Prevalence and associated factors of mental disorders among prisoners in Mbarara municipality, southwestern Uganda: a cross-sectional study

BACKGROUND: Research in high income countries reports higher prevalence of mental disorders among prisoners than in the general population. Lack of published data from low resource settings affects planning and eventual service provision to the prisoners. This study aimed to determine the burden of mental disorders and associated factors among prisoners in Mbarara municipality in southwestern Uganda. METHODS: This was a prison facility based cross sectional study among 414 inmates in Mbarara municipality. We consecutively enrolled them by simple random sampling from 3 prison facilities. Participants completed a sociodemographic and clinical factor questionnaire, and the M.I.N.I. Version 6.0. Data were analyzed using STATA 12.0. Univariate, bivariate and multivariate logistic regression analyses were conducted to determine the prevalence, and associated factors using the individual odds ratios with their 95% Confidence Intervals and P-values as a measure of association, clinical and statistical significance respectively. RESULTS: A total of 354 (86%) prison-inmates met criteria for a psychiatric disorder. Of these, 338 (95%) had one or more diagnoses. Major depression was the most common diagnosis (44%). Factors associated with mental disorders included history of traumatic brain injury (OR = 2.57; 95% CI = 1.22-5.42; P-value = 0.01), low income status (OR = 0.32; 95% CI = 0.16-0.63; P-value = 0.001) and authoritarian parenting (OR = 0.37; 95% CI = 0.18-0.75; P-value = 0.006). CONCLUSIONS: There is a high prevalence of psychiatric illness among prisoners in Mbarara municipality with most of them having more than one diagnosis. Majority of the prisoners with mental illness go undiagnosed and untreated.