a lack of standardisation at the court stage results in difficulties determining onward service provision and outcomes. CONCLUSIONS Greater consistency in access to pre-prison health services in the criminal justice system is needed, especially for those with preexisting vulnerabilities, and it may have a role in preventing subsequent deterioration. A single system for health information flow across the whole pathway would be beneficial.
Collapse
Affiliation(s)
- Karen Slade
- Division of Psychology, Nottingham Trent University, UK.
| | - Chiara Samele
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Lucia Valmaggia
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Andrew Forrester
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; South London and Maudsley NHS Foundation Trust, UK.
| |
Collapse
|
8
|
O’Neill C, Smith D, Caddow M, Duffy F, Hickey P, Fitzpatrick M, Caddow F, Cronin T, Joynt M, Azvee Z, Gallagher B, Kehoe C, Maddock C, O’Keeffe B, Brennan L, Davoren M, Owens E, Mullaney R, Keevans L, Maher R, Kennedy HG. STRESS-testing clinical activity and outcomes for a combined prison in-reach and court liaison service: a 3-year observational study of 6177 consecutive male remands. Int J Ment Health Syst 2016; 10:67. [PMID: 27766115 PMCID: PMC5057273 DOI: 10.1186/s13033-016-0097-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Accepted: 10/01/2016] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND People with major mental illness are over-represented in prison populations however there are few longitudinal studies of prison in-reach services leading to appropriate healthcare over extended periods. AIMS We aimed to examine measures of the clinical efficiency and effectiveness of a prison in-reach, court diversion and liaison service over a 3 year period. Secondly, we aimed to compare rates of identification of psychosis and diversion with rates previously reported for the same setting in the 6 years previously. We adopted a stress testing model for service evaluation. METHOD All new male remand committals to Ireland's main remand prison from 2012 to 2014 were screened in two stages. Demographic and clinical variables were recorded along with times to assessment and diversion. The DUNDRUM Toolkit was used to assess level of clinical urgency and level of security required. Binary logistic regression was used to assess factors relevant to diversion. RESULTS All 6177 consecutive remands were screened of whom 1109 remand episodes (917 individuals) received a psychiatric assessment. 4.1 % (95 % CI 3.6-4.6) had active psychotic symptoms. Levels of self-harm were low. Median time to full assessment was 2 days and median time to admission was 15.0 days for local hospitals and 19.5 days for forensic admissions. Diversion to healthcare settings outside prison was achieved for 5.6 % (349/6177, 95 % CI 5.1-6.3) of all remand episodes and admissions for 2.3 % (95 % CI 1.9-2.7). Both were increased on the previous period reported. Mean DUNDRUM-1 and DUNDRUM-2 Triage Security Scores were appropriate to risk and need. CONCLUSIONS We found that a two-stage screening and referral process followed by comprehensive assessment optimised identification of acute psychosis. The mapping approach described shows that it is possible for a relatively small team to sustainably achieve effective identification of major mental illness and diversion to healthcare in a risk-appropriate manner. The stress-testing structure adopted aids service evaluation and may help advise development of outcome standards for similar services.
Collapse
Affiliation(s)
- Conor O’Neill
- National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, 14 Ireland
- Department of Psychiatry, Trinity College, Dublin, Ireland
| | - Damian Smith
- National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, 14 Ireland
- Department of Psychiatry, Trinity College, Dublin, Ireland
| | - Martin Caddow
- National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, 14 Ireland
| | - Fergal Duffy
- National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, 14 Ireland
| | - Philip Hickey
- National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, 14 Ireland
| | - Mary Fitzpatrick
- National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, 14 Ireland
| | - Fintan Caddow
- National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, 14 Ireland
| | - Tom Cronin
- National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, 14 Ireland
| | - Mark Joynt
- National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, 14 Ireland
| | - Zetti Azvee
- National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, 14 Ireland
| | - Bronagh Gallagher
- National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, 14 Ireland
| | - Claire Kehoe
- National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, 14 Ireland
| | - Catherine Maddock
- National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, 14 Ireland
| | - Benjamin O’Keeffe
- National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, 14 Ireland
| | - Louise Brennan
- National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, 14 Ireland
| | - Mary Davoren
- National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, 14 Ireland
| | - Elizabeth Owens
- National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, 14 Ireland
| | - Ronan Mullaney
- National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, 14 Ireland
| | | | | | - Harry G. Kennedy
- National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, 14 Ireland
- Department of Psychiatry, Trinity College, Dublin, Ireland
| |
Collapse
|
9
|
Igoumenou A, Kallis C, Coid J. Treatment of psychosis in prisons and violent recidivism. BJPsych Open 2015; 1:149-157. [PMID: 27703740 PMCID: PMC4995573 DOI: 10.1192/bjpo.bp.115.000257] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 08/07/2015] [Accepted: 10/16/2015] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Violence among released prisoners with psychosis is an important public health problem. It is unclear whether treatment in prison can influence criminal behaviour subsequent to release. AIMS To investigate whether treatment in prison can delay time to reoffending. METHOD Our sample consisted of 1717 adult prisoners in England and Wales convicted of a serious violent or sexual offence. We used Cox regression to investigate the effects of treatment received in prison on associations between mental illness and time to first reconviction following release. RESULTS Prisoners with current symptoms of schizophrenia reoffended quicker following release. Nevertheless, treatment with medication significantly delayed time to violence (18% reduction). Treatment for substance dependence delayed violent and non-violent reoffending among prisoners with drug-induced psychosis. CONCLUSIONS Identifying prisoners with psychosis and administering treatment in prison have important protective effects against reoffending. Repeated screening with improved accuracy in identification is necessary to prevent cases being missed. DECLARATION OF INTEREST None. COPYRIGHT AND USAGE © The Royal College of Psychiatrists 2015. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.
