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Tijdschrift voor Psychiatrie 41 (1999) 10, 575 - 585

State-of-the-art-article

Psychopathology among detainees

B.H. Bulten, W. van Tilburg, J. van Limbeek

The prevalence of psychiatric disorders among detainees is much higher than in the general population. Only a small part of the detainees doesn't meet the criteria of one of the dsm-iii-r-diagnoses. One can speak of so-called comorbidity (axis-i-disorders, addiction and axis-ii-disorders), combined with severe social problems by a substantial group of prisoners.
Apart from the high prevalence of anti-social personality disorders there are strong cues for a high prevalence of other personality disorders. The question whether the mental disorders and a high level of subjective non-well-being existed before the detention or developed during the detention is yet unresolved. The article stresses the conduct disorders at an early age which are typical for a lot of detainees, the concept 'secondary development of psychopathy' and the use of drugs and alcohol as a means of 'selfmedication'.
Like in general population, there is a discrepancy between the psychiatric morbidity and the consumption of care. In a situation of detention this discrepancy is much larger. There is an association between (certain aspects of) psychopathology and violent, delinquent behaviour. The consequences of the research findings and the relationship between the justice system and the general mental health care are discussed.

keywords comorbidity, detainees, psychopathology