The problem of co-occurring disorders among jail detainees - Antisocial disorder, alcoholism, drug abuse, and depression

This paper documents the degree and pattern of overlap of antisocial disorder. alcoholism. drug use disorders, and major depression among 688 randomly selected male jail detainees. Diagnostic assessments were made using the NIMH Diagnostic Interview Schedule. Data indicate that multiple disorders are a serious problem among male detainees. Detainees were more likely to have two or three disorders than to have a single disorder. Of detainees, 44% had a lifetime prevalence of two or more of these syndromes. Few subjects with multiple disorders were found to have primary, or initial onset of, substance abuse disorders or primary depression. Rather, antisocial disorder predominated as the primary syndrome in diagnostic profiles. The preponderance of antisocial disorder among codisordered detainees is disturbing because it is a poor prognostic indicator. Implications for substance abuse intervention, treatment of depression, and intervention with antisocial personality disorder among detainees are discussed.