Prevalence of Epilepsy in Prisoners: Systematic Review

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Henry Maudsley, doyen of 19th century British psychiatry, believed that people with epilepsy were particularly prone to violence and criminality, a view shared by many leading psychiatrists and neurologists today. Epilepsy is typically claimed to be about two to four times more common in prisoners than in the general population, but the epidemiological evidence cited to support this claim is of uncertain validity.

Previous surveys of prisoners have involved unrepresentative populations, proxy measures (such as use of anticonvulsant drugs), and secondhand respondents (such as prison medical officers). To help clarify the evidence, we conducted a meta-analysis of available surveys based on personal clinical interviews in general prison populations.

We sought studies of the prevalence of epilepsy, fits, convulsion, or seizures in approximately general prison populations (that is, excluding studies of prisoners referred for neuropsychiatric assessment) reported between January 1966 and August 2001 by computer based searches (Embase, PsycINFO, Medline), scanning of relevant reference lists, and hand searching of forensic psychiatry journals and other relevant journals. We used combinations of keywords relating to epilepsy (for example, epilep*, seizure, fit, convulsion) and to prisoners (for example, inmate, sentenced, remand, detainee, felon). Eligible studies reported on an adult history of chronic epilepsy (defined as a condition characterised by two or more recurrent seizures, unprovoked by any immediately identifiable cause).

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References

Fazel S, Vassos E, Danesh J. BMJ. 2002 Jun 22;324(7352):1495.