title: The course of major depression during imprisonment - A one year cohort study.
abstract: BACKGROUND
  First longitudinal studies in prisoners point to improvements of depressive symptoms during imprisonment. The aim of the present study was to assess the course of major depressive disorder during imprisonment and to identify factors influencing remission.
  
  
  METHODS
  Prisoners with major depressive disorder in a sample of consecutive admissions to the penal justice system in Santiago de Chile were reassessed after one year of imprisonment. Psychiatric diagnoses were established using the Mini-International Neuropsychiatric Interview; psychological symptoms were assessed with the Symptom-Check-List 90 Revised (SCL-90-R). Mean symptom scores were compared at baseline and follow-up using Student's t-test. Odds ratios (OR) of comorbid disorders and socio-demographic factors at baseline to predict depression at follow-up were calculated.
  
  
  RESULTS
  N=79 out of 80 inmates (99%) with major depression at baseline were included. Thirty-five prisoners (44%) had major depression at follow-up. The mean global severity score and all mean subscale scores of the SCL-90-R improved. High suicide risk was present in 37 prisoners (47%) at admission and in 11 (14%) at follow-up. The comorbid diagnosis of PTSD (OR 6.3; p<0.001) at admission and having been previously imprisoned (OR 2.5; p=0.05) predicted major depressive disorder at follow-up.
  
  
  CONCLUSIONS
  The study could not account for temporary improvements between the assessments.
  
  
  CONCLUSIONS
  In spite of important symptom improvements, only about half of the prisoners with major depression at admission remit after one year of imprisonment. New interventions should target people with major depression and comorbid PTSD at admission.
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité Campus Mitte Universitätsmedizin Berlin, Germany; Department of Psychiatry and Mental Health, Hospital Clínico Universidad de Chile, Santiago, Chile.
authors.forename: Alicia
authors.initials: A
authors.lastname: Baier
authors.affiliation: Department of Psychiatry and Mental Health, Hospital Clínico Universidad de Chile, Santiago, Chile; Department of Psychiatry, Universidad de los Andes, Chile.
authors.forename: Rosemarie
authors.initials: R
authors.lastname: Fritsch
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité Campus Mitte Universitätsmedizin Berlin, Germany.
authors.forename: Yuriy
authors.initials: Y
authors.lastname: Ignatyev
authors.affiliation: Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Services Development), Queen Mary University of London, United Kingdom.
authors.forename: Stefan
authors.initials: S
authors.lastname: Priebe
authors.affiliation: Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Services Development), Queen Mary University of London, United Kingdom; Facultad de Medicina, Universidad Diego Portales, Santiago, Chile; Escuela de Medicina sede Puerto Montt, Universidad San Sebastián, Chile; Facultad de Medicina, Universidad de Chile, Santiago, Chile. Electronic address: a.mundt@qmul.ac.uk.
authors.forename: Adrian P
authors.initials: AP
authors.lastname: Mundt
mesh_terms: D000328:Adult; D002677:Chile / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D011329:Prisoners / Q000523:psychology*; D011379:Prognosis; D012074:Remission Induction; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D055815:Young Adult
keywords: Cohort; Longitudinal study; Major depression; Mental disorders; Prison population; Psychological symptoms