R Arnal1, M Spodenkiewicz2, J Lacoste3, L Jehel4, B Falissard5. 1. CESP/Inserm U1018, université Paris-Sud and université Paris Descartes, 75006 Paris, France; Département de psychiatrie et psychologie médicale psychotraumatologie & addictologie, CHU de Martinique, 97261 Fort-de-France, Martinique. Electronic address: romain.arnal@hotmail.fr. 2. CESP/Inserm U1018, université Paris-Sud and université Paris Descartes, 75006 Paris, France; Centre d'investigation clinique (CIC 1410), 97410 Saint-Pierre, La Réunion; Unité de pédopsychiatrie d'urgence et de liaison, centre hospitalier universitaire Sud Réunion, 97410 Saint-Pierre, La Réunion. 3. CESP/Inserm U1018, université Paris-Sud and université Paris Descartes, 75006 Paris, France; Département de psychiatrie et psychologie médicale psychotraumatologie & addictologie, CHU de Martinique, 97261 Fort-de-France, Martinique. 4. Département de psychiatrie et psychologie médicale psychotraumatologie & addictologie, CHU de Martinique, 97261 Fort-de-France, Martinique; CESP/Inserm U1018, université Paris-Saclay, université Paris-Sud, UVSQ, 94800 Villejuif, France; Université Antilles-Guyane, département de psychiatrie, Campus de Fouillole, 97110 Pointe-à-Pitre, Guadeloupe. 5. CESP/Inserm U1018, université Paris-Sud and université Paris Descartes, 75006 Paris, France.
Abstract
BACKGROUND: Prisoners' sociocultural backgrounds and prison environments have an influence on detainees' psychopathology; complex judicial and public policies are also to be taken into account in the dynamics of that environment. Scientific literature shows a wide range prison inmates' profiles across the world. However, very little data about the mental health of Caribbean jail inmates has been published. Martinique is a French overseas administrative district in the Caribbean, with a population of about 400,000 inhabitants. Its only prison is located in the city of Ducos. Our study proposes a description of the psychiatric characteristics of jail inmates in Martinique with epidemiological tools. Its objectives are to highlight their specific features and compare them to mainland France's jail population. METHODS: The initial study was a multicenter cross-sectional survey conducted in 18 French prisons. The selection was done using a two-stage stratified sampling strategy. For the purpose of our study, two groups were defined and compared: the detainees from the prison of Ducos (n=100) were compared to inmates from mainland France (n=698). Current psychiatric diagnoses were rigorously collected, through clinical and semi-structured interviews. We conducted a multiple logistic regression for each assessed mental disorder. Each prisoner gave us his oral and written informed consent. RESULTS: In terms of sociodemographic characteristics, we found more children per prisoner in the Martinican group and a better educational status in the mainland France group. The inmates from Martinique had significantly more adverse experiences in their childhood and the length of incarceration at the time of the interview was longer in the Martinique sample. Major depressive disorders (aOR=0.51; 95% CI=0.26-0.95) and psychotic disorders (aOR=0.24; 95% CI=0.08-0.57) were significantly less frequent in the Martinique sample. The data concerning substance-related disorders showed significant differences in bivariate analysis but this link was no longer statistically significant in the multiple logistic regression analysis. CONCLUSION: Even if imprisonment conditions are extremely tough, the inmates carry the heavy burden of difficult family histories, and the use of cannabis seems to be a major problem, it appears that Martinique's jail inmates have lower rates of mental illness than their counterparts from mainland France. We think this could be due to the benefit of greater proximity to their relatives and a united community, both which may contribute to lower prevalence of mental disorders.
BACKGROUND: Prisoners' sociocultural backgrounds and prison environments have an influence on detainees' psychopathology; complex judicial and public policies are also to be taken into account in the dynamics of that environment. Scientific literature shows a wide range prison inmates' profiles across the world. However, very little data about the mental health of Caribbean jail inmates has been published. Martinique is a French overseas administrative district in the Caribbean, with a population of about 400,000 inhabitants. Its only prison is located in the city of Ducos. Our study proposes a description of the psychiatric characteristics of jail inmates in Martinique with epidemiological tools. Its objectives are to highlight their specific features and compare them to mainland France's jail population. METHODS: The initial study was a multicenter cross-sectional survey conducted in 18 French prisons. The selection was done using a two-stage stratified sampling strategy. For the purpose of our study, two groups were defined and compared: the detainees from the prison of Ducos (n=100) were compared to inmates from mainland France (n=698). Current psychiatric diagnoses were rigorously collected, through clinical and semi-structured interviews. We conducted a multiple logistic regression for each assessed mental disorder. Each prisoner gave us his oral and written informed consent. RESULTS: In terms of sociodemographic characteristics, we found more children per prisoner in the Martinican group and a better educational status in the mainland France group. The inmates from Martinique had significantly more adverse experiences in their childhood and the length of incarceration at the time of the interview was longer in the Martinique sample. Major depressive disorders (aOR=0.51; 95% CI=0.26-0.95) and psychotic disorders (aOR=0.24; 95% CI=0.08-0.57) were significantly less frequent in the Martinique sample. The data concerning substance-related disorders showed significant differences in bivariate analysis but this link was no longer statistically significant in the multiple logistic regression analysis. CONCLUSION: Even if imprisonment conditions are extremely tough, the inmates carry the heavy burden of difficult family histories, and the use of cannabis seems to be a major problem, it appears that Martinique's jail inmates have lower rates of mental illness than their counterparts from mainland France. We think this could be due to the benefit of greater proximity to their relatives and a united community, both which may contribute to lower prevalence of mental disorders.