Frequency of mental and addictive disorders among 320 men and women entering the Iowa prison system: use of the MINI-Plus.

The Mini-International Neuropsychiatric Interview-Plus (MINI-Plus) was used to assess the frequency of mental and addictive disorders among 320 randomly selected men and women newly committed to the general population of the Iowa prison system. More than 90 percent of offenders met criteria for a current or lifetime psychiatric disorder. The most frequent were substance use disorders (90%), mood disorders (54%), psychotic disorders (35%), antisocial personality disorder (35%), and attention deficit hyperactivity disorder (22%). Offenders had a mean of 4.2 MINI-Plus disorders, and two-thirds had 3 or more disorders. Contrary to expectation, there were few gender-based differences. Thirty percent of the offenders were rated at risk for suicide. We conclude that mental and addictive disorders are common among incarcerated offenders and that these individuals are at risk for suicidal behavior.

Borderline personality disorder in male and female offenders newly committed to prison.

BACKGROUND: The objective of the study was to estimate the rate of borderline personality disorder (BPD) in male and female offenders newly committed to the Iowa Department of Corrections. We also compared clinical and demographic characteristics of offenders with and without BPD. METHODS: A random sample of 220 offenders entering Iowa's prison system were evaluated by using a version of the Mini International Neuropsychiatric Interview, the BPD module of the Structured Interview for DSM-IV Personality Disorders, the Medical Outcome Survey Short Form-36 Health Survey, and the Level of Service Inventory-Revised. RESULTS: Borderline personality disorder was present in 65 (29.5%) subjects, although 93.2% had at least one Diagnostic and Statistical Manual of Mental Disorders-IV BPD trait. The percentage of women meeting criteria for BPD was more than twice that for men. Subjects with BPD were more likely than those without to be married, employed, and to have a high suicide risk score. Offenders with BPD were more likely than others to report prior mental health treatment, and to have reported high levels of interference from their mental disorder. Offenders with BPD had worse quality of life than offenders without BPD as assessed with the Medical Outcome Survey Short Form 36 Health Survey, and higher rates of mood, anxiety, psychotic, and eating disorders; antisocial personality disorder; and attention deficit hyperactivity disorder. Borderline personality disorder was also associated with higher Level of Service Inventory-Revised total scores, which indicates their having a greater risk for recidivism than nonborderline offenders. These relationships were observed after adjusting for sex, age, race/ethnicity, and presence of antisocial personality disorder. CONCLUSION: Borderline personality disorder is relatively common among both male and female offenders in prison, and is associated with substantial psychologic stress and impaired quality of life. Early recognition and treatment of BPD in prisons may be warranted.

Adult outcomes of attention deficit hyperactivity disorder and conduct disorder: are the risks independent or additive?

METHODS: Data were obtained from a longitudinal study sample of 754 adoptees and categorized based on review of the available adoption agency, medical, and psychiatric records of the biological parents. Categorical data were analyzed using chi2 or Fisher's exact tests, as appropriate. Logistic regression analyses were used to assess the relative contribution of variables. RESULTS: There was not a statistically significant difference in the frequency or type of self-reported adult disruptive behavior, arrests, jail stays, felony arrests, or frequency of conduct disorder (CD) when inattentiveness, impulsivity, and hyperactivity were analyzed individually. The contributions of attention deficit hyperactivity disorder (ADHD) were independent and no additional increased risk for future illegal behavior was conferred by the combination of the disorders. While the effect of CD on illegal behavior was correlated with substance abuse and dependence, ADHD continued to be a significant contributor after controlling for substance abuse and dependence. CONCLUSIONS: Data indicated that ADHD and CD are related but different disorders conferring risk for adult illegal behavior or arrest. In this sample, inattention was the most common domain impaired among those with ADHD, followed closely by hyperactivity, with impulsivity reported least often among those endorsing symptoms of ADHD.

Characteristics of admissions for primary stimulant dependence during 2001.

The production and consumption of synthetic stimulants has been increasing in recent years accompanied by an increase in the number of individuals seeking treatment for synthetic stimulant "abuse."1 The misuse of stimulants is occurring at younger ages and primarily in the context of polysubstance use. This article examines the characteristics of admissions entering treatment centers that received some form of public funding in 2001 as compiled in the Treatment Episodes Data Set produced by the Substance Abuse Mental Health Services Administration, Office of Applied Studies. It compares those admissions indicating stimulants as a primary substance of use with those admissions not listing stimulants. Findings indicated that stimulant primary admissions were younger, more frequently Caucasian, and more frequently female than nonstimulant admissions. Additionally, stimulant primary admissions had fewer prior treatment episodes and substance use referrals than the nonstimulant admissions but were more commonly referred by the criminal justice system, raising the concern that adequate screening for stimulant misuse is not occurring in health care settings.