Revista Espanola de Sanidad Penitenciaria最新文献

Objectives: Review the epidemiology of metabolic dysfunction-associated steatotic liver disease (MASLD), and the main diagnostic and therapeutic challenges, with a specific focus on its management in the prison population.

Material and method: MASLD is the most prevalent form of chronic liver disease worldwide and represents an increasing challenge for public health and healthcare systems. Prison inmates are particularly vulnerable to this condition due to a combination of individual and social factors and to characteristics within the correctional system itself. These vulnerabilities have contributed to an epidemiological transition, whereby metabolic comorbidities have replaced transmittable diseases as the main cause of morbimortality.

Conclusions: The growing burden of metabolic disease in correctional settings underscores the urgent need for effective screening and referral strategies for early MASLD detection. However, current protocols remain poorly defined, and there is limited evidence regarding their cost-effectiveness in this specific context. These gaps highlight the pressing need for further research and the development of public health policies tailored to the unique characteristics of this high-risk population.

Objectives: Spain has one of the highest incarceration rates in Europe, and its prison population shows a significantly higher prevalence of mental illness and toxic substances use disorder compared to the general population. Despite this, there is a lack of studies focused on mental disorders in Spanish prisons. This study aims to explore the differences between Spanish and foreign persons deprived of liberty with severe mental disorders.

Material and method: We evaluated the sociodemographic (Spanish vs. foreign) and clinical characteristics of 106 persons deprived of liberty admitted to a Spanish prison module for psychiatric decompensation between 2009 and 2022.

Results: Immigrants represent 51.9% of the sample, predominantly young unmarried males, primarily admitted for suicidal behavior (43.6%). Compared to Spaniards, they have fewer psychiatric histories and less mental health follow-up in the previous six months. In contrast, Spanish inmates are older, have higher rates of bipolar disorder and personality disorders, and receive more psychotropic prescriptions. They also present with more cardiovascular risk factors and physical comorbidities.

Discussion and conclusions: Foreign incarcerated person are overrepresented in psychiatric admissions and are particularly vulnerable to suicidal behavior. Social precarity likely accounts for some of the differences observed compared to the native population.

Objective: Describe the characteristics of inmates who have or have had tuberculosis (TB) and identify associated factors.

Material and method: An observational, prospective, multicenter, population-based study was carried out on patients admitted to the nine prisons in Catalonia between March 1 and June 30, 2023. The patient's history of TB was assessed, and the presence of current TB was confirmed/ruled out. In TB cases, predictor variables were studied using bivariate and multivariate logistic regression analysis, calculating the risk ratio (RR) and its 95% confidence interval (CI).

Results: There were 1,679 admissions, 2.3% with previous TB and 1 with TB detected at screening. TB cases were older (45.1 vs. 33.7 years) and more frequently intravenous drug users (6.9% vs. 1.7% in non-users), Asian (9.1% vs. 1.4% in non-Asian), HIV-infected (10.3% vs. 1.9% in non-infected) and homeless (3.4% vs. 1.9% in those with a home). Multivariate analysis confirmed the association with: a) be older (RR: 2.9 in >30 years of age and RR=5.8 in >60 years of age, p =0.001); b) Asian origin (RR: 8.81; p <0.001); and c) not having a home (RR: 3.07; p = 0.005).

Discussion: 2.3% had or had previously had tuberculosis. Therefore, it is essential to carry out tuberculosis screening upon admission to detect new cases or exacerbations and prevent TB transmission in an enclosed environment. Previous tuberculosis was more common in older adults, Asians, and those without shelter or housing; such groups require special follow-up.

Objectives: This study aims to analyze the different types of gender discrimination faced by female inmates and their impact on their psychological well-being.

Material and method: A systematic review was carried out in accordance with the PRISMA guidelines. The search was carried out on the PubMed and Scopus databases using keywords related to gender discrimination, mental health, and the prison context. Filters were applied for language (Spanish and English), publication period (2015-2025), and study type (quantitative, qualitative, or mixed methods).

Results: A total of 13 studies were selected (1 longitudinal, 9 cross-sectional, and 3 mixed methods), conducted across diverse geographical and social contexts. The evidence shows that incarcerated women face institutional violence, stigmatization, and structural barriers that limit their access to basic services and rehabilitation programs. These conditions exacerbate disorders such as depression, anxiety, and post-traumatic stress disorder, which are further intensified by histories of gender-based violence and racial discrimination. In addition, family separation and challenges in social reintegration stemming from a lack of education and employment opportunities perpetuate a cycle of exclusion and marginalization. Despite some interventions aimed at reducing these inequalities, the findings indicate that they remain insufficient to address the specific needs of incarcerated women.

Conclusions: There is an urgent need to reform prison policies, adopting more inclusive and intersectional approaches that ensure equitable access to psychological care, rehabilitation programs, and effective reintegration strategies. Only by doing so can the cycle of discrimination and vulnerability affecting this population be broken.

Introduction: Prison officers play a crucial role in the precarious prison systems of Latin America, even though their working conditions and the implications of these on their mental health and absenteeism have been scarcely studied.

