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Prevalence, Types and Possible Causes of Insomnia in a Swiss Remand Prison

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Abstract

Study objectives: To determine the prevalence of insomnia complaints and possible causes among prisoners. Design: Prospective study of medical consultations during 1 year (questionnaire A) to identify reasons for consultation and diagnoses. After this year we compared the medical records (questionnaire B) of 112 non-substance misusing (NSM) insomniac prisoners identified through questionnaire A with the records of 103 NSM prisoners without insomnia complaint. Setting: Outpatient service of the remand prison in Geneva, Switzerland. Patients: 995 prisoners. Interventions: None. Measurements and results: The general practitioners returned completed questionnaires A for 92%(n = 2772) of the consultations (995 patients). Using questionnaire A and B, we identified 112 NSM insomnia patients. Among these, chronic forms of insomnia were more common than transitory insomnia (<3 weeks). The most frequently reported reason for insomnia was anxiety related to incarceration. A higher percentage of the 112 insomnia patients than of the 103 non-insomnia patients had a history of medical and psychiatric illness, suffered from anxiety or depression in prison, and received prescriptions of psychotropic and analgesic medications. After the study of the records, we estimated the overall prevalence of insomnia at 44.3% of the 995 patients of whom 51%(n = 223) were drug misusers. Conclusions: Our results confirm that insomnia is a frequent complaint among prisoner patients and that at least half of insomnia patients are substance misusers. In NSM patients, insomnia does not seem to be an only transitory problem of adaptation to incarceration, but a more chronic problem lasting more than 3 weeks, related to a higher degree of medical and psychological problems before and during incarceration.

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References

  1. Jaeger M, Monceau M. La consommation des mé dicaments psychotropes en prison. Ramonville Saint-Agne: Editions Erè s, 1996.

  2. Vasseur V. FrMé decin chef à la prison de la santé. Paris: Le Livre de Poche, 2001.

  3. Turnbull P, Stimson GV. Drug use in prison. Br Med J 1994; 308: 1716.

    Google Scholar 

  4. Korte T, Pykalainen J, Seppala T. Drug abuse of Finnish male prisoners in 1995. Forensic Sci Int 1998; 97: 171–183.

    Google Scholar 

  5. Brooke D, Taylor C, Gunn J, Maden A. Substance misusers remanded to prison-a treatment opportunity? Addiction 1998; 93: 1851–1856.

    Google Scholar 

  6. Brooke D, Taylor C, Gunn J, Maden A. Point prevalence of mental disorder in unconvicted male prisoners in England and Wales. Br Med J 1996; 313: 1524–1527.

    Google Scholar 

  7. Birmingham L, Mason D, Grubin D. Prevalence of mental disorder in remand prisoners: Consecutive case study. Br Med J 1996; 313: 1521–1524.

    Google Scholar 

  8. Harding T. FrDé pression en milieu carcé ral (IIe rencontre Internationale 'Psychiatrie et Epidé miologie' Genè ve 17-19 mars 1983). Psychologie Mé dicale 1984; 16: 835–839.

    Google Scholar 

  9. Andersen HS, Sestoft D, Lillebaek T, Gabrielsen G, Hemmingsen R, Kramp P. A longitudinal study of prisoners on remand: Psychiatric prevalence, incidence and psychopathology in solitary vs. non-solitary con-finement. Acta Psychiatr Scand 2000; 102: 19–25.

    Google Scholar 

  10. Harding T, Zimmermann E. Psychiatric symptoms, cognitive stress and vulnerability factors. A study in a remand prison. Br J Psychiatry 1989; 155: 36–43.

    Google Scholar 

  11. Lessenger JE. Health care in jails: A unique challenge in medical practice. Postgrad Med 1982; 72: 131–134, 137, 141-144.

    Google Scholar 

  12. Nurse J, Woodcock P, Ormsby J. Influence of environmental factors on mental health within prisons: Focus group study. Br Med J 2003; 327: 480.

    Google Scholar 

  13. Levin BH, Brown WE. Susceptibility to boredom of jailers and law enforcement officers. Psychol Rep 1975; 36: 190.

    Google Scholar 

  14. Elger BS, Goehring C, Antonini Revaz S, Morabia A. Prescription of hypnotics and tranquillisers at the Geneva prison's outpatient service in comparison to an urban outpatient medical service. Soz Praventivmed 2002; 47: 39–43.

    Google Scholar 

  15. Kupfer DJ, Reynolds CF. Management of insomnia. N Engl J Med 1997; 336: 341–346.

    Google Scholar 

  16. Bourgeois D. Troubles du sommeil en milieu carcé ral [Sleep disorders in prison]. Encephale 1997; 23: 180–183.

    Google Scholar 

  17. Barnas C, Rossmann M, Roessler H, Riemer Y, Fleischhacker WW. Benzodiazepines and other psychotropic drugs abused by patients in a methadone maintenance program: Familiarity and preference. J Clin Psychopharmacol 1992; 12: 397–402.

