Chapter

Anxiety disorders including post traumatic stress disorder (PTSD)

Catherine F. Lewis

in Oxford Textbook of Correctional Psychiatry

Published on behalf of Oxford University Press

Published in print March 2015 | ISBN: 9780199360574
Published online May 2015 | e-ISBN: 9780190224042 | DOI: http://dx.doi.org/10.1093/med/9780199360574.003.0035

Series: Oxford Textbooks in Psychiatry

Anxiety disorders including post traumatic stress disorder (PTSD)

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Increasing numbers of studies of correctional populations have emphasized diagnosis with structured clinical instruments over the past two decades. These studies have primarily focused on serious mental illness (i.e., psychotic and mood disorders), substance use disorders, and personality disorders. The focus has made sense because of the need to identify the severely mentally ill who are incarcerated and to identify the most common disorders. Anxiety disorders include generalized anxiety disorder, social anxiety disorder, panic disorder, and specific phobias. One anxiety disorder that stands apart from others is PTSD, which is prevalent at much higher rates in both incarcerated men and women than in the community. Despite this fact, other anxiety disorders are often co-morbid and add to overall disease burden and impair ability to function. Individuals with a greater disease burden (i.e., number of diagnoses, symptom counts) have worse outcomes than those with uncomplicated disorders. These impaired outcomes include a deteriorating trajectory of illness, increased health service utilization, poor prognosis, and increased likelihood of morbidity and mortality. Thus, while anxiety disorders may not be the primary focus of the correctional system, they must be recognized as important. Unrecognized anxiety disorders can result in behavior that is disruptive and may appear to be volitional. They can also lead to overutilization of health services that are already facing substantial demands. Appropriate, available, and consistent assessment, diagnosis, and treatment that are well integrated can successfully intervene in the range of anxiety disorders that present in correctional settings.

Chapter.  4800 words. 

Subjects: Psychiatry ; Forensic Psychiatry

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