Which Clinical and Demographic Factors are Related to Incarceration in Male Patients With Antisocial Personality Disorder?

Abstract

Antisocial Personality Disorder (APD) is a condition largely represented in detention centers where can reach a prevalence of 60% in male prisoners. The objective of this study is to identify the clinical and demographic factors that differentiate subjects with APD and hosted in penitentiary with respect to those are treated in outpatient psychiatric clinics. We recruited 65 male patients affected by APD, whose 26 were followed up in community mental health services and 39 were serving their sentence in a detention center located in Monza. Socio-demographic and clinical data were obtained through a review of the clinical charts, and interviews with patients or their relatives (if available). We performed descriptive analyses on the total sample, then we compared the two groups identified by the type of setting (outpatient clinic vs. penitentiary) by independent sample t tests (quantitative variables) or χ2 tests (qualitative ones). For qualitative variables odds ratios ( ORs) were also calculated. Outpatients with APD (with respect to those hosted in the detention center) resulted: to be older ( p = .02), to be less likely married ( p = .01), to have more pre-onset psychiatric comorbidity ( p = .05), to have more pre-onset substance poly-misuse ( p = .01), to have more previous psychiatric hospitalizations ( p < .01), and to be less likely to have received lifetime psychotherapy ( p < .01). Globally, the results of this study show how the presence of psychiatric comorbidity or substance abuse (with the probable access to psychiatric services) before the onset of APD prevents imprisonment. This aspect is even more surprising when we consider that the two groups of patients show no differences in the frequency of crimes. Future research will have to confirm if early mental health care can really limit the access to penitentiary of subjects affected by APD.

Sociodemographic and clinical factors associated with prescription of first- versus second-generation long-acting antipsychotics in incarcerated adult males

“…However, prisons contain some of the most vulnerable and disadvantaged individuals in society. Indeed, it is consistently reported that individuals experiencing mental illness are overrepresented in prison populations than those of similar ages living in community (Fazel and Seewald, 2012; Esposito et al ., 2022), particularly in case of co-occurring serious mental illnesses and substance use disorders (dual diagnosis) (Fazel et al ., 2016; Baranyi et al ., 2022). Of note, people who are incarcerated are a highly fragile population as demonstrated by high rates of self-harm, suicide, victimization, violence, poverty, unemployment, family breakdown, homelessness, physical health problems as well as of reoffending and eventual reincarceration (Wallace and Wang, 2020; Capuzzi et al ., 2021a).…”