CLINICAL SPECIFICITY OF PRISON-INMATES WITH SEVERE MENTAL-DISORDERS -A CASE-CONTROL STUDY

Background We wished to determine whether prison inmates with severe m ental disorders possess specific clinical characteristics compared wit h psychiatric in-patients suffering from similar problems. Method Unde r a case-control design, 69 male prison inmates suffering from a schiz ophrenic or major affective disorder were matched for age and diagnost ic spectrum to 60 male psychiatric inpatients. Standardised interviews were used to diagnose psychiatric disorders according to DSM-III-R an d social functioning criteria. Case-notes were reviewed to cull data r egarding social life, criminal record and service use. Results Inmates were more likely to suffer from delusional/NOS psychotic disorders (7 2%) or major depression (70%), and psychiatric in-patients from schizo phrenic or bipolar disorder (62% and 71%, respectively). Comorbidity w as more prevalent among inmates than among in patients, while in-patie nts presented less social autonomy than did inmates. Conclusions The c linical specificity of prison inmates with severe mental disorders cle arly differentiates them from psychiatric in-patients, and warrants re cognition of their special needs for assessment and integrated treatme nt approaches.