Collapse
Affiliation(s)
- Artemis Igoumenou
- , PhD, , PhD, , MD, Violence Prevention Research Unit, Queen Mary University, London, UK
| | - Constantinos Kallis
- , PhD, , PhD, , MD, Violence Prevention Research Unit, Queen Mary University, London, UK
| | - Jeremy Coid
- , PhD, , PhD, , MD, Violence Prevention Research Unit, Queen Mary University, London, UK
| |
Collapse
|
10
|
Bruce M, Laporte D. Childhood trauma, antisocial personality typologies and recent violent acts among inpatient males with severe mental illness: exploring an explanatory pathway. Schizophr Res 2015; 162:285-90. [PMID: 25636995 DOI: 10.1016/j.schres.2014.12.028] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 11/23/2014] [Accepted: 12/19/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Prevalence of childhood trauma is elevated among individuals with severe mental illness (SMI) compared to the general population and associated with poor prognosis, substance misuse, lower treatment compliance and violence. Antisocial personality disorder (ASPD) typologies (childhood vs adult onset) also represent possible mediating mechanisms to explain risk of violence among men with SMI. The current study aimed to explore an explanatory pathway linking childhood traumatic exposure, antisocial personality typologies and risk of violent behaviour among adult male inpatients with SMI. METHODS A total of 162 male inpatients with SMI were examined using a cross-sectional survey design. Information was extracted from medical files, interviews and official criminal records. RESULTS Fifty-two participants (32.1%) reported experiencing a childhood trauma before 15. This group was 2.8 times more likely to engage in violent acts within the past 6months than those without such a history. Furthermore, those with childhood onset ASPD (early starters) were more likely to report childhood trauma and engage in violence compared to adult onset ASPD (late starters) and those without antisocial histories. Multivariate analyses revealed that early starter ASPD was the only variable that independently predicted violence and mediated the relationship between childhood trauma and recent violent acts. CONCLUSIONS A significant subset of men reporting trauma and antisocial conduct from childhood (early starter ASPD) is at considerably elevated risk of engaging in violent behaviours. Assessment of antisocial typologies in men with SMI may assist effective and defensible case prioritisation, resource allocation and treatment planning.
Collapse
Affiliation(s)
- Matt Bruce
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, United Kingdom.
| | - Dionne Laporte
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, United Kingdom
| |
Collapse
|
11
|
Doyle M, Coid J, Archer-Power L, Dewa L, Hunter-Didrichsen A, Stevenson R, Wainwright V, Kallis C, Ullrich S, Shaw J. Discharges to prison from medium secure psychiatric units in England and Wales. Br J Psychiatry 2014; 205:177-82. [PMID: 25012684 DOI: 10.1192/bjp.bp.113.136622] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Early findings from a national study of discharges from 32 National Health Service medium secure units revealed that nearly twice as many patients than expected were discharged back to prison. AIMS To compare the characteristics of those discharged back to prison with those discharged to the community, and consider the implications for ongoing care and risk. METHOD Prospective cohort follow-up design. All forensic patients discharged from 32 medium secure units across England and Wales over a 12-month period were identified. Those discharged to prison were compared with those who were discharged to the community. RESULTS Nearly half of the individuals discharged to prison were diagnosed with a serious mental illness and over a third with schizophrenia. They were a higher risk, more likely to have a personality disorder, more symptomatic and less motivated than those discharged to the community. CONCLUSIONS Findings suggest that alternative models of prison mental healthcare should be considered to reduce risks to the patient and the public.