Objectives: This article analyses, from a mainly quantitative perspective, the situation of mental health and absenteeism in a sample of Chilean prison officers in 20 prisons throughout the country.

Material and method: We used a methodological combination that included: the application of the General Health Questionnaire (GHQ-12) instrument, applied to a simple random sample of 1,171 prison officers belonging to 20 prisons throughout Chile; the Staff Quality of Life (SQL) questionnaire in the same sample; and administrative data on absenteeism (sick leave) provided by the Chilean prison service (Gendarmerie), in order to describe the magnitude of the phenomenon in the country's prisons. The data were analyzed using descriptive statistics, bivariate analysis, and multiple linear regression modeling.

Results and discussion: Our main conclusion is that prison officers present significant deterioration in their physical and mental health, which was observed both in the high rates of absenteeism from work (sick leave), as well as in the high percentages of officers reporting the presence of some psychopathology, according to the GHQ-12, far exceeding figures obtained in the general Chilean population.

Objectives: Prisons present a unique opportunity to address the high prevalence of hepatitis C (HCV) among inmates, a population disproportionately affected by the disease. Specific conditions within correctional facilities contribute to increased HCV transmission rates. Incarceration offers a strategic chance to reach individuals who are often inaccessible through traditional healthcare systems, transforming prison time into a window for targeted health interventions.

Material and method: This study utilized a qualitative approach, conducting a comprehensive literature review on HCV management within correctional settings and incorporating data and insights from the "Let's End HepC" European project. The findings informed the development of the PIO-NEER framework, which emphasizes evidence-based public health policies to enhance health safety in prisons for hepatitis C.

Results: Effective control of HCV in prisons requires a multifaceted approach, including education, counseling, harm-reduction initiatives such as safe tattooing practices, provision of direct-acting antiviral (DAA) treatments, and improvements in prison conditions. Emphasis should also be placed on fostering respect for prisoners' human rights, implementing preventive measures, and reducing HCV transmission within correctional facilities.

Discussion: Incarceration represents a critical opportunity for diagnosing and treating hepatitis C, contributing to improved health outcomes for inmates and reducing transmission risks within the wider community. By addressing HCV in prisons, incarceration can be reframed as a public health intervention to mitigate community health risks when inmates are reintegrated.

Objectives: To evaluate the impact of a motivational interviewing (MI) training program for prison professionals by analysing the progression of MI-compatible competence and adherence, as well as the reduction of non-compatible practices.

Material and method: A longitudinal quasi-experimental study with repeated measures was conducted over four months at three time points. A total of 25 correctional professionals participated in a three-phase training program. A Spanish-translated version of the Motivational Interviewing Assessment: Supervisory Tools for Enhancing Proficiency (MIA:STEP) questionnaire from Substance Abuse and Mental Health Services Administration (SAMHSA) was used for self-assessment. Statistical analyses included repeated measures ANOVA, Friedman's test, effect size (h²), and observed power.

Results: Non-compatible adherence to MI significantly decreased (p <0.001, h² = 0.360; c² = 20.796, p <0.001), representing the most notable finding. Compatible competence in MI showed a non-significant increase in ANOVA (p = 0.138), but a significant improvement in Friedman's test (c² = 9.621, p = 0.008). Compatible adherence initially increased (p <0.001, h² = 0.267) but subsequently declined (c² = 9.939, p = 0.007). Non-compatible competence significantly increased between the initial and final assessments (p = 0.012, h² = 0.169; c² = 9.711, p = 0.008).

Discussion: The program was effective in significantly reducing non-compatible adherence to MI, which emerged as the most substantial outcome. While compatible adherence fluctuated and compatible competence exhibited a differentiated progression depending on the statistical test used, the findings indicate progressive learning and areas requiring further reinforcement. The ecological validity of the study design strengthens the applicability of the results, providing evidence of the impact of MI training in correctional settings.The study was approved by the Ethics Committee of the University of Salamanca (CEISH).

Objectives: Female inmates have the right to reproductive and sexual health care. In addition, this population presents risk factors that make them especially vulnerable to obstetric-gynaecological pathologies. For this reason, they should be guaranteed the necessary care. The aim of this study is to determine the main obstetric and gynaecological reasons for female inmates to visit the midwife's clinic.

Material and method: Descriptive observational study carried out between 18/04/23 and 01/06/23. The target population were the female inmates at the Madrid VII Prison-Estremera.

Results: 77.5% of the women were of childbearing age. The sample showed 3.8% human immuno-deficiency virus, 8.7% hepatitis B virus and hepatitis C virus, 13% human papillomavirus, 5.8% syphilis. 40% were smokers and 37.6% users of illegal substances. There were 75.6% scheduled consultations, mainly for cervical cancer prevention and contraceptive advice. Consultations on demand accounted for 23.2%, mainly for concerns relating to contraception or vaginal issues.

Discussion: Since female inmates have multiple risk factors for the development of obstetric and gynaecological pathologies, prevention by the midwife cannot be ignored in prisons, with activities such as vaccination, health education, early detection tests, etc. In addition, the degree of participation has been high, so it is understood that female inmates demand this type of health care.