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First diagnosis of psychosis in the prison: results from a data-linkage study

  • Nabila Z. Chowdhury (a1), Olayan Albalawi (a1) (a2), Handan Wand (a3), Armita Adily (a4), Azar Kariminia (a5), Stephen Allnutt (a6), Grant Sara (a7), Kimberlie Dean (a8), Julia Lappin (a9), Colman O'Driscoll (a10), Luke Grant (a11), Peter W. Schofield (a12), David Greenberg (a13) and Tony Butler (a14)...

Abstract

Background

Psychosis is more prevalent among people in prison compared with the community. Early detection is important to optimise health and justice outcomes; for some, this may be the first time they have been clinically assessed.

Aims

Determine factors associated with a first diagnosis of psychosis in prison and describe time to diagnosis from entry into prison.

Method

This retrospective cohort study describes individuals identified for the first time with psychosis in New South Wales (NSW) prisons (2006–2012). Logistic regression was used to identify factors associated with a first diagnosis of psychosis. Cox regression was used to describe time to diagnosis from entry into prison.

Results

Of the 38 489 diagnosed with psychosis for the first time, 1.7% (n = 659) occurred in prison. Factors associated with an increased likelihood of being diagnosed in prison (versus community) were: male gender (odds ratio (OR) = 2.27, 95% CI 1.79–2.89), Aboriginality (OR = 1.81, 95% CI 1.49–2.19), older age (OR = 1.70, 95% CI 1.37–2.11 for 25–34 years and OR = 1.63, 95% CI 1.29–2.06 for 35–44 years) and disadvantaged socioeconomic area (OR = 4.41, 95% CI 3.42–5.69). Eight out of ten were diagnosed within 3 months of reception.

Conclusions

Among those diagnosed with psychosis for the first time, only a small number were identified during incarceration with most identified in the first 3 months following imprisonment. This suggests good screening processes are in place in NSW prisons for detecting those with serious mental illness. It is important these individuals receive appropriate care in prison, have the opportunity to have matters reheard and possibly diverted into treatment, and are subsequently connected to community mental health services on release.

Declaration of interest

None.

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Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

Correspondence: Tony Butler, Justice Health Research Program, Kirby Institute, Wallace Wurth Building, High St, University of New South Wales, Kensington NSW 2052, Australia. Email: tbutler@kirby.unsw.edu.au

References

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Keywords

First diagnosis of psychosis in the prison: results from a data-linkage study

  • Nabila Z. Chowdhury (a1), Olayan Albalawi (a1) (a2), Handan Wand (a3), Armita Adily (a4), Azar Kariminia (a5), Stephen Allnutt (a6), Grant Sara (a7), Kimberlie Dean (a8), Julia Lappin (a9), Colman O'Driscoll (a10), Luke Grant (a11), Peter W. Schofield (a12), David Greenberg (a13) and Tony Butler (a14)...

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First diagnosis of psychosis in the prison: results from a data-linkage study

  • Nabila Z. Chowdhury (a1), Olayan Albalawi (a1) (a2), Handan Wand (a3), Armita Adily (a4), Azar Kariminia (a5), Stephen Allnutt (a6), Grant Sara (a7), Kimberlie Dean (a8), Julia Lappin (a9), Colman O'Driscoll (a10), Luke Grant (a11), Peter W. Schofield (a12), David Greenberg (a13) and Tony Butler (a14)...
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