Revista Espanola de Sanidad Penitenciaria最新文献

Objectives: To describe the possible relationship between the use of antipsychotic drugs and the presence of metabolic syndrome. Other objectives are to list the main side effects of antipsychotic treatment, and to determine if there is any pharmacological treatment that can contribute towards counteracting metabolic syndrome.

Material and method: A narrative bibliographic review was carried out of the following databases: PubMed, Cochrane, CINAHL, IBECS, LILACS and HealthCare. Preference in the selection process was given to clinical trials and systematic review articles or review articles and some articles that were considered relevant because of their content. The time period was limited to between January 2014 and November 2019. The languages were English and Spanish. Repeated articles and those that were not related to the objectives were rejected. The search criteria were: "antipsychotic AND metabolic syndrome"; "schizophrenia AND metabolic syndrome"; "bipolar disorder AND metabolic syndrome"; "metabolic syndrome AND suicide NOT disorder"; "metabolic syndrome AND prisons"; "metabolic syndrome AND prolactin".

Results: 24 articles were selected out of the 510 that were consulted. The relationship between atypical antipsychotics and metabolic syndrome was evident. Other anticholinergic, antidopaminergic effects, extrapyramidal syndromes, neuroleptic malignant syndrome, hypotension, arrhythmias, sedation, hypovitaminosis D, increased prolactin, sexual dysfunction, sleep disturbances, etc. are also highlighted. Pharmacological associations with other drugs were also found.

Discussion: There is a relationship between the use of atypical antipsychotics and weight gain, lipid disorders, glucose and high blood pressure. There are some associated drugs that decrease some symptoms (ranitidine, topiramate, metformin, melatonin, modafinil). Patients taking this type of medication should be monitored and encouraged to lead healthy lifestyles.

Objectives: Overweight and obesity constitute a public health problem; There are few prevalence studies of inmates. The objectives of this study are to determine the prevalence of overweight and obesity amongst inmates of the Islas Marias Prison Complex and to evaluate the waist-to-hip ratio (WHR) and the waist-to-height ratio (WHtR) as diagnostic measurements for abdominal obesity in this population.

Material and method: Analytical, retrospective cross-sectional study at Rural Hospital No. 20 Islas Marias Nayarit, Mexico, with 426 cases from January 2016 to March 2017, who were male inmates from 18 to 73 years of age. The following ratios were calculated: BMI, WHR WHtR. A descriptive analysis was carried out for quantitative variables, frequencies and percentages by group, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), Youden index, positive and negative likelihood ratios of WHR and WHtR; ANOVA F test, Student's t-test, ROC curve, STROBE statement, SPSS v. 22.

Results: 51.41% cases presented as overweight, 25.35% were obese, the cut-off point was 0.935 for WHR (s = 0.833; e = 0.717) and 0.545 for WHtR ICA (s = 0.981; e = 0.818). WHtR showed a good performance according to the Youden index.

Discussion: There was a high prevalence of overweight and obesity in prisoners at the Islas Marias Prison Complex, WHtR showed better performance than WHR for diagnosing abdominal obesity. It is suggested that measurement of WHI should be included in daily medical practice.

Objectives: To determine the influence of perceived social support and resilience in the use of alcohol and other drugs amongst female inmates.

Material and method: A cross-sectional study with 174 inmates was conducted in two prisons in the Region of Murcia. A self-administered questionnaire was used, which included socio-demographic, prison, alcohol and other drug consumption, perceived social support and resilience variables.

Results: 28.2% of the inmates consumed at least one of the substances analyzed (alcohol, cannabis, cocaine, heroin and/or tranquillizers without medical prescription) in prison. The female consumers showed significantly lower levels of perceived social support and resilience, compared to the counterparts who did not consume in prison.

Discussion: Findings show how perceived social support and resilience are factors of protection against substance use in prison, and these can be incorporated in future prevention programs for the consumption of alcohol and other drugs during imprisonment.

Objectives: To examine the predictive validity of the HCR-20 (The Historical Clinical Risk Management-20) to predict future violent incidents in a representative sample of patients with severe mental disorders and with a history of previous admission to prison, who after release are in a situation of extreme social exclusion.

Material and method: The study sample was selected from the 235 patients treated by the Mental Health Street Team of Madrid (ECASAM) from June 2014 to June 2017, including those with a previous history of a previous internment in a penitentiary (about which, the HCR-20 was completed).

Results: Of the 44 patients included, 29.6% (n=13) ended up participating in a violent incident after the release. The ROC curves (Receiver Operating Characteristic) analysis indicated that the total score of HCR-20 (AUC 0.98, p=0.01) has a high predictive validity.

Conclusions: The social and medical changes that take place after the release of patients with severe mental illness justify the need to reassess the risk of violence. In this evaluation, the HCR-20 guide is a useful tool for predicting the risk of involvement in future violent incidents, and the inclusion of factors such as social exclusion and its consequences, as well as problems with substance use is especially important.

