Prevalence of Vitamin-D deficiency and insufficiency among prisoners across the globe: A systematic review and meta-analysis

Background and aimInadequate nutrition is linked to a wide range of detrimental chronic and infectious illness outcomes among the prison populations. However, there is a paucity of thorough analysis of the prevalence of vitamin D deficiency among jail inmates. Consequently, in order to bridge this gap, we conducted a thorough research to ascertain the incidence of vitamin D deficiency among prisoners worldwide.MethodSix computer-based literature indexes were thoroughly searched for topic focused publications. The I2 test was used to determine heterogeneity among the studies. The overall effect was assessed using a random-effects model with a 95% confidence interval. We used metafor package in R version 4.2.1 for the analysis of data.ResultOut of 612 studies, 4 studies were included for analysis. The estimated pooled prevalence of vitamin D deficiency was 55% among prisoners. On the other hand, 29.41% were found to have insufficient vitamin D levels.ConclusionDespite the scant available research, vitamin D deficiency is prevalent among prisoners. Regular vitamin D status evaluations using reliable health tests, dietary inspection and supplementation are crucial.Prospero registration idCRD42023396203.     

Suicidal tendencies among the elderly in Mie Prefecture, Japan, between 1996 and 2002

This study aims to show the causative factors of suicide among the elderly (over 65) in Mie Prefecture, and to discuss the prevention of the factors contributing to suicide in the elderly group. We obtained an agreement from the Mie Prefectural Police Headquarters and investigated all inquest records collected between 1996 and 2002 in Mie Prefecture and focused on suicide in the elderly group. During the test period, the number of suicides in the elderly group was 842. In causative factors, the two major causative factors of suicide were "suffering from physical illness" and "psychiatric disorders". In particular, the three most frequent physical illnesses were "cardiovascular disease", "orthopedic disorder", and "digestive organ disease", and these physical illnesses are mentally stressful, and thus have a psychiatric component, the same as psychiatric illnesses do. Consequently, it is concluded that improvements in the home nursing and mental health care should include the prevention of suicide in the elderly who "suffer from physical illness" and "psychiatric disorders" to prevent suicide. In addition, medical staff and the general public should be educated on the factors that can influence elderly persons' mental condition, and should be cautioned to observe elderly persons for suicidal signs and symptoms.     

Outcome of referral to a prison mental health team

This retrospective case note study describes the demographic, offence and diagnostic characteristics of 115 referrals made to a psychiatric service within HMP Perth between May 2003 and April 2004. Twenty per cent of referrals were diagnosed with a major mental illness with remand prisoners having a higher overall prevalence. Nearly 70% had previous contact with psychiatric services, a similar percentage had previous substance misuse. Over 8% were transferred out of prison and over a quarter continued to be followed up at the end of the study period. A wide range of index offences was seen. Over two-thirds had a previous history of offending and nearly 60% had a previous custodial sentence, reflecting a high degree of recidivism. This study supports the high degree of psychiatric morbidity in the prison population shown in other studies. The role of a prison psychiatric service is discussed in the context of services to mentally disordered offenders.     

Physical activity, musculoskeletal pain and personality among employees of a prison and of a psychiatric hospital

The relationship between personality traits, habitual physical activity and musculoskeletal pain among employees of a psychiatric maximum security hospital and of a state penitentiary were analyzed using data from a compound self-report questionnaire. The questionnaire comprised items from the Karolinska Scales of Personality (KSP), the Eysenck Personality Questionnaire (Epa), the Örebro questionnaire for musculoskeletal pain (ÖQ) and items concerning physical activity. A total of 122 (85%) employees filled in the questionnaire. There were no differences in physical activity, body mass index (BMI) or pain between the psychiatric hospital and prison employees. There was no association between physical activity and musculoskeletal pain. At the aggregate level, physical activity was positively associated with indices of extraversion and negatively with indices of anxiety. A discriminant analysis suggested that subjects with low back pain had an increased frequency of sick leave, more cervical as well as hip pa a higher BMI and higher scores in indices of social conformity.     

