Peters discusses some limitations in relation to our systematic
review of the prevelance of substance abuse and dependence in prisoners.
Peters states that we have not disaggregated findings obtained from
sentenced and unsentenced prisoners. In fact, in Table 3, we do present
the findings of sentenced and remand prisoners separately by gender, and
by type of substance (alcohol and drug).
Peters discusses some limitations in relation to our systematic
review of the prevelance of substance abuse and dependence in prisoners.
Peters states that we have not disaggregated findings obtained from
sentenced and unsentenced prisoners. In fact, in Table 3, we do present
the findings of sentenced and remand prisoners separately by gender, and
by type of substance (alcohol and drug).
Peters also states that we have reported the findings from his study
inaccurately. This depends on how the data are extracted. The Peters study
involved diagnostic interviews with 400 inmates consecutively admitted to
a state prison. Peters states that the prevalence of "drug use" was 36.8%
and "alcohol use" was 34.5% - and this uses denominators of 307 and 380
prisoners, respectively. However, we extracted the data for "dependence
disorder" rather than "use" - again, this is in order to be consistent
with the other included studies (where studies provided both data on
prevalences for "dependence" and "abuse or dependence", we used the
former). Further, we decided to use 400 inmates as the denominator. This
is based on an assumption that those who did not complete the protocols
were not substance dependent, which we believe is reasonable. Even if it
is not, as we did not meta-analyse the data, this does not alter our main
findings, and the alternative estimates from the Peters study fall within
the range of prevalences already given in our review. The alternative
prevalences for drug dependence would be 28.0% rather than 25.0%, and for
alcohol 26.3% rather than 21.5%.
Finally, Peters states that with changes in the types of drugs used
in the community, it is unclear whether the range of prevelances for drug
dependence would still be applicable. By eyeballing the figures in our
review, there does not appear to be any time trend for the prevalence
estimates in the included studies (1988-1998 in the men; 1996-2001 in the
women), periods when it is also likely for there to have been changes in
the types of drugs used in the community.
The summary notes in EBMH rightly state that the inclusion criterion
for sample size was not clearly reported in our review of reception
studies. In fact, we chose not to have a sample size criterion and all
studies - of any size - were included that met the other criteria.
Is it not just as plausible to postulate a relative protection
from schizophrenia in less developed countries that is inversely
proportional to their degree of development. In this scenario the
schizophrenia genotypes would be more prevalent in these countries and
only become more liable to expression upon migration. This of course
would be particularly so for those in the high risk years which a numbe...
Is it not just as plausible to postulate a relative protection
from schizophrenia in less developed countries that is inversely
proportional to their degree of development. In this scenario the
schizophrenia genotypes would be more prevalent in these countries and
only become more liable to expression upon migration. This of course
would be particularly so for those in the high risk years which a number
of first generation migrants would have traversed. This argument would be
supported by the well documented improved outcomes with schizophrenias in
the less developed world.
It would be interesting to know what proportion of the sample that
had the initial positive response maintain the improvement in the longer
term. This is important as tardive dyskinesia characteristically occurs
after prolonged neuroleptic therapy. There are several case reports of
long-term risperidone therapy causing tardive dyskinesia [1-5]. Recently a child in my
clinic developed tardive dyskines...
It would be interesting to know what proportion of the sample that
had the initial positive response maintain the improvement in the longer
term. This is important as tardive dyskinesia characteristically occurs
after prolonged neuroleptic therapy. There are several case reports of
long-term risperidone therapy causing tardive dyskinesia [1-5]. Recently a child in my
clinic developed tardive dyskinesia after being on risperidone for 18
months. Risperidone was used in this case to control the behavioural
symptoms of autism.
References:
1. Mullen A. Risperidone and tardive dyskinesia: a case of
blepharospasm. [Case Reports. Letter] Australian & New Zealand Journal
of Psychiatry. 34(5):879-80, 2000 Oct
2. Ipekci S. Birsoz S. Tardive dyskinesia caused by the atypical
antipsychotic risperidone and cured by the use of another drug of the same
class, olanzapine. [Case Reports. Letter] European Psychiatry: the Journal
of the Association of European Psychiatrists. 16(4):259-60, 2001 Jun.
3. Suzuki E. Obata M. Yoshida Y. Miyaoka H. Tardive dyskinesia with
risperidone and anticholinergics. [Case Reports. Letter] American Journal
of Psychiatry. 159(11):1948, 2002 Nov.
4. Karama S. Lal S. Tardive dyskinesia following brief exposure to
risperidone--a case study. [Case Reports. Letter] European Psychiatry: the
Journal of the Association of European Psychiatrists. 19(6):391-2, 2004
Sep
5. Kwon H. Tardive dyskinesia in an autistic patient treated with
risperidone. [Case Reports. Letter] American Journal of Psychiatry.
161(4):757-8, 2004 Apr
Dear Editor,
Peters discusses some limitations in relation to our systematic review of the prevelance of substance abuse and dependence in prisoners. Peters states that we have not disaggregated findings obtained from sentenced and unsentenced prisoners. In fact, in Table 3, we do present the findings of sentenced and remand prisoners separately by gender, and by type of substance (alcohol and drug).
Pet...
Dear Editor,
It would have been utterly helpful if you had included a citation for the APA-NAMI-NMHA-statement in your article - or the following hypertext- link: http://www.nmha.org/newsroom/system/news.vw.cfm?do=vw&rid=662.
Kind regards,
Th. Schumann
Dear Editor,
Is it not just as plausible to postulate a relative protection from schizophrenia in less developed countries that is inversely proportional to their degree of development. In this scenario the schizophrenia genotypes would be more prevalent in these countries and only become more liable to expression upon migration. This of course would be particularly so for those in the high risk years which a numbe...
Dear Editor,
It would be interesting to know what proportion of the sample that had the initial positive response maintain the improvement in the longer term. This is important as tardive dyskinesia characteristically occurs after prolonged neuroleptic therapy. There are several case reports of long-term risperidone therapy causing tardive dyskinesia [1-5]. Recently a child in my clinic developed tardive dyskines...