Prevalence of Traumatic Brain Injury in Prisons in Scotland

McMillan, T. (2016) Prevalence of Traumatic Brain Injury in Prisons in Scotland. The International Brain Injury Association’s Eleventh World Congress on Brain Injury, The Hague, The Netherlands, 02-05 Mar 2016.

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Objectives: Published findings of estimates of prevalence of traumatic brain injury (TBI) in prisons range widely between 25–87%. These estimates are often based on selected or non-representative sub-groups of the prison population and are without exception, based on self-report. This study investigates the prevalence of recorded hospitalized TBI from medical records in the prison population in three prisons in the West of Scotland Methods: This is a data linkage study. Everyone in Scotland has a unique National Health Service identification number which is noted in all prison admissions. This was linked to the NHS database of all hospital admissions (Scottish Morbidity Records-01) for all prison inmates in the Glasgow area in Scotland on a census date in 2014 to determine the prevalence of hospitalized TBI. Scottish Morbidity Records classify disease using ICD codes. TBI was defined according to the ICD-9 and ICD-10 codes (ICD-9: 800, 801, 803, 804 and 850–854; ICD 10: S02.0, S02.1, S02.7–S02.9, S06.0–S06.9 and S09.90). Results: Of 1135 prisoners, 97% were male, reflecting the admission policy of the prisons. Analyses were restricted to the 1096 male prisoners. Of these 327/1096 (30%) had a past hospital admission with a head injury. The prevalence of hospitalized HI in males in the general population in the Glasgow area who were in the same age range as the prison population (i.e. 21–72) at the census date and over the same exposure period (1981–2014) was 12%. Hence, the prevalence of HI in the prison population (30%) was 2.5-times that in the general population. The proportion of prison inmates who sustained a TBI before the age of 25 was also higher (41%) than for the general population (14%). Conclusions: There is a higher prevalence of hospitalized TBI in prisoners than in the general population and the TBI is more likely to have occurred before the age of 25, during which time the prefrontal cortex continues to develop. These findings are discussed in the context if indicators of the severity of TBI and implications for recidivism and rehabilitation.

Item Type:Conference or Workshop Item
Glasgow Author(s) Enlighten ID:McMillan, Professor Tom
Authors: McMillan, T.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing

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