Forensic mental health evaluations of military personnel with traumatic life event,in a university hospital in Ankara,Turkey

IntroductionThe definition of psychological trauma has been rephrased with the DSM-5. From now on, witnessing someone else's traumatic event is also accepted as a traumatic life event. Therefore, the psychiatric examination of forensic cases gains importance for not overlooking a psychiatric trauma. This research aims to discuss the psychiatric examinations of military personnel who had a traumatic life event and to reveal psychiatric states of soldiers after trauma.Materials and methodsThe forensic reports prepared at Gulhane Military Medical Academy (GMMA), Forensic Medicine polyclinic between January 1, 2011 and November 30, 2014 were examined, and among them the cases sent to GMMA Psychiatry polyclinic for psychiatric examination were analyzed retrospectively.ResultsThere were a total of 2408 cases who applied for the arrangement of a judicial report and 167 of them required a psychological examination. Among 167 cases, 165 were male and 2 were female, and the mean age was 25.6 years. Anxiety disorder (53.9%) was the most common diagnosis as a result of the psychiatric examination, following posttraumatic stress disorder (PTSD) (18.6%), and 3.6% had no psychopathology. It was determined that injuries caused by firearms (38.3%) and explosive materials (26.3%) had caused psychological trauma the most. On the other hand, 11 (6.6%) cases were determined to have undergone a psychological trauma on account of being a witness to their friends' injuries during the conflict without experiencing any physical injury. There were not any statistically significant relationships between the severity of physical injury and being PTSD or anxiety disorder.DiscussionDevelopment of PTSD risk is directly correlated with the nature of trauma. The trauma types of the cases in our study were in the high-risk group because of the military population. Our study is of importance in terms of putting forward the psychiatric disorders seen in the military population with traumatic life history associated with war (combat-related). In this research, 26.1% of the cases followed up due to combat-related trauma were diagnosed with PTSD. Interestingly, this ratio was lower than the studies that have larger case numbers. There is still the need to conduct studies that will involve larger participants.     

Medical,social, and law characteristics of intoxicant's users medically examined in police custody

IntroductionThere are no studies on medically examined persons in custody which specifically focus on identifying dependence profiles among users of intoxicants. Nonetheless, the characterisation of dependence profiles for intoxicants such as alcohol, cannabis, cocaine, heroin, amphetamines and their by-products is a medical necessity in this setting.Materials and methodsA prospective, monocentric, open-ended study conducted by structured questionnaire was carried out on detainees who admitted to having taken an intoxicant/s (tobacco, alcohol, drugs or illegal substances). Social, legal and medical data were collected. The aim of the study was to explore characteristics of these persons in police custody.Results817 questionnaires were examined. More than one-third have a dependence on at least one substance. 37.7% were dependant of tobacco, 86.5% of drinkers, 24.7% of cannabis users. Of these, 90.1% were from men with a mean age of 29.4 years, 40% from individuals living alone, 25.7% from persons with no financial means and 19.6% from homeless persons. 10% were believed to be suffering from mental illness, 7.2% were thought to be asthmatic, 3% to have a chronic infection, and 2.9% to have epilepsy. 36.2% reportedly received treatment, 37.5% of which included benzodiazepine and 20.3% opiate substitution therapy. Incidence of psychological and psychiatric disorders is close to 10% of intoxicant detainees.DiscussionIn this study, some of the stated pathologies occur in ratios similar to those in other published results. But, there is a high, and probably underestimated, prevalence of psychological and psychiatric disorders in this population of detainees reporting exposure to intoxicant or illegal substances.     

A small scale qualitative study to investigate the interaction between psychiatric patients and diagnostic radiographers in one Irish hospital

Background

A substantial number of patients with psychiatric illnesses present to the Imaging Department across the Irish Republic each year. Patients who have a psychiatric illness may present difficulties for the radiographer during a radiographic examination. These difficulties may include communication difficulties, and an increased prevalence to become violent due to their illness.

Aims

To investigate if radiographers feel confident interacting with psychiatric patients. To ascertain if radiographers need more training in this area of patient interaction.

Method

A qualitative approach was used drawing upon six radiographers working in a regional hospital with a psychiatric unit attached. The radiographers were interviewed individually and the results were thematically analysed.

Results

The results indicated that the level of the radiographers own confidence in relation to interacting with psychiatric patients was influenced by the number of years since qualification. The majority of radiographers in the study displayed a poor knowledge of psychiatric conditions and how they affect patients.

Conclusion

Based upon this small study, the results suggest that newly qualified radiographers do not feel confident in their own abilities when interacting with psychiatric patients and would welcome and benefit from specific training with regards to strategies to deal with psychiatric patients. The radiographers reported that particular areas which may be improved upon are more information on psychiatric illnesses, manifestations of different types of psychiatric illness and the subsequent effect on patients. A larger study encompassing the whole of the Republic of Ireland would be valuable as a precursor to a European comparative study in order to investigate this phenomenon at a deeper level. Additionally it is recommended that further research is conducted within a wider European context on student radiographers and lecturers teaching on undergraduate radiography courses to ascertain if this topic is addressed at undergraduate level.     

