Mental disorders in pregnant and lactating women deprived of liberty in the prison system: systematic review
Bibliographic record
Abstract
Introduction: Female incarceration has increased due to several factors, including changes in criminal policies, social and economic inequalities, abuse of psychoactive substances and issues related to gender and mental health. Being a woman and experiencing pregnancy or lactation in the prison system can be an even more challenging and difficult experience due to precarious sanitary conditions, lack of adequate medical care, stigma, isolation and separation from the child. Objective: Analyze mental disorders among pregnant and lactating women in the female prison system. Method: This is a systematic review, which evaluates and brings together similar studies for statistical analysis. To write this review, the PRISMA checklist guidelines were followed. Furthermore, the protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO) platform, under registration number CRD42022350737. Using the PECOT strategy (Population, Exposure, Control, Outcomes/Outcomes and Types of Studies/Observational), the research question was constructed: “what are the mental disorders among pregnant and lactating women in the female prison system?” Included were studies on pregnant women and the development of mental disorders (depression, anxiety, stress and insomnia, postpartum depression) during incarceration in comparison to pregnant women not exposed to incarceration or deprivation of liberty in the prison system. Literature reviews, case series, case reports and qualitative studies were not considered. Searches were carried out in the following databases: PubMed, Web of Science, Embase, Latin American and Caribbean Literature in Health Sciences (LILACS), Scopus and Nursing Database (BDENF), without restriction on the language of the articles or of the year of publication. The search strategy used medical subjective vocabularies (MeSH) and a variety of other keywords. To assess the risk of bias, the Newcastle Ottawa Scale was used to assess the methodological quality of the research, while the Grading of Recommendations Assessment, Developing and Evaluation (GRADE) method was used to classify the evidence into the quality levels of the studies. Results: Of the 2165 studies found, the final sample consisted of four articles. The analysis and level of methodological quality were carried out, as well as the strength of recommendation of the evidence with the GRADE system. The studies were carried out in the last decade, in the United States and Canada and evaluated regarding characteristics, implementation and evaluation of the evidence. The prevalent mental disorders found in pregnant and lactating women in the women's prison system were anxiety, common mental disorders, schizophrenia, self-mutilation, and postpartum depression. It is believed that the prevalence outcomes presented a risk of bias to the detriment of contextual specificity, making the results provocative for carrying out interventions in the scenario. Final considerations: It was concluded that there is an increase in mental disorders in pregnant and lactating women in the prison system, indicating a growing trend, as the context of imprisonment increases illness and psychological suffering. However, it is suggested that new studies be carried out to better elucidate the prison scenario, as well as to develop measurement instruments/scales aimed at the prison scenario due to the uniqueness of the environment.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.026 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.004 |
| Bibliometrics | 0.009 | 0.011 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".