First-episode psychosis among people who are incarcerated: What is hidden behind the “prison psychosis” concept?

Abstract

“Prison psychosis” is a historical concept that is still used in clinical practice, but little explored in research. In this short paper, we propose to revisit this concept by studying first-episode psychosis (FEP) in the prison population. We analyzed a series of incarcerated people who were hospitalized for a FEP from November 2020 to May 2021 in a French facility. We dated the onset of the first psychotic symptoms (PSs) in relation to the date of incarceration and of hospitalization and we calculated the duration of untreated psychosis (DUP). While the characteristics of our sample were consistent with what we know about people diagnosed with psychosis in correctional settings (young men with positive symptoms and psychiatric comorbidities), we found great heterogeneity in the DUP and in the chronological sequence between incarceration and the onset of PSs. This preliminary but original work shows the diversity of first diagnosis of psychosis in prison, reflecting the multiplicity and complexity of interactions between psychosis and incarceration.