The comparison of disposal attitudes towards forensic psychiatric patients among police officers,psychiatrists and community members in China

ObjectiveTo understand disposal attitudes towards forensic psychiatric patients among police officers, psychiatrists and community members in China.Method118 community members, 121 psychiatrists and 105 police officers completed a questionnaire regarding disposal attitudes towards forensic psychiatric patients.ResultSurveyed respondents (87.4%) believed patients with mental disorders experienced discrimination, and 97.4% were in favor of providing livelihood security for them. Police officers (89.5%) agreed that patients with mental illness were more violent than the general population, which was significantly higher than 74.4% of psychiatrists (X² = 14.29, P = 0.000). Among three groups, the most preferred disposal option for those found not guilty by reason of insanity (NGRI) was to treat them in the custody of a forensic psychiatric hospital, such as an Ankang Hospital (86.9%). The respondents agreed (96.8%) that an independent review board should be established for disposing decisions for forensic psychiatric patients. The percentage who agreed that police officers, prosecutors, and judges should be included in the review board was significantly higher among police officers than among community members (x² = 6.60, P = 0.01; x² = 9.74, P = 0.002; x² = 7.38, P = 0.007). When asked, “who has the legal right to determine whether offenders with mental disorders should bear criminal responsibility”, forensic psychiatrists and judges were the top two responders (79.5% and 63.4%, respectively).ConclusionThis study suggested that the majority of those surveyed, especially police officers, held that patients with mental illness were violent and should receive violence risk assessments. Although psychiatrists paid more attention to the rights of patients, they also lacked legal knowledge, similar to community members and police officers. Therefore, it is necessary to inform the public regarding mental health, and to provide legal knowledge.     

The prevalence of mental health problems in elite athletes

ObjectivesThe first aim was to examine mental health problems (MHP) in elite athletes addressing prevalence, sex-differences, onset, recurrent episodes, help-seeking, symptoms of specific disorders and previous psychiatric diagnoses. The second aim was to investigate if sport-specific instruments could indicate clinical levels of psychiatric symptoms.DesignCross-sectional survey.MethodsElite athletes representing different Swedish national teams and applying for a university scholarship (n = 333) answered a web-based survey. Females represented 58.9%. Mean age was 24.6(±3.1) years and 77.2% were individual- and 22.8% team-sport athletes.ResultsLifetime prevalence of MHP was 51.7% (females 58.2%, males 42.3%). Point prevalence was 11.7% (females 13.8%, males 8.8%). Onset of first MHP episode peaked at age 19 with 50% of onsets between ages 17–21. Recurrent episodes were common, and females sought help more than males (females 37.8%, males 16.8%). Overall 19.5% reached the clinical cut-offs for symptoms of anxiety and/or depression (females 26.0%, males 10.2%). Previous psychiatric diagnoses existed among 8.1% (females 10.7%, males 4.4%). A depressive disorder, an eating disorder or a trauma and stress related disorder (self-reported as burnout) were most common. Finally, most sport-specific instruments (80%) demonstrated a fair diagnostic accuracy compared to clinically validated instruments.ConclusionsLifetime prevalence of MHP was reported by more than half of the athletes. Symptoms manifested in young age and recurrent episodes were common. Sport-specific instruments indicating when symptoms reach clinical levels are potentially useful for data summary purposes on a group level, but without sufficiently high sensitivity and specificity to be recommend for applied work with athletes.     

Patients with affective disorders admitted to maximum secure care (1999--2003)

The State Hospital, Carstairs, is a special secure psychiatric facility for Scotland and Northern Ireland. This study describes the background, illness and offence (where appropriate) characteristics of 25 patients admitted between 1999 and 2003 with a diagnosis of any affective disorder. Patients were, on average, 37 years old and had a lengthy history of psychiatric contact. Patients with an affective disorder were more likely to be admitted under civil proceedings, following a transfer from hospital, as opposed to being admitted under criminal procedure. Sixty per cent were discharged to prison, court or local hospitals within one year of their admission to special secure care. Significant violence during an episode of mania or hypomania (even in the presence of psychotic symptoms) appears rare. Recurrent unipolar depression resistant to first and second line treatments in women, and lithium withdrawal mania in male bipolar patients were the most common clinical problems. Treatments aimed at reducing co-morbid substance misuse, and improving compliance with mood stabilisers, appear important in managing this patient group.     

