The use of benzodiazepines and the mental health of women in prison: a cross-sectional study

In this article we assessed the prevalence of benzodiazepine (BZD) use in women before and during imprisonment, as well as its related factors and association with symptoms of anxiety, depression, and posttraumatic stress disorder in a quantitative, cross-sectional, analytical study of regional scope. Two female prisons in the Brazilian Prison System were included. Seventy-four women participated by completing questionnaires about their sociodemographic data, BZD use and use of other substances. These questionnaires included the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C). Of the 46 women who reported no BZDs use before arrest, 29 (63%) began using BZDs during imprisonment (p < 0.001). Positive scores for PTSD, anxiety, and depression, as well as associations between BZD use during imprisonment and anxiety (p = 0.028), depression (p = 0.001) and comorbid anxiety and depression (p = 0.003) were found when a bivariate Poisson regression was performed. When a multivariate Poisson regression was performed for tobacco use, the PHQ-9 and GAD-7 scales, BZD use was associated with depression (p = p = 0.008), with tobacco use (p = 0.012), but not with anxiety (p = 0.325). Imprisonment increases the psychological suffering of women, consequently increasing BZD use. Nonpharmacological measures need to be considered in the health care of incarcerated women.