title: Treating substance abuse is not enough: comorbidities in consecutively admitted female prisoners.
abstract: BACKGROUND
  Several studies have pointed to high rates of substance use disorders among female prisoners. The present study aimed to assess comorbidities of substance use disorders with other mental disorders in female prisoners at admission to a penal justice system.
  
  
  METHODS
  A sample of 150 female prisoners, consecutively admitted to the penal justice system of Berlin, Germany, was interviewed using the Mini-International Neuropsychiatric Interview (MINI). The presence of borderline personality disorder was assessed using the Structured Clinical Interview II for DSM-IV. Prevalence rates and comorbidities were calculated as percentage values and 95% confidence intervals (CIs).
  
  
  RESULTS
  Ninety-three prisoners (62%; 95% CI: 54-70) had substance use disorders; n=49 (33%; 95% CI: 24-42) had alcohol abuse/dependence; n=76 (51%; 95% CI: 43-59) had illicit drug abuse/dependence; and n=53 (35%; 95% CI: 28-44) had opiate use disorders. In the group of inmates with substance use disorders, 84 (90%) had at least one other mental disorder; n=63 (68%) had comorbid affective disorders; n=45 (49%) had borderline or antisocial personality disorders; and n=41 (44%) had comorbid anxiety disorders.
  
  
  CONCLUSIONS
  Female prisoners with addiction have high rates of comorbid mental disorders at admission to the penal justice system, ranging from affective to personality and anxiety disorders. Generic and robust interventions that can address different comorbid mental health problems in a flexible manner may be required to tackle widespread addiction and improve mental health of female prisoners.
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Universitätsmedizin Berlin, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Mir
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Universitätsmedizin Berlin, Germany.
authors.forename: Sinja
authors.initials: S
authors.lastname: Kastner
authors.affiliation: Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Services Development), Queen Mary University of London, UK.
authors.forename: Stefan
authors.initials: S
authors.lastname: Priebe
authors.affiliation: Institute of Forensic Psychiatry, Charité Universitätsmedizin Berlin, Germany.
authors.forename: Norbert
authors.initials: N
authors.lastname: Konrad
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Universitätsmedizin Berlin, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Ströhle
authors.affiliation: Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Services Development), Queen Mary University of London, UK; Escuela de Medicina sede Puerto Montt, Universidad San Sebastián, Chile. Electronic address: a.mundt@qmul.ac.uk.
authors.forename: Adrian P
authors.initials: AP
authors.lastname: Mundt
mesh_terms: D000328:Adult; D000987:Antisocial Personality Disorder / Q000150:complications / Q000453:epidemiology; D001008:Anxiety Disorders / Q000150:complications / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000150:complications / Q000453:epidemiology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D019964:Mood Disorders / Q000150:complications / Q000453:epidemiology; D015995:Prevalence; D011329:Prisoners / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology / Q000534:rehabilitation*; D059020:Suicidal Ideation
keywords: Admission study; Comorbidity; Female prison population; Mental disorders; Prevalence rates; Substance use disorders