Illness and infection in elite full-contact football-code sports: A systematic review

ObjectivesFull-contact football-code team sports offer a unique environment for illness risk. During training and match-play, players are exposed to high-intensity collisions which may result in skin-on-skin abrasions and transfer of bodily fluids. Understanding the incidence of all illnesses and infections and what impact they cause to time-loss from training and competition is important to improve athlete care within these sports. This review aimed to systematically report, quantify and compare the type, incidence, prevalence and count of illnesses across full-contact football-code team sports.Design/methodsA systematic search of Cochrane Library, MEDLINE, SPORTDiscus, PsycINFO and CINAHL electronic databases was performed from inception to October 2019; keywords relating to illness, athletes and epidemiology were used. Studies were excluded if they did not quantify illness or infection, involve elite athletes, investigate full-contact football-code sports or were review articles.ResultsTwenty-eight studies met the eligibility criteria. Five different football-codes were reported: American football (n = 10), Australian rules football (n = 3), rugby league (n = 2), rugby sevens (n = 3) and rugby union (n = 9). One multi-sport study included both American football and rugby union. Full-contact football-code athletes are most commonly affected by respiratory system illnesses. There is a distinct lack of consensus of illness monitoring methodology.ConclusionsFull-contact football-code team sport athletes are most commonly affected by respiratory system illnesses. Due to various monitoring methodologies, illness incidence could only be compared between studies that used matching incidence exposure measures. High-quality illness surveillance data collection is an essential component to undertake effective and targeted illness prevention in athletes.     

Functioning and psychiatric symptoms among military men and women exposed to sexual stressors

OBJECTIVE: The goal was to describe military men's and women's functioning and psychiatric symptoms according to their military sexual stressor exposure. METHOD: A cross-sectional survey of 204 Army soldiers and 611 other active duty troops (487 men and 327 women) was performed. RESULTS: Forty-five percent of men and 80% of women reported at least one sexual stressor type (i.e., sexual identity challenges, sexual harassment, or sexual assault). After adjustment, subjects reporting more types of sexual stressors had poorer physical, work, role, and social functioning; more-severe post-traumatic stress disorder, depression, and anxiety symptoms; and more somatic concerns, compared with subjects reporting fewer or no sexual stressor types (all p < or = 0.004). Interactions by gender were insignificant (all p > 0.11). Within sexual stressor category, men and women reported similar mean adjusted functioning and psychiatric symptoms. CONCLUSIONS: For both men and women, impaired functioning and more severe psychiatric symptoms were more common among those reporting more types of sexual stressors.     

Assessing death by poisoning: does the medical history help?

During one year we sought medical historical data for all medico-legal autopsies with toxicological analysis (n = 51); the same procedure was applied to a control group of autopsies without toxicological analysis. Historical data was available in 70 cases (69%), the proportion being significantly higher among cases where the cause of death was poisoning (84%) than in the non-poisoning cases (48%). In the poisoning cases information was more often available from the emergency service, the psychiatric service and the prison medical service. Autopsy observations revealed a higher proportion of prior pathology than the medical history. But in a minority of cases, potentially significant prior illnesses were shown by the medical history and not at the autopsy (for example, in cases of advanced decomposition and in cases with no pathological lesions: idiopathic epilepsy; HIV infection). Historical data was judged to make some contribution to the conclusions concerning the cause of death in 71% of the cases of poisoning. The most important single contribution was the assessment of dependence status among drug or alcohol abusing subjects.     

