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BACKGROUND: Prisoners are one of the most vulnerable groups for having high prevalence of mental health disorders. In comparison with general population, prisoners are at increased risk of suffering from a psychic disorder that transcends countries and diagnosis. 87% of the Asian countries have had increased number of prisoners over past decade and Nepal is no exception, although accurate data regarding increment is not
available. Most studies regarding psychiatric morbidity in prisoners are entirely based on research done in western countries and there is a dearth of major studies conducted amongst prisoners in Nepal.

AIM: To study the prevalence and nature of psychiatric morbidity in prisoners attending general out-patient department (OPD) of Central jail, Bhadrakali. 

METHODOLOGY: The research design is descriptive. All the prisoners attending OPD of central jail every friday for a duration of six months have been included in this study based on inclusion and exclusion criteria. All are given self reporting questionnaire (SRQ) and those who have been found to have distress on SRQ are given semi-structured proforma and interviewed and psychiatric diagnosis is made based on International
Classification of Disease 10- Diagnostic criteria for research (ICD-10 DCR), which has been confirmed separately by consultant psychiatrist. Only those prisoners having psychiatric morbidity are analyzed using computer program SPSS version 16.

RESULT AND CONCLUSION: 121 prisoners (92 male, 29 female), out of 300 prisoners (200 male, 100 female) attending OPD of central jail during a period of 6 months, had been diagnosed to suffer from psychiatric morbidity. Majority of cases were within age group 26-30 years (20.7%), with male preponderance (76.9%), were married (69.4%) and educated up to higher secondary level (38%) followed by lower secondary
level (20.7%). Most of the prisoners having psychiatric morbidity had occupation as labor work (24%) followed by business (21.5%). Hindu religion was predominantly found among cases and majority were janajatis (32.2%) and had lower socio-economic status (51.2%), belonging to joint family (50.4%), and were from rural areas (45.5%). Murder was the most common offence committed (33.9%) followed by drug trafficking (28.1%).
Majority of cases were sentenced (71.1%) and were staying in prison between 12-24 months. Most common crime among sentenced prisoners was murder (37.2%) followed by drug trafficking (25.6%) whereas most common crime in remand prisoners was drug trafficking (34.3%) followed by murder (25.7%). Majority of cases have symptoms developing within 6 months after imprisonment. Most common primary diagnosis belong
to neurotic, stress-related and somatoform disorder (57%) followed by mood disorder (32.2%). Most common psychiatric morbidity among prisoners according to ICD-10 DCR was generalized anxiety disorder accounting for 36.4% of cases, followed by moderate depressive episode (23.1%), somatoform disorder (9.1%) with persistent somatoform pain disorder (5%), paranoid schizophrenia (5.8%), and adjustment disorder (5.8%).
The overall prevalence of psychiatric morbidity in prisoners attending OPD of central jail hospital was found to be 40.33%.

Author : Dr. Praveen Bhattarai


Author(s) : Dr. Praveen Bhattarai