Anti-depressant prescribing patterns for prison inmates with depressive disorders.
BACKGROUND
Although prison inmates are reported to exhibit elevated rates of depressive disorders, little is known about anti-depressant prescribing patterns in correctional institutions.


METHODS
The study population consisted of 5305 Texas Department of Criminal Justice (TDCJ) inmates who were diagnosed with one of three depressive disorders: major depression, dysthymia, and bipolar disorder (excluding those with manic episodes only). Information on medical conditions, sociodemographic factors, and pharmacotherapy was obtained from an institution-wide medical information system.


RESULTS
In 1998, 78.2% of all inmates diagnosed with depressive disorders were treated with antidepressant medication. Of these, 47.3% were treated exclusively with tricyclic anti-depressants (TCA); 30.9% were treated with selective serotonin re-uptake inhibitors (SSRI); and 21.8% were not treated with any form of anti-depressant medication. Prescribing patterns varied substantially according to a number of sociodemographic factors under study.


CONCLUSIONS
Because the present study relied on retrospective, clinical data, the investigators had limited ability to assess: specific symptomatology for each diagnosed depressive condition under study; socio-economic status, pre-incarceration access to health care; and the overall reliability and validity of the data.


CONCLUSIONS
The proportion of prison inmates with depressive disorders who receive appropriate medication management is substantially higher than that reported among similarly diagnosed nonincarcerated samples. It will be important, however, for future investigators to examine the sources of sociodemographic variation in treatment patterns found in the present study.
Department of Pediatrics, University of Texas Health Science Center, San Antonio, TX 78284-7802, USA. baillargeon@uthscsa.edu
J
J
Baillargeon
S A
SA
Black
S
S
Contreras
J
J
Grady
J
J
Pulvino
D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy*; D015331:Cohort Studies; D003866:Depressive Disorder / Q000188:drug therapy*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D011329:Prisoners; D012923:Social Class
D000928:Antidepressive Agents