A cross-sectional comparative study of insomnia, depression, and suicidality between male and female prisoners of Guwahati Central Jail

Background: Female prisoners are consistently reported to suffer more from insomnia, affective disturbances, and higher suicide rates than males. Objective: To compare the prevalence of insomnia, depression, and suicidality between male and female inmates, and to probe how the internal turmoil and the psychological burden consequent of the committed crime influences these morbid occurrences. Method: Forty male and 40 female prisoners of Guwahati Central Jail, Assam, India were assessed clinically and Beck Depression Inventory II, Pittsburgh Insomnia Rating Scale, and Columbia Suicide Severity Rating Scale were administered. Appropriate statistical tests for categorical and continuous variables were performed with significance defined as p<0.05. Results: Prevalence of depression was 62.5 per 100 males and 85 per 100 females (p=0.04), that of insomnia and suicidal ideation were 65% and 72.5% (p<0.01), and ten per cent and 30% for male and female prisoners respectively (p<0.05). The relative risk of suicide was 0.33. Depression, insomnia, and suicidality were significantly associated with longer duration of stay, convict status, presence of physical illness, any substance abuse, and with higher age of their children in female prisoners; whereas, male prisoners had a striking association of the studied morbidities with under trial status and being free from any physical illness. Conclusions: Although limited in its inability to attribute causality, our study conclusively demonstrated increased prevalence of depression, insomnia, and suicidality in female prisoners. Penal status, duration of stay, comorbid physical illness, substance abuse, and factors related to motherhood negatively influenced the fairer sex in custody.