Anti-depressant prescribing patterns for prison inmates with depressive disorders

Background: Although prison inmates are reported to exhibit elevated rates of depressive disorders, little is known about anti-depressant prescribing patterns in correctional institutions. Methods: The study population consis ted of 5305 Texas Department of Criminal Justice (TDCJ) inmates who were di agnosed with one of three depressive disorders: major depression, dysthymia , and bipolar disorder (excluding those with manic episodes only). Informat ion on medical conditions, sociodemographic factors, and pharmacotherapy wa s obtained from an institution-wide medical information system. Results. In 1998, 78.2% of all inmates diagnosed with depressive disorders were treate d with antidepressant medication. Of these, 47.3% were treated exclusively with tricyclic anti-depressants (TCA); 30.9% were treated with selective se rotonin re-uptake inhibitors (SSRI); and 21.8% were not treated with any fo rm of anti-depressant medication. Prescribing patterns varied substantially according to a number of sociodemographic factors under study. Limitations : Because the present study relied on retrospective, clinical data, the inv estigators had limited ability to assess: specific symptomatology for each diagnosed depressive condition under study; socio-economic status, pre-inca rceration access to health care; and the overall reliability and validity o f the data. Conclusion: The proportion of prison inmates with depressive di sorders who receive appropriate medication management is substantially high er than that reported among similarly diagnosed nonincarcerated samples. It will be important, however, for future investigators to examine the source s of sociodemographic variation in treatment patterns found in the present study. (C) 2001 Elsevier Science B.V. All rights reserved.