Objectives:Mental illness is a very common issue in the prison population. This study set out to analyse the prevalence of mental disorders among inmates at Zuera Prison (Zaragoza). Material and method:A descriptive cross-sectional study was conducted in September 2023, including inmates undergoing active treatment with psychotropic drugs. The sample included 598 prisoners (560 men and 38 women), with a mean age of 39.3 years for men and 41.3 years for women. Results:The results showed that neurotic disorders were the most prevalent in both sexes (47% men, 55.30% women), followed by disorders due to psychoactive substance use (35.40% men, 23.70% women) and, in third place, personality disorders. Significant differences were observed in the distribution of diagnoses according to gender, nationality and recidivism: repeat offenders had a higher prevalence of drug-related disorders, while first-time offenders had more neurotic disorders. The foreign population showed a lower association with drug-related pathologies than the Spanish population. Discussion:The high prevalence of mental health disorders observed, and the differences found according to sociodemographic and prison-related characteristics, highlight the need to strengthen strategies for early detection, prevention and comprehensive mental health care within the prison system, particularly for individuals with a history of reoffending and substance-use disorders.
Objectives:To map scientific production of dental care in prisons, identifying trends, gaps, and organizational aspects of access. Material and method:Scoping review in accordance with Johanna Briggs Institute (JBI) and PRISMA-ScR guidelines in MEDLINE, Web of Science (WoS), Latin American and Caribbean Health Sciences Literature (LILACS), and Embase. Primary studies in three languages were included, without time restrictions. Results:From 28 studies (mostly from Brazil, France, and India), high rates of caries, periodontal disease, and tooth loss prevail under a reactive emergency model. Discussion:Prison care reflects structural inequities. Initiatives such as tele-dentistry and screening protocols are effective for improving a comprehensive approach. A transition toward a public health logic is necessary to guarantee the right to care within the prison system.
Diabetes is a chronic metabolic disease characterised by high glucose levels and altered carbohydrate and lipid metabolism, affecting an increasing number of people worldwide. Spain ranks fifth among European countries with the highest incidence of diabetes. Hyperglycaemia causes damage to numerous cell types, including keratinocytes and fibroblasts in the skin. Dermatological manifestations appear in more than 30% of cases of diabetes at the onset of the disease and in up to 100% during the course of the disease. This makes skin examination of patients particularly important, as early treatment of diabetes can slow the progression of the disease and improve its prognosis. In addition, some dermatological changes may alert us to suboptimal metabolic control of previously known diabetes. Some lesions are associated with insulin resistance, others are due to fungal or bacterial infections, there are also alterations due to diabetes itself or to chronic complications of diabetes; finally, there are lesions due to pharmacological treatment of the disease and to devices such as insulin infusion pumps and sensors for interstitial glucose measurement. Knowing and recognising dermatological changes is therefore essential in our daily work, because they guide us towards a better management of the disease and its causes.
Objectives: To evaluate the baseline prevalence of latent tuberculosis infection (LTBI) and longitudinal changes in interferongamma release assay (IGRA) positivity among male and female prison officers in Paraná, Brazil. Material and method: A longitudinal study was conducted with prison officers in direct contact with inmates. LTBI was diagnosed using the QuantiFERON-TB® Gold Plus (IGRA) test. Results: The proportion of IGRA-positive individuals decreased from 22.6% in 2022 to 5.7% in 2024. However, increases were observed in cigarette consumption, alcohol use, and daily consumption of medications. Discussion: The findings highlight the importance of periodic monitoring of latent tuberculosis infection and strengthening occupational health promotion strategies for prison officers.
This review examines the current evidence on screening recommendations for M. tuberculosis infection (MTB), contemporary diagnostic approaches, and the indications and components of treatment-namely, who should be treated, when treatment is warranted, and which pharmacotherapeutic options are appropriate. To this end, World Health Organization (WHO) recommendations have been compiled, analyzing the changes introduced in recent years, particularly those following the development and implementation of a new class of MTB antigen-based skin tests. In the therapeutic domain, the classical long-course isoniazid regimen (6-9 months) is subjected to a critical comparative appraisal against shorter rifamycin-based regimens. For this purpose, documents issued by the WHO and by major national and international guidelines and consensus statements have been reviewed. The review focuses particularly on screening, diagnosis, and treatment in the incarcerated population.
Objectives: This article aims to analyse the judicial and penitentiary response to serious crimes committed by individuals with mental disorders, with particular attention to the type of sentence imposed and the indication of psychiatric treatment during its execution. Material and methods: A descriptive study was carried out, combining a literature review with the analysis of 38 judicial rulings issued in Spain. The study examines the recognition of mental pathology, the corresponding degree of criminal responsibility, and the measures applied. The selected sentences relate to crimes of homicide, murder, and sexual assault, all of which explicitly mention a relevant clinical diagnosis. Results: The results reveal a clear tendency towards the imposition of ordinary prison sentences, even in cases of diminished criminal responsibility. Only two cases, classified as criminally non-responsible, led to the application of a security measure involving psychiatric institutionalisation. In over half of the remaining rulings, the need for psychiatric treatment was noted, although without specifying how its effective implementation would be ensured. This vagueness, combined with the lack of specialised resources in the prison setting, significantly limits the possibility of appropriate clinical intervention. Discussion: The study highlights the structural shortcomings of the Spanish penal and penitentiary system in addressing mental health needs, as well as the insufficient coordination between the justice system and the healthcare network. It calls for a more individualised approach that integrates clinical, criminological, and social factors of the offender, and that prioritises rehabilitation over purely punitive logic.
Objectives: Incarceration affects various aspects of a prisoner’s health, nutrition, and coping behaviours. This study aimed to explore and compare socio-demographic characteristics, dietary habits, and health-related experiences among male inmates in two Indian district prisons at Lucknow and Unnao. Material and method: A cross-sectional survey was conducted among 60 male inmates (30 from each prison). Data were collected using a structured questionnaire covering dietary habits, body mass index, nutritional awareness, physical activity, and substance use. Descriptive statistics and comparative analysis were used to assess inter-prison differences. Results: Most participants were young adults with no significant difference in age or body mass index between the two groups. An urban background was more common in Lucknow, whereas a rural background was predominant in Unnao. Nutritional awareness was higher in Lucknow (53.3%) than in Unnao (33.3%). Overall access to fresh produce and dietary variety was limited. Only 13.3% had received any nutritional counselling. Meal satisfaction was significantly higher in Lucknow (P = 0.04), and access to physical activity was more frequently reported. Discussion: Nutritional awareness, diet quality, and access to physical activity were influenced by institutional differences. Targeted interventions such as structured nutrition education and exercise programs are needed to improve the health and wellbeing of incarcerated populations.
Objectives:Review the epidemiology of metabolic dysfunction-associated steatotic liver disease (MASLD), and the main diagnostic and therapeutic challenges, with a specific focus on its management in the prison population. Material and method:MASLD is the most prevalent form of chronic liver disease worldwide and represents an increasing challenge for public health and healthcare systems. Prison inmates are particularly vulnerable to this condition due to a combination of individual and social factors and to characteristics within the correctional system itself. These vulnerabilities have contributed to an epidemiological transition, whereby metabolic comorbidities have replaced transmittable diseases as the main cause of morbimortality. Conclusions:The growing burden of metabolic disease in correctional settings underscores the urgent need for effective screening and referral strategies for early MASLD detection. However, current protocols remain poorly defined, and there is limited evidence regarding their cost-effectiveness in this specific context. These gaps highlight the pressing need for further research and the development of public health policies tailored to the unique characteristics of this high-risk population.
Objectives:Spain has one of the highest incarceration rates in Europe, and its prison population shows a significantly higher prevalence of mental illness and toxic substances use disorder compared to the general population. Despite this, there is a lack of studies focused on mental disorders in Spanish prisons. This study aims to explore the differences between Spanish and foreign persons deprived of liberty with severe mental disorders. Material and method:We evaluated the sociodemographic (Spanish vs. foreign) and clinical characteristics of 106 persons deprived of liberty admitted to a Spanish prison module for psychiatric decompensation between 2009 and 2022. Results:Immigrants represent 51.9% of the sample, predominantly young unmarried males, primarily admitted for suicidal behavior (43.6%). Compared to Spaniards, they have fewer psychiatric histories and less mental health follow-up in the previous six months. In contrast, Spanish inmates are older, have higher rates of bipolar disorder and personality disorders, and receive more psychotropic prescriptions. They also present with more cardiovascular risk factors and physical comorbidities. Discussion and conclusions:Foreign incarcerated person are overrepresented in psychiatric admissions and are particularly vulnerable to suicidal behavior. Social precarity likely accounts for some of the differences observed compared to the native population.
Objective:Describe the characteristics of inmates who have or have had tuberculosis (TB) and identify associated factors. Material and method:An observational, prospective, multicenter, population-based study was carried out on patients admitted to the nine prisons in Catalonia between March 1 and June 30, 2023. The patient's history of TB was assessed, and the presence of current TB was confirmed/ruled out. In TB cases, predictor variables were studied using bivariate and multivariate logistic regression analysis, calculating the risk ratio (RR) and its 95% confidence interval (CI). Results:There were 1,679 admissions, 2.3% with previous TB and 1 with TB detected at screening. TB cases were older (45.1 vs. 33.7 years) and more frequently intravenous drug users (6.9% vs. 1.7% in non-users), Asian (9.1% vs. 1.4% in non-Asian), HIV-infected (10.3% vs. 1.9% in non-infected) and homeless (3.4% vs. 1.9% in those with a home). Multivariate analysis confirmed the association with: a) be older (RR: 2.9 in >30 years of age and RR=5.8 in >60 years of age, p =0.001); b) Asian origin (RR: 8.81; p <0.001); and c) not having a home (RR: 3.07; p = 0.005). Discussion:2.3% had or had previously had tuberculosis. Therefore, it is essential to carry out tuberculosis screening upon admission to detect new cases or exacerbations and prevent TB transmission in an enclosed environment. Previous tuberculosis was more common in older adults, Asians, and those without shelter or housing; such groups require special follow-up.
Objectives:This study aims to analyze the different types of gender discrimination faced by female inmates and their impact on their psychological well-being. Material and method:A systematic review was carried out in accordance with the PRISMA guidelines. The search was carried out on the PubMed and Scopus databases using keywords related to gender discrimination, mental health, and the prison context. Filters were applied for language (Spanish and English), publication period (2015-2025), and study type (quantitative, qualitative, or mixed methods). Results:A total of 13 studies were selected (1 longitudinal, 9 cross-sectional, and 3 mixed methods), conducted across diverse geographical and social contexts. The evidence shows that incarcerated women face institutional violence, stigmatization, and structural barriers that limit their access to basic services and rehabilitation programs. These conditions exacerbate disorders such as depression, anxiety, and post-traumatic stress disorder, which are further intensified by histories of gender-based violence and racial discrimination. In addition, family separation and challenges in social reintegration stemming from a lack of education and employment opportunities perpetuate a cycle of exclusion and marginalization. Despite some interventions aimed at reducing these inequalities, the findings indicate that they remain insufficient to address the specific needs of incarcerated women. Conclusions:There is an urgent need to reform prison policies, adopting more inclusive and intersectional approaches that ensure equitable access to psychological care, rehabilitation programs, and effective reintegration strategies. Only by doing so can the cycle of discrimination and vulnerability affecting this population be broken.
Objectives: Female inmates have the right to reproductive and sexual health care. In addition, this population presents risk factors that make them especially vulnerable to obstetric-gynaecological pathologies. For this reason, they should be guaranteed the necessary care. The aim of this study is to determine the main obstetric and gynaecological reasons for fe-male inmates to visit the midwife’s clinic. Material and method: Descriptive observational study carried out between 18/04/23 and 01/06/23. The target population were the female inmates at the Madrid VII Prison-Estremera. Results: 77.5% of the women were of childbearing age. The sample showed 3.8% human immuno-deficiency virus, 8.7% hepatitis B virus and hepatitis C virus, 13% human papillomavirus, 5.8% syphilis. 40% were smokers and 37.6% users of illegal substances. There were 75.6% scheduled consultations, mainly for cervical cancer prevention and contraceptive advice. Consultations on demand accounted for 23.2%, mainly for concerns relating to contracep-tion or vaginal issues. Discussion: Since female inmates have multiple risk factors for the development of obstetric and gyne-cological pathologies, prevention by the midwife cannot be ignored in prisons, with activi-ties such as vaccination, health education, early detection tests, etc. In addition, the degree of participation has been high, so it is understood that female inmates demand this type of health care.
Objectives: Prisons present a unique opportunity to address the high prevalence of hepatitis C (HCV) among inmates, a population disproportionately affected by the disease. Specific conditions within correctional facilities contribute to increased HCV transmission rates. Incarceration offers a strategic chance to reach individuals who are often inaccessible through traditional healthcare systems, transforming prison time into a window for targeted health interventions. Material and method: This study utilized a qualitative approach, conducting a comprehensive literature review on HCV management within correctional settings and incorporating data and insights from the “Let’s End HepC” European project. The findings informed the development of the PIO-NEER framework, which emphasizes evidence-based public health policies to enhance health safety in prisons for hepatitis C. Results: Effective control of HCV in prisons requires a multifaceted approach, including education, counseling, harmreduction initiatives such as safe tattooing practices, provision of direct-acting antiviral (DAA) treatments, and improvements in prison conditions. Emphasis should also be placed on fostering respect for prisoners’ human rights, implementing preventive measures, and reducing HCV transmission within correctional facilities. Discussion: Incarceration represents a critical opportunity for diagnosing and treating hepatitis C, contrib-uting to improved health outcomes for inmates and reducing transmission risks within the wider community. By addressing HCV in prisons, incarceration can be reframed as a public health intervention to mitigate community health risks when inmates are reintegrated.
