Chapter

Mood disorders

Jayesh Kamath and Ajay Shah

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: https://dx.doi.org/10.1093/med/9780199360574.003.0034

Series: Oxford Textbooks in Psychiatry

Mood disorders

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Depression and Bipolar Disorder comprise a substantial percentage of all psychiatric care in the community. This is also the case in correctional settings. Diagnosis and treatment may vary in multiple ways, given the context and characteristics of jails and prisons. Reassessment of symptomatology at every visit, especially in the first few months of incarceration, enhances accurate diagnosis. The clinical presentation of many individuals at the time of incarceration is frequently confounded by substance withdrawal, adjustment issues, and other comorbidities. The clinical picture frequently evolves and allows improved accuracy over weeks to months. Decades of research conducted in the community and correctional settings have shown a close but controversial relationship between mood disorders, aggression, and criminality. This may be reflected in a substantially increased risk of multiple incarcerations as with the observation that inmates with bipolar disorders are 3.3 times more likely to have had four or more previous incarcerations compared with inmates who had no major psychiatric disorders. In terms of management risks, studies conducted with both genders in the correctional setting have shown a strong association between depression and near-lethal suicide attempts. Data reflect the importance of both psychotherapy and targeted, thoughtful medication management in the effective treatment of mood disorders. This chapter discusses the data and those characteristics, as well as core management, best-practice, and evidence based therapeutic approaches to the treatment of major depressive disorders and bipolar disorders in jails and prisons.

Chapter.  4425 words.  Illustrated.

Subjects: Psychiatry ; Forensic Psychiatry

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