Female depression and substance dependence in the Mexico City penitentiary system / Depresión en mujeres y la dependencia a sustancias en el sistema penitenciario de la Ciudad de México

ABSTRACT

Summary: The prevalence of mental disorders in people deprived of freedom has been estimated at between 10 and 15%. Acute or chronic mental illnesses provoke a major breakdown and maladjustment to prison conditions. The more frequent diagnose of mental disorders have been substance consumption, major depression, bipolar disorder, post-traumatic stress disorder and psychotic disorders. Objective To identify the frequency of major depressive episode in women in prison in Mexico City, its frequency of association with alcohol and substance dependence, and to describe the symptomatic and socio-demographic characteristics. Material and method A transversal, non-experimental, descriptive, ex post facto field study, in two prisons of Mexico City (Centro Preventivo Femenil Oriente [Preventivo Oriente] and the Feminine Center for Social Readaptation Tepepan CERESO), in a non- probabilistic sample of 213 women, selected by convenience. The instrument was designed ex profeso. For the evaluation of the major depressive episode, the Mini International Neuropsychiatric Interview (MINI) and DSM-IV criteria were used for substance dependence. Field work lasted from August 2001 to March 2004. Interviews were carried out under previous informed consent; confidentiality and anonymity were guaranteed. In collaboration with the Center of Orientation and Classification (COC), each center elaborated a list of inmates with a history of substance abuse who met the inclusion criteria to take part in the research. Results The mean age of the interviewed population was 30.6 ± 7.9 years; 45.5% belonged to the age group between 28 to 40 years; the school attainment more frequent was elementary school (41.3%), followed by secondary school. Single women represented 48.6% of the population and 50.2% referred having, at the moment of the interview, a partner relationship. The type of offense reported with major frequency was robbery (51.6%, in different modalities unspecific, simple, aggravated, not-aggravated, unspecific, burglary, tentative of robbery and car theft). The researched population referred that 43.7% had previously done time in some penal institution. The frequency of depressive episodes was 62% (n=132) in the interviewed population. The group between 18 to 27 years, with lower years of schooling, single mothers with children under 18 years presented the highest frequency of depression and substance abuse. Alcohol dependence and depression were more frequent in women with less than six months in prison. For depression and substance dependence, the more affected group was the one between one to four years of imprisonment. As to the length of the sentence, women with three to seven years were the most affected by the two diagnoses. Conclusions The interviewed population showed that the longer the imprisonment or the sentence, the higher the frequency of the depressive disorder. A possible explanation is that being imprisoned for a long time may have severe consequences in women's well-being due in part to the fact that in most of the cases women are abandoned by their relatives and loved ones, which intern increases their loss of social support networks. The problem of mental disorders becomes more evident when it is estimated that only 40% of the people who have a disorder had received treatment. Nearly half of the depressed women had not received support and care for their mental health problem. In the group of women with alcohol dependence, less than a quarter had asked for help, in contrast with the group with substance dependence where half of the women had asked for help. On the other hand, prison by itself generates depression and it is a normal reaction in the face of the new situation. There is also the erroneous belief that symptoms will fade away by themselves. In other studies it has been observed that being deprived of freedom causes the lose of emotional relationships, solitude and boredom, lack of services, heterosexual relationships, autonomy, security, a problematic cohabitation with other unpredictable prisoners, all of which cause fear and anxiety. All these deprivations may constitute serious threats to the personality and self-esteem.

RESUMEN

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