Introduction: Involuntary outpatient treatment (IOT) is a kind of compulsory outpatient treatment, whose aim is to improve the adherence to the treatment in people with severe mental illness and with no awareness of disease. In these cases, therapeutic abandonment involves a high risk of relapse, with appearance of disruptive and/or self-aggressive or hetero-aggressive behavior, repeated hospitalizations and frequent emergencies. The application of IOT is not an issue without contention. Therefore, the need of legislative regulation in Spain has been a controversial subject for several years, and there are both advocates and opponents.

Objective: The objective of this study is to bring together the opinion of clinical psychiatrists and resident doctors in psychiatry on the involuntary outpatient treatment and its legislative regulation.

Material and method: This study is descriptive in nature. The study population consists of 42 clinical professionals in mental health (32 psychiatrists and 10 resident doctors in psychiatry). At the beginning of this study (March 2018), some of these professionals were working in the Psychiatry Department's facilities of the University Hospital Complex of Huelva. A personal survey in paper form consisting of ten questions about IOT was carried out to each member of this study.

Results: 85.7% of clinicians know the current initiative that tries to carry out the legislative regulation of IOT, and 92.8% of them agree to such regulation. In this sense, 83.3% of them are against the fact that more coercive measures for the psychiatric patients such as the involuntary commitment or the civil incapacitation are regulated and IOT is not. On the one hand, 78.6% of the professionals in mental health believe that IOT is beneficial for the patients. Moreover, 95.2% of them think that is beneficial for their relatives, too. On the other hand, 78.6% of clinicians do not consider that the application of IOT to mentallyill patients is stigmatizing.

Conclusion: The vast majority of clinicians think that the legislative regulation of involuntary outpatient treatment is necessary in Spain, and they think this treatment is beneficial not only for the patient but also for their family.

Objectives: To determine the prevalence of diagnosed diabetes (DD) and its control amongst prisoners in Catalonia.

Materials and methods: Transversal study carried out in four Catalan prisons between April and May 2016. The prevalence of DD in inmates was calculated by intentional sampling and collecting the following variables about: a) type of diabetes, value of glycosylated hemoglobin (HbA1c) and treatment; b) comorbidities; c) epidemiological and prison variables; knowledge of hyperglycaemia/hypoglycaemia, and e) participation in educational activities. Optimal control was considered to exist if Hb1A<7.5% and high risk if Hb1Ac >9%. Test x2 was used in order to study the association among qualitative variables. Multivariate analysis was carried out using logistic regression to determine variables associated with disease control.

Results: The study group considered 4,307 male patients, 50.2 years of average age. Ninety-three cases of DD were detected (prevalence 2.16%). 22.6% were treated with insulin, 51.6% with oral antidiabetics (OAD) and 25.8% with both. Type 1 users were younger, thinner, diagnosed at a younger age, heavy drug users and acknowledged to know how to act in the event of hyperglycaemia/hypoglycaemia. Optimal control was more common in type 2 diabetics, but multivariate analysis only associated it with OAD treatment.

Discussion: The prevalence observed in DD is much lower than that of the population outside prison and may be underestimated. Optimal control is low, and risk is very high, the results may be biased by the type of population, frequently drug-dependent and with few healthy habits. It is recommended to implement diabetes programmes or improve existing ones in order to increase the diagnosis and management of the disease.

Objectives: Literature on this issue has shown a high prevalence of alcohol and other drug use in the prison population. Although many risk factors have been linked to this behavior in prison, it is not common to find research that analyses the influence of family/social contact in prison.

Material and method: A cross-sectional study was carried out on 2,709 inmates (2,484 men and 225 women) in 9 prisons in Spain, data was collected through self-report questionnaires, including information at socio-demographic level, family-social contact and use of alcohol and other drugs in the last month in prison.

Results: Inmates with no family contact in prison show a higher prevalence of use for all the substances analyzed, binary logistic regression analysis shows statistically significant associations with the use of cannabis (OR: 1.86, p ≤0.001) or cocaine (OR: 3.40, p ≤0.001) in prison.

Discussion: More knowledge about this public health problem amongst social workers in the prison environment could be an effective diagnostic and preventive tool for reducing the use of alcohol and other drugs during imprisonment.

Objective: In Peru, prisons are spaces with overcrowding, deteriorated infrastructure, poor sanitary conditions and difficult access to medical treatment. The objective of this study is to estimate the burden of disease and access to treatment for different morbidities in the Peruvian inmate population.

Methods: An analysis of secondary data of the First National Penitentiary Census (PCNP) 2016 in Peru was carried out. The absolute frequencies and percentages of each self-reported health condition, the presence of a diagnosis of a disease before entering the prison system and access to treatment were obtained.

Results: 74,130 inmates were included in the analysis. The most common diseases in prisons are depression (9.6%), anxiety (8.6%), chronic lung disease (8.4%) and arterial hypertension (6.9%). All diseases included, with the exception of hepatitis, have a diagnostic before the incarceration of less than 60%. Access to medical treatment was higher in women than in men and in general, mental health illnesses had low access to medical treatment.

Conclusions: Chronic and infectious diseases are frequent in those deprived of liberty, with mental health problems being more prevalent in women. In general, access to treatment is low, especially in men and for mental health illnesses. This situation reflects the need to develop intervention programs that promote health and increase the universality of health care in those deprived of liberty.