A longitudinal study of psychiatric prevalence and psychopathology in remanded prisoners

Longitudinal Study of Prisoners on Remand: Psychiatric Prevalence, Incidence and Psychopathology in Solitary vs. Non-Solitary Confinement

Author(s) Name: Andersen HS, Sestoft D, Lillebnk T, Gabrielsen G, Hemmingsen R,

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Quantitative investigations were ocnductedconducted in order to assess result of solitary confinement (SC) among remand prisoners and to see whether SC resulted in psychiatric disorder and, if so, to which extent.

Existing studies disagree about effects of solitary confinement on remand prisoners with some finding no difference between results of punishments and others finding that it results in stressful disorders.

Design Criteria

Author identified:

that solitary confinement carries a higher risk of resulting in psychiatric disorder than non-SC.

InformeDesign Identified:

Be aware that solitary confinement may result in adjustment disorder such as anxiety, depressive, psychosomatic and other symptoms

Key Concepts

Two random samples of prisoners on remand on solitary confinement and non-SC were selectively studied. Age was between 18 to 60, and both genders were included. The SC group consisted of 133 participants

Participants in both groups were interviewed thrice by psychiatrist and given cognitive assessment. Medical files of each subject were examined

A three-way analysis of variance was used to compare subjects without disorders when comparing those with disorders

In 28 of 37 (76%) SC subjects with incident disorders the disorder was present already at the first examination. In non-SC 11 of 14 (79%) disorders were present from the beginning.

Examinations amongst the 2 groups demonstrated that latent disorders arose incrementally from SC group but not from non-SC group. In six of seven (86%) SC subjects with transient disorders the morbidity disappeared after transferral from SC to non-SC.

Symptoms were a mixture of anxiety, depressive and psychosomatic symptomatology. Worrying, difficulty in concentrating, insomnia, irritability, depression and sadness, anxiety, anergia and passivity . Brief visual hallucinations were reported in six SC subjects after 3 weeks -- three had formed and three had unformed hallucinations. Three SC subjects reported changed perception, five SC subjects had experienced derealization and one SC subject depersonalization. no such symptoms were reported in the non-SC group.

Authors concluded that results conform to those of previous studies where SC is correlated with a surplus of psychopathology. Although international comparison of SC is difficult, the medical implications of the procedure are questionable, a nd, therefore, SC is a method that is best avoided.

Research Method

Two random samples of prisoners on remand on solitary confinement and non-SC were selectively studied. Age was between 18 to 60, and both genders were included. The SC group consisted of 133 participants. The non-SC group consisted of 95 participants.

Using a parallel study design, participants in both groups were interviewed by psychiatrist after imprisonment and given cognitive assessment day after interview. The assessments were longitudinal repeated assessments.

The interview employed the following aspects: Present State Examination, 10th edn (PSE-10).; Hamilton Anxiety and Depression Scales (HAS & HDS); assessment of usage of drugs; Sociodemographic interview; Wechsler Adult Intelligence Scale (WAIS); General Health Questionnaire; and Eysenck Personality Questionnaire (EPQ)

Medical as well as criminal files of each subject were examined.

A three-way analysis of variance was used to compare subjects without disorders when comparing those with disorders. Comparisons were tested for significance with Mann±Whitney's rank sum test.

Limitations

The results are only valid in western society with disciplinary rather than collusionary SC.

SC has different connotations and practices varying from country to country therefore difficult to measure.

Commentary

Effects of SC too may have psychological context that may impact prisoner differently. This was not taken into account. To elaborate; a prisoner who feels idealistic about his SC-incurred punishment and the behavior that incurred it may be more resilient to psychopathology than 'regular' remand prisoners.