Abstract：
OBJECTIVE: Despite the high rates of psychotic disorders amongst people in prison, current prison mental health screening approaches have not included assessment of the full psychosis spectrum to capture those at-risk of an emerging psychosis as well as those with established illness nor assessed the concurrent validity of psychosis symptom screening.
METHODS: Using a clinical staging approach to establish the prevalence of Ultra High Risk (UHR), first episode of psychosis (FEP) and established psychosis (EP) groups, 291 adults entering custody in two prison reception centres in NSW completed a two-stage (screening and validation) interview process. The Comprehensive Assessment of At-Risk Mental States (CAARMS) was used to determine the clinical stages of psychosis and concurrent validity of symptom screening in identifying individuals on the psychosis spectrum was formally assessed.
RESULTS: Amongst men and women entering prison, almost one quarter (24.1%) met UHR criteria, 5.1% met the FEP threshold and 10.6% had an established psychosis. Those on the psychosis spectrum reported greater disadvantage across sociodemographic and justice factors. The presence of perceptual disturbance and paranoid beliefs emerged as the two best screening items for identifying those with an underlying psychosis spectrum illness.
CONCLUSIONS: The prevalence of psychosis spectrum illness, including the UHR state, amongst those entering prison is high. Current prison mental health approaches should include screening for the presence of perceptual disturbances and paranoid beliefs to improve the detection of psychosis spectrum illness.
METHODS: Using a clinical staging approach to establish the prevalence of Ultra High Risk (UHR), first episode of psychosis (FEP) and established psychosis (EP) groups, 291 adults entering custody in two prison reception centres in NSW completed a two-stage (screening and validation) interview process. The Comprehensive Assessment of At-Risk Mental States (CAARMS) was used to determine the clinical stages of psychosis and concurrent validity of symptom screening in identifying individuals on the psychosis spectrum was formally assessed.
RESULTS: Amongst men and women entering prison, almost one quarter (24.1%) met UHR criteria, 5.1% met the FEP threshold and 10.6% had an established psychosis. Those on the psychosis spectrum reported greater disadvantage across sociodemographic and justice factors. The presence of perceptual disturbance and paranoid beliefs emerged as the two best screening items for identifying those with an underlying psychosis spectrum illness.
CONCLUSIONS: The prevalence of psychosis spectrum illness, including the UHR state, amongst those entering prison is high. Current prison mental health approaches should include screening for the presence of perceptual disturbances and paranoid beliefs to improve the detection of psychosis spectrum illness.
摘要：
目的：尽管在监狱中精神病患者的发病率很高，目前的监狱精神健康检查方法没有包括对整个精神病范围的评估,以捕获那些有新出现精神病风险的人以及那些已确诊疾病的人,也没有评估精神病症状筛查的同时有效性.
方法：使用临床分期方法来确定超高风险（UHR）的患病率，首发精神病（FEP）和既定精神病（EP）组，在新南威尔士州两个监狱接待中心被拘留的291名成年人完成了两个阶段（筛选和验证）的访谈过程。危险心理状态综合评估（CAARMS）用于确定精神病的临床阶段，并正式评估了症状筛查在识别精神病谱中的个体中的并发有效性。
结果：在进入监狱的男女中，近四分之一(24.1%)符合UHR标准，5.1%达到FEP阈值，10.6%患有精神病。精神病患者报告说，在社会人口统计学和正义因素方面存在更大的劣势。知觉障碍和偏执信念的存在成为识别患有潜在精神病谱系疾病的人的两个最佳筛查项目。
结论：精神病谱系疾病的患病率，包括UHR州，进入监狱的人很高。当前的监狱心理健康方法应包括筛查知觉障碍和偏执信念的存在，以改善对精神病谱系疾病的发现。
方法：使用临床分期方法来确定超高风险（UHR）的患病率，首发精神病（FEP）和既定精神病（EP）组，在新南威尔士州两个监狱接待中心被拘留的291名成年人完成了两个阶段（筛选和验证）的访谈过程。危险心理状态综合评估（CAARMS）用于确定精神病的临床阶段，并正式评估了症状筛查在识别精神病谱中的个体中的并发有效性。
结果：在进入监狱的男女中，近四分之一(24.1%)符合UHR标准，5.1%达到FEP阈值，10.6%患有精神病。精神病患者报告说，在社会人口统计学和正义因素方面存在更大的劣势。知觉障碍和偏执信念的存在成为识别患有潜在精神病谱系疾病的人的两个最佳筛查项目。
结论：精神病谱系疾病的患病率，包括UHR州，进入监狱的人很高。当前的监狱心理健康方法应包括筛查知觉障碍和偏执信念的存在，以改善对精神病谱系疾病的发现。
