title: Drug-related disorders and the criminal and clinical background of the prison population of São Paulo State, Brazil.
abstract: OBJECTIVE
  To analyze the association between drug (DAD) and alcohol (AAD) abuse and dependency and criminal and clinical background by gender of prisoners in São Paulo, Brazil.
  
  
  METHODS
  Cross-sectional study, random sample stratified by administrative district, from which prisons and prisoners were selected via random, multistage sampling. Psychiatric diagnoses were made with the CIDI 2.1. Lifetime prevalence and 95% CI were calculated and adjusted via analysis of complex samples. Multinomial logistic regression analysis was carried out with four categories of dependent variables: presence AAD; presence DAD; presence of another mental disorder; no mental disorders. For female alcohol and drug abuse and dependency (ADAD) were combined into a single category.
  
  
  RESULTS
  The sample was composed by 1809 interviewed prisoners (1192 men and 617 women). Prevalence of DAD and AAD was 25.2% and 15.6%, respectively, among female prisoners, and 26.5% and 18.5% among males. Male prisoners with DAD were more likely to have a criminal record as an adolescent (OR 2.17), to be a repeat offender (OR 2.85), and to have committed a property crime (OR 2.18). Prisoners with AAD were repeat offenders (OR 2.18). Among female prisoners, ADAD was associated with repeat offenses (OR 3.39), a criminal record as an adolescent (OR 9.24), a clinical or infectious condition (OR 5.09), another health problem (OR 3.04), and violent crime (OR 2.5).
  
  
  CONCLUSIONS
  The study confirmed an association between drug-use disorders and the criminal and clinical background in the study population. Prisoners with such disorders were more likely to be repeat offenders and to have a criminal record as adolescents. Among female prisoners disorders were also associated with violent crime and health problems, while among males they were associated with property crime. These patterns in clinical and criminal backgrounds illustrate the need for social rehabilitation programs and specific medical treatment for prison populations.
authors.affiliation: Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil; Program in Public Health, Universidade Catolica de Santos, Santos, São Paulo, Brazil.
authors.forename: Maíra
authors.initials: M
authors.lastname: Mendes dos Santos
authors.affiliation: Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil.
authors.forename: Maria Ines
authors.initials: MI
authors.lastname: Quintana
authors.affiliation: Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil.
authors.forename: Fernanda Gonçalves
authors.initials: FG
authors.lastname: Moreira
authors.affiliation: Department of Clinical Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
authors.forename: José Geraldo Vernet
authors.initials: JG
authors.lastname: Taborda
authors.affiliation: Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil.
authors.forename: Jair de Jesus
authors.initials: Jde J
authors.lastname: Mari
authors.affiliation: Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil; Program in Public Health, Universidade Catolica de Santos, Santos, São Paulo, Brazil.
authors.forename: Sérgio Baxter
authors.initials: SB
authors.lastname: Andreoli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D001938:Brazil / Q000453:epidemiology; D057237:Criminals / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011329:Prisoners / Q000523:psychology*; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult