Quality of Life in a Population of Dutch Prisoners with Mental Disorders: Relations with Psychopathological, Social, Demographical, Judicial and Penitentiary Factors

Abstract

Little research is done on the impact of psychopathology in prison settings as expressed in outcome measures such as Quality of Life (QOL). The aim of the present study was to examine the QOL of Dutch male prisoners with mental disorders and to compare their QOL with the QOL of three reference groups: the general Dutch population (GDP), psychiatric outpatients, and prisoners without mental disorders. Also, the QOL of the reference group of prisoners without mental disorders was compared with the QOL of the other reference groups. An additional aim was to investigate possible relationships between the QOL of the study population and psychopathological, social, demographic, judicial and penitentiary factors. The QOL of the study population (N = 71) was measured with the WHOQOL-Bref. In addition, psychopathological, social, demographic, judicial and penitentiary data were collected. The QOL of the study population was worse compared with the QOL of the GDP and prisoners without psychopathology but better than the QOL of the psychiatric outpatients. Within the study population, the impact of DSM-IV-TR Axis I and II disorders on experienced QOL was of a similar negative magnitude. Correlations between substance dependence or abuse, social and demographic variables, judicial/penitentiary variables and QOL were small or absent. Psychopathological factors explained the major part of the known QOL variance of the study population. The relatively good QOL of the imprisoned patient group, in comparison to the QOL of the outpatient group, leads to the recommendation to implement elements of the detention regime in regular psychiatric care.

Keywords:

• Quality of Life
• WHOQOL-Bref
• prisoners
• psychopathology

Notes

¹Substance-related disorders are not included here due to forced abstinence of the participants. Substance abuse and/or dependence prior to imprisonment were recorded separately.

²The figures represent the amounts of recorded personality disorders. Due to the phenomenon of comorbidity (i.e., the classification of more than one personality disorder in one participant) the total of recorded disorders exceeds the number of participants diagnosed with a (at least one) personality disorder.

³The use of Methadone on doctor's prescription was not classified as an opiate dependence.

⁴All three mentally retarded participants were diagnosed with an Axis I diagnosis and/or a personality disorder.

¹Most severe crime for which participants were convicted or of which they were accused (suspects awaiting trial).

¹Single axis morbidity: participant is diagnosed with one or more diagnoses on either Axis I or Axis II according to DSM-IV classification.

²Comorbidity: participant is diagnosed with one or more diagnoses on both Axis I and Axis II according to DSM-IV classification.

¹Presence of significant differences between groups at the .05 level are indicated (+), at the .01 level with (++), and at the .001 level with (+++).

²One-Way ANOVA (with Post Hoc Bonferroni).

³These results are adapted (with permission) from Masthoff et al. (2006a).

⁴Student T tests.

⁵Single axis morbidity: participant is diagnosed with one or more diagnoses on either Axis I or Axis II according to DSM-IV classification.

⁶Comorbidity: participant is diagnosed with one or more diagnoses on both Axis I and Axis II according to DSM-IV classification.

¹Adjusted R-square.