Co-occurring mental disorder and intellectual disability in a large sample of Australian prisoners

Dias, Shannon, Ware, Robert S., Kinner, Stuart A. and Lennox, Nicholas G. (2013) Co-occurring mental disorder and intellectual disability in a large sample of Australian prisoners. Australian and New Zealand Journal of Psychiatry, 47 10: 938-944. doi:10.1177/0004867413492220


Author Dias, Shannon
Ware, Robert S.
Kinner, Stuart A.
Lennox, Nicholas G.
Title Co-occurring mental disorder and intellectual disability in a large sample of Australian prisoners
Journal name Australian and New Zealand Journal of Psychiatry   Check publisher's open access policy
ISSN 0004-8674
1440-1614
Publication date 2013-10-01
Year available 2013
Sub-type Article (original research)
DOI 10.1177/0004867413492220
Volume 47
Issue 10
Start page 938
End page 944
Total pages 7
Place of publication London, United Kingdom
Publisher Sage Publications Ltd.
Language eng
Formatted abstract
Objective: Prisoners with intellectual disability who have a coexisting mental health issue often have unmet health needs and are more likely to reoffend than those with intellectual disability alone. The aims of this study were to estimate the prevalence of co-occurring mental disorder among prisoners with intellectual disability and to explore the association between intellectual disability and mental disorder. Methods: Cross-sectional study of adult prisoners within 6 weeks of release from custody in seven prisons in Queensland, Australia between August 2008 and July 2010. Intellectual disability was assessed using a practical composite screening tool. Prisoners who scored 85 on the Hayes Ability Screening Index and reported either having attended a special school or having been diagnosed with intellectual disability were identified as having an intellectual disability. Mental health was assessed using self-reported psychiatric diagnoses, the Kessler Psychological Distress Scale (K-10), and the Mental Component Summary score of the Short-Form-36 health survey version 2. The association between intellectual disability and mental health was assessed using univariate and multivariate logistic regression. Results: Overall, 1279 prisoners completed the HASI: 316 (24%) scored below the recommended cut off for further diagnostic assessment of intellectual disability, 181 (14%) reported attending a special school, and 56 (4%) reported that they had been iagnosed with an intellectual disability. On our composite measure, 115 (9%) participants were identified as having an intellectual disability. Among prisoners with intellectual disability, the estimated lifetime and current prevalence of co-occurring mental disorders was 52.5% (95% CI 43.361.5) and 37.2% (95% CI 28.846.5), respectively. Of those with intellectual disability, 13.5% (95% CI 8.321.1) reported very high psychological distress, as measured by the K10. Prisoners with intellectual disability were significantly more likely than their non-disabled peers to report a current diagnosis of depression [adjusted odds ratio (AOR) 1.8, 95% CI 1.13.2] or substance dependence (AOR 3.7, 95% CI 1.68.4], after adjusting for potentially confounding variables. Prisoners with intellectual disability were also significantly more likely than their non-disabled peers to use antipsychotic medication (AOR 1.7, 95% CI 1.02.8). Conclusions: Prisoners with an intellectual disability were more likely than their non-disabled peers to have elevated rates of psychiatric comorbidity and unmet treatment needs. There is a need for enhanced collaboration between specialist intellectual disability psychiatric services and mainstream prison mental health services, to ensure coordinated service delivery for this dually disadvantaged group.
Keyword Dual diagnosis
Intellectual disability
Mental illness
Psychiatric Disorders
Psychological Distress
Retarded Adults
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Faculty of Health and Behavioural Sciences -- Publications
Official 2014 Collection
School of Medicine Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 9 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 9 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Sun, 10 Nov 2013, 10:25:05 EST by System User on behalf of School of Medicine