Prevalence and correlates of common mental disorders among incarcerated men in Kerala, India

Abstract

Researches around the world have demonstrated the higher prevalence of mental illness in prisons when compared to the general population. However there is a dearth of data on mental illness, among prisoners from low and lower middle-income countries. We hypothesize that there is an increased prevalence of common mental disorders (CM.D.) in Indian prisons, when compared to the general population. The study aims to find the prevalence and correlates of common mental disorders among incarcerated men in a prison in Kerala, South India. Randomly selected sample of 329 male prisoners were interviewed between November 2008 and May 2009. Prevalence was measured using the General Health Questionnaire (GHQ-12). Socio demographic information, reports of repeated incarceration, history of mental illness, hazardous alcohol use and substance abuse were also collected and compared. Prevalence of common mental disorder was 18.2% (n=60; 95% Confidence interval (Cl) 14.2-22.8); and men from younger age groups were at an increased risk. After adjusting for age, we found higher risk among married men, those with two or more children and those who had experienced extreme poverty. Men affected were more likely to report history of psychiatric illness, suicidal attempt(s) and family history of psychiatric illness; and were also more likely to seek general medical care from the prison hospital. Associations were also found with repeated jail incarceration, prescription drug abuse and use of Marijuana during the past 12 months. The final multivariate model found poverty (OR 3.4; 95% (Cl) 1.8-6.6), use of marijuana during the past 12 months (OR 3.8; 95% (CI) 1.8-8.2), seeking general medical care (OR 2.7; 95% (Cl) 1.3-5.6), history of suicidal attempt(s) (OR 4.9; 95% (Cl) 2-11.7), and repeated incarceration (OR 2.3; 95% (Cl) 1.03­ 5.0) independently associated with common mental disorders. Our study found significantly higher rates of common mental disorder among incarcerated men (18.2%) compared to general Indian population (6.54%). It is closely associated with several high risk behaviors. Public health implication of the results will be discussed at the congress.