Intra-familiar homicides: From 2006 to 2021 in the judicial district of Milan

IntroductionThe present research aims at analyzing criminological and medico-legal characteristics of intra-familiar homicides occurred in two major Italian cities (Milano and Monza) from the beginning of 2006 to the end of 2021.MethodsCases were identified using the Institutional database of the Institute of Legal Medicine of Milan, where all the autopsies of victims were performed. Data about these cases were obtained from autopsies findings, preliminary investigation reports, local papers and victim relatives’ interviews.In this period 11,480 autopsies were performed: 392 were homicides and, among these, 94 were confirmed as intra-familiar homicides (as a result of 84 events).Cases were classified according to the classic definition of intimate partner violence (referring only to an intra-familiar context), parricides, filicides, fratricides, familicides and grannicides.Age, sex, nationality and risk factors of the victims and perpetrators, as well as methods of murder were registered for each case. Only in some cases, motives for murder were known.ResultsThe most frequent type of intra-familiar homicides was intimate partner violence (41.5%), followed by parricides (16%, mainly matricides), filicides (10.7%) and fratricides (6.4%). 9.6% of the total number of events were familicides.Risk factors were frequently involved, in particular among perpetrators and in the group of parricides, while among siblicides they showed minimal relevance. Overall, psychiatric pathologies were the main risk factors involved (at least 23.8%), unlike extrafamiliar homicides, where previous criminal report or involvement in illicit traffics are frequently reported among perpetrators. This finding enlightens the difficulties of caring for a relative with a mental disorder, who can become dangerous for the domestic caregiver.Furthermore, the high number of physical illness and the advanced age of victims points out the tragical consequences of the lack of social support system for these categories of people.Methodsof murder were mainly cold steel (30–31.9%) and firearms (21–22.3%). However choking/manual ligature (9–9.6%), blunt force trauma inflicted using objects found on the scenario or bare handed (16–17%) and combined methods (11–11.7%) were frequently represented confirming the expected high level of impulsivity related to this kind of crime.     

Widening the scope of the hybrid order

Hybrid orders under section 45A of the Mental Health Act allow for convicted mentally disordered offenders to be given a sentence of imprisonment and simultaneously transferred to hospital for psychiatric treatment. In England and Wales their use is limited to patients with psychopathic disorder and the order has been little used. Two recent judgments by the House of Lords and the Court of Appeal have interpreted the law in a manner which widens its scope, allowing treatment of a greater range of offenders under the order, including offenders with co-morbid mental illness.     

Incidence,prevalence and consequences of illness in academy rugby league players

ObjectivesTo assess the incidence, prevalence and consequences of illness in one professional academy rugby league club during an in-season period.DesignObservational prospective cohort study.MethodSeventeen male rugby league players (age 17.7 ± 0.7 years, stature 178.8 ± 5.1 cm, body mass 87.2 ± 9.6 kg) completed a weekly self-report illness questionnaire using an amended version of the Oslo Sports Trauma Research Centre (OSTRC) questionnaire on health problems.ResultsA total of 24 new illnesses were reported over the 25-week study period. 65% of players experienced at least one illness during the study. The incidence of illness in this cohort was 14.3 per 1000-player days, with the respiratory system being most commonly affected (n = 15; 62.5%). The average weekly illness prevalence was 10.3%. Time-loss illness incidence was 1.4 per 1000-player days. Loss of body mass and sleep disruptions were the most commonly reported consequences of illness episodes. Mean body mass loss during a period of illness was 2.2 ± 0.6 kg.ConclusionsAcademy rugby league players are most commonly affected by respiratory illness with a total of nineteen training and competition days lost to illness. Associated consequences of illness, such as loss of body mass and sleep disruptions may present a challenge and negatively impact a rugby league player’s development. Appropriate medical provisions should be provided for Academy rugby league players to support them during periods of illness to limit the impact of these consequences.     

Shoplifting in the mentally ill: the role of bipolar affective disorder and mental retardation

This study explores shoplifting behaviour in mentally ill patients, and evaluates the association between shoplifting and different mental illnesses in a local Chinese population. A comparison is made between shoplifting offenders and a matched control group of non-offenders among the psychiatric patients registered at a university department of psychiatry. Major depression, bipolar affective disorder (BAD) and mental retardation (MR) are the most common diagnoses among mentally ill shoplifters, while patients with a diagnosis of BAD or MR are at higher risk of committing an offence than patients with other diagnoses. Bipolar affective disorder has not been described as a risk factor for shoplifting behaviour in the psychiatric literature. Such a possibility should be seriously considered in the psychiatric assessment of shoplifting cases.     

Assessment in police custody of individuals under the influence of alcohol with co-morbid psychiatric disorders

Individuals with a diagnosis of excessive alcohol intake are commonly encountered in police custody. These individuals have a high incidence of co-morbid psychiatric disorders. The Epidemiological Catchment Area (ECA) Study reported that 37% of alcoholics have a co-morbid mental disorder.(1)It is, therefore, important that individuals in custody who have a history of excessive alcohol intake are adequately assessed, in order to identify such co-morbid disorders so that appropriate management is implemented. Assessment of all individuals in police custody should include: To date, little has been written on how such assessments should be carried out in police custody. This paper discusses the presentation of psychiatric disorders in individuals with a history of excessive alcohol intake and suggests how they should be assessed in custody. A subsequent issue of the journal will include an article discussing the management of such individuals.