    Google Scholar 

  18. Socares BG, Lima MS, Reisser AA, Farrell M. Dopamine agonists for cocaine dependence. Cochrane Database Syst Rev 2003; 2: CD003352.

    Google Scholar 

  19. Staedt J, Wassmuth F, Stoppe G, et al. Effects of chronic treatment with methadone and naltrexone on sleep in addicts. Eur Arch Psychiatry Clin Neurosci 1996; 246: 305–309.

    Google Scholar 

  20. Schenck CH, Mahowald MW, Sack RL. Assessment and management of insomnia. JAMA 2003; 289: 2475–2479.

    Google Scholar 

  21. Gowing L, Ali R, White J. Buprenorphine for the management of opioid withdrawal. Cochrane Database Syst Rev 2002; 2: CD002025.

  22. Eichenberger G. FrLes mé dicaments en prison pré ventive. Der Strafvollzug in der Schweiz 1978; 2: 81–92.

    Google Scholar 

  23. Hohagen F, Rink K, Kappler C, et al. Prevalence and treatment of insomnia in general practice. A longitudinal study. Eur Arch Psychiatry Clin Neurosci 1993; 242: 329–336.

    Google Scholar 

  24. Shochat T, Umphress J, Israel AG, Ancoli-Israel S. Insomnia in primary care patients. Sleep 1999; 22(Suppl 2): S359-S365.

  25. Simon GE, VonKorff M. Prevalence, burden, and treatment of insomnia in primary care. Am J Psychiatry 1997; 154: 1417–1423.

    Google Scholar 

  26. Schramm E, Hohagen F, Kappler C, Grasshoff U, Berger M. Mental comorbidity of chronic insomnia in general practice attenders using DSM-III-R. Acta Psychiatr Scand 1995; 91: 10–17.

    Google Scholar 

  27. Quera-Salva MA, Orluc A, Goldenberg F, Guilleminault C. Insomnia and use of hypnotics: Study of a French population. Sleep 1991; 14: 386–391.

    Google Scholar 

  28. Ohayon M, Caulet M, Lemoine P. FrSujets ages, habitudes de sommeil et consommation de psychotropes dans la population francaise [The elderly, sleep habits and use of psychotropic drugs by the French population]. Encephale 1996; 22: 337–350.

    Google Scholar 

  29. Ohayon MM, Caulet M. Psychotropic medication and insomnia complaints in two epidemiological studies. Can J Psychiatry 1996; 41: 457–464.

    Google Scholar 

  30. Ohayon M. Epidemiological study on insomnia in the general population. Sleep 1996; 19: S7–S15.

    Google Scholar 

  31. Schmitt BE, Gugger M, Augustiny K, Bassetti C, Radanov BP. FrPra¨ valenz von Schlafsto¨ rungen bei einer werkta¨ tigen Schweizer Population: Ergebnisse einer Fragebogenumfrage [Prevalence of sleep disorders in an employed Swiss population: Results of a questionnaire survey]. Schweiz Med Wochenschr 2000; 130: 772–778.

    Google Scholar 

  32. Angst J, Vollrath M, Koch R, Dobler-Mikola A. The Zurich Study. VII. Insomnia: Symptoms, classification and prevalence. Eur Arch Psychiatry Neurol Sci 1989; 238: 285–293.

    Google Scholar 

  33. Vollrath M, Wicki W, Angst J. The Zurich study. VIII. Insomnia: Association with depression, anxiety, somatic syndromes, and course of insomnia. Eur Arch Psychiatry Neurol Sci 1989; 239: 113–124.

    Google Scholar 

  34. Tan TL, Kales JD, Kales A, Soldatos CR, Bixler EO. Biopsychobehavioral correlates of insomnia. IV: Diagnosis based on DSM-III. Am J Psychiatry 1984; 141: 357–362.

    Google Scholar 

  35. Ford DE, Kamerow DB. Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention? JAMA 1989; 262: 1479–1484.

    Google Scholar 

  36. McCaul ME, Svikis DS, Moore RD. Predictors of outpatient treatment retention: Patient versus substance use characteristics. Drug Alcohol Depend 2001; 62: 9–17.

    Google Scholar 

  37. Zimmermann E, von Allmen M. FrConsultations mé dicales et consommations mé dicamenteuses en cours de dé tention pré ventive à la prison de Champ-Dollon. Soz Praventivmed 1985; 30: 312–321.

    Google Scholar 

  38. McElrath K. A comparison of two methods for examining inmates' self-reported drug use. Int J Addict 1994; 29: 517–524.

    Google Scholar 

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  1. Médecine pénitentiaire et Institut universitaire de médecine légale, 9 av. de Champel, 1211, Geneva 4, Switzerland

    Bernice S. Elger

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Elger, B.S. Prevalence, Types and Possible Causes of Insomnia in a Swiss Remand Prison. Eur J Epidemiol 19, 665–677 (2004). https://doi.org/10.1023/B:EJEP.0000036805.58237.e3

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  • DOI: https://doi.org/10.1023/B:EJEP.0000036805.58237.e3

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