Collapse
Affiliation(s)
- Michael Doyle
- Michael Doyle, RMN, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester; Jeremy Coid, MB ChB, FRCPsych, MD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Laura Archer-Power, BSc, Lindsay Dewa, MSc, Alice Hunter-Didrichsen, MSc, Rachel Stevenson, MSc, Verity Wainwright, MSc, Institute of Brain Behaviour and Mental Health, University of Manchester; Costas Kallis, PhD, Simone Ullrich, PhD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Jenny Shaw, MB ChB, FRCPsych, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester, UK
| | - Jeremy Coid
- Michael Doyle, RMN, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester; Jeremy Coid, MB ChB, FRCPsych, MD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Laura Archer-Power, BSc, Lindsay Dewa, MSc, Alice Hunter-Didrichsen, MSc, Rachel Stevenson, MSc, Verity Wainwright, MSc, Institute of Brain Behaviour and Mental Health, University of Manchester; Costas Kallis, PhD, Simone Ullrich, PhD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Jenny Shaw, MB ChB, FRCPsych, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester, UK
| | - Laura Archer-Power
- Michael Doyle, RMN, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester; Jeremy Coid, MB ChB, FRCPsych, MD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Laura Archer-Power, BSc, Lindsay Dewa, MSc, Alice Hunter-Didrichsen, MSc, Rachel Stevenson, MSc, Verity Wainwright, MSc, Institute of Brain Behaviour and Mental Health, University of Manchester; Costas Kallis, PhD, Simone Ullrich, PhD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Jenny Shaw, MB ChB, FRCPsych, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester, UK
| | - Lindsay Dewa
- Michael Doyle, RMN, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester; Jeremy Coid, MB ChB, FRCPsych, MD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Laura Archer-Power, BSc, Lindsay Dewa, MSc, Alice Hunter-Didrichsen, MSc, Rachel Stevenson, MSc, Verity Wainwright, MSc, Institute of Brain Behaviour and Mental Health, University of Manchester; Costas Kallis, PhD, Simone Ullrich, PhD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Jenny Shaw, MB ChB, FRCPsych, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester, UK
| | - Alice Hunter-Didrichsen
- Michael Doyle, RMN, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester; Jeremy Coid, MB ChB, FRCPsych, MD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Laura Archer-Power, BSc, Lindsay Dewa, MSc, Alice Hunter-Didrichsen, MSc, Rachel Stevenson, MSc, Verity Wainwright, MSc, Institute of Brain Behaviour and Mental Health, University of Manchester; Costas Kallis, PhD, Simone Ullrich, PhD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Jenny Shaw, MB ChB, FRCPsych, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester, UK
| | - Rachel Stevenson
- Michael Doyle, RMN, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester; Jeremy Coid, MB ChB, FRCPsych, MD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Laura Archer-Power, BSc, Lindsay Dewa, MSc, Alice Hunter-Didrichsen, MSc, Rachel Stevenson, MSc, Verity Wainwright, MSc, Institute of Brain Behaviour and Mental Health, University of Manchester; Costas Kallis, PhD, Simone Ullrich, PhD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Jenny Shaw, MB ChB, FRCPsych, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester, UK
| | - Verity Wainwright
- Michael Doyle, RMN, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester; Jeremy Coid, MB ChB, FRCPsych, MD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Laura Archer-Power, BSc, Lindsay Dewa, MSc, Alice Hunter-Didrichsen, MSc, Rachel Stevenson, MSc, Verity Wainwright, MSc, Institute of Brain Behaviour and Mental Health, University of Manchester; Costas Kallis, PhD, Simone Ullrich, PhD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Jenny Shaw, MB ChB, FRCPsych, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester, UK
| | - Costas Kallis
- Michael Doyle, RMN, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester; Jeremy Coid, MB ChB, FRCPsych, MD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Laura Archer-Power, BSc, Lindsay Dewa, MSc, Alice Hunter-Didrichsen, MSc, Rachel Stevenson, MSc, Verity Wainwright, MSc, Institute of Brain Behaviour and Mental Health, University of Manchester; Costas Kallis, PhD, Simone Ullrich, PhD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Jenny Shaw, MB ChB, FRCPsych, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester, UK
| | - Simone Ullrich
- Michael Doyle, RMN, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester; Jeremy Coid, MB ChB, FRCPsych, MD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Laura Archer-Power, BSc, Lindsay Dewa, MSc, Alice Hunter-Didrichsen, MSc, Rachel Stevenson, MSc, Verity Wainwright, MSc, Institute of Brain Behaviour and Mental Health, University of Manchester; Costas Kallis, PhD, Simone Ullrich, PhD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Jenny Shaw, MB ChB, FRCPsych, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester, UK
| | - Jenny Shaw
- Michael Doyle, RMN, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester; Jeremy Coid, MB ChB, FRCPsych, MD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Laura Archer-Power, BSc, Lindsay Dewa, MSc, Alice Hunter-Didrichsen, MSc, Rachel Stevenson, MSc, Verity Wainwright, MSc, Institute of Brain Behaviour and Mental Health, University of Manchester; Costas Kallis, PhD, Simone Ullrich, PhD, Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University London; Jenny Shaw, MB ChB, FRCPsych, PhD, Institute of Brain Behaviour and Mental Health, University of Manchester, UK
| |
Collapse
|
12
|
Konrad N, Opitz-Welke A. The challenges of treating the mentally ill in a prison setting: the European perspective. ACTA ACUST UNITED AC 2014. [DOI: 10.2217/cpr.14.44] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|