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Now published in The Lancet

Severe Mental Illness and Substance Use Disorders in Prisoners in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis of Prevalence Studies

32 Pages Posted: 3 Oct 2018

See all articles by Gergő Baranyi

Gergő Baranyi

University of Edinburgh

Carolin Scholl

University of Edinburgh

Seena Fazel

University of Oxford - Department of Psychiatry

Vikram Patel

Harvard Medical School - The Pershing Square Professor of Global Health

Stefan Priebe

Queen Mary University of London - Unit for Social and Community Psychiatry

Adrian Mundt

Universidad Diego Portales - Medical Faculty

More...

Abstract

Background: Although more than two thirds of prisoners are based in low- and middle-income countries (LMIC), the burden of psychiatric disorders is not reliably known. This review provides estimates for the prevalence of severe mental illness and substance use disorders in incarcerated individuals in LMIC.

Methods: Systematic literature searches were conducted in 17 electronic databases identifying prevalence studies of psychiatric disorders in prison populations, published between January 1987 and May 2018. We pooled prevalences using random-effects meta-analyses and assessed the sources of heterogeneity by meta-regression. We extracted general population estimates from the Global Burden of Diseases 2016 database to calculate prevalence ratios. The review was registered in PROSPERO (CRD42015020905).

Findings: We identified 23 publications reporting estimates for 14,527 prisoners. The pooled one-year prevalence rates were estimated to be 6·2% (95% CI 4·0-8·6) for psychosis, 16·0% (95% CI 11·7-20·8) for major depression, 3·8% (95% CI 1·2-7·6) for alcohol use disorders, and 5·1% (95% CI 2·9-7·8) for drug use disorders. We found elevated prevalences at prison intake and geographic variations for substance use disorders. Prevalence ratios indicated substantially higher rates among prisoners than in the general population.

Interpretation: The prevalence of major psychiatric disorders is high in prisoners in LMIC. As these findings are likely to reflect unmet needs, the development of scalable interventions should be a public health priority in resource-poor settings.

Funding: This work was funded by CONICYT of the Chilean government (FONDECYT Regular grant number 1160260 to APM) and The Wellcome Trust (grant number 202836/Z/16/Z to SF).

Declaration of Interest: We declare no competing interests.

Keywords: prevalence, psychosis, depression, substance use disorders, prisoners, low-and middle-income countries

Suggested Citation

Baranyi, Gergő and Scholl, Carolin and Fazel, Seena and Patel, Vikram and Priebe, Stefan and Mundt, Adrian, Severe Mental Illness and Substance Use Disorders in Prisoners in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis of Prevalence Studies (August 16, 2018). Available at SSRN: https://ssrn.com/abstract=3235631 or http://dx.doi.org/10.2139/ssrn.3235631

Gergő Baranyi

University of Edinburgh

Old College
South Bridge
Edinburgh, Scotland EH8 9JY
United Kingdom

Carolin Scholl

University of Edinburgh

Old College
South Bridge
Edinburgh, Scotland EH8 9JY
United Kingdom

Seena Fazel

University of Oxford - Department of Psychiatry ( email )

Oxford
United Kingdom

Vikram Patel

Harvard Medical School - The Pershing Square Professor of Global Health

Boston, MA
United States

Stefan Priebe

Queen Mary University of London - Unit for Social and Community Psychiatry ( email )

Adrian Mundt (Contact Author)

Universidad Diego Portales - Medical Faculty ( email )

Ejercito 233
Santiago, 8370068
Chile

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