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Title: Treatment for female patients with eating disorders in the largest medical prison in Japan
Authors: Asami, Tomokuni
Yanase, Maya  kyouindb  KAKEN_id
Nomura, Toshiaki
Okubo, Yoshiro
Author's alias: 梁瀬, まや
Keywords: Anorexia nervosa
Eating disorder
Prison
Crime
Drug-offense
Correctional facility
Shoplifting
Excessive exercise
Antisocial behavior
Issue Date: 13-May-2015
Publisher: BioMed Central Ltd.
Journal title: BioPsychoSocial Medicine
Volume: 9
Thesis number: 13
Abstract: The number of offenders with eating disorders in women's prisons in Japan has grown annually over the last 15 years. Women's prisons have experienced significant difficulties in the management of patients with eating disorders who have body-critical complications arising from low body weight, in addition to behavioral problems. Patients in Japan's 185 correctional facilities who display high refractoriness or who present a physical risk are transferred to the Hachioji medical prison, a national specialty hospital operated by the Ministry of Justice. The medical prison must manage any psychosomatic problems necessary for the safety of inmates regardless of a patient's wishes. The most common conviction resulting in imprisonment of women with eating disorders was shoplifting (n = 44; 63%), with the second most common being drug-offenses (n = 17; 24%). While shoplifting is of concern in relation to eating disorders, a causal relationship remains unclear. Most patients in the shoplifting group did not have histories of antisocial and/or impulsive behaviors such as drug abuse, sexual deviation, self-injury, or other criminal activity. Instead, shoplifting appears to be an obsessive-compulsive behavior deeply rooted in the psychopathology of severe eating disorder patients. Patients in this group tended to have histories of relatively high education and steady employment, although most also had histories of prolonged eating disorders and unstable treatment. Although adherence to treatment was poor among patients with eating disorders in the medical prison, body weight and behavioral problems improved following treatment in the special compulsory environment, without severe sequelae or patient death. The Ministry of Justice recently established another specialized ward for the care for female patients with eating disorders. If greater emphasis is placed on early-stage, protective, medical treatment, the number of patients with eating disorders in prisons may decrease. Further research is required to investigate the relationship between shoplifting and eating disorders.
Rights: © 2015 Asami et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.
URI: http://hdl.handle.net/2433/212505
DOI(Published Version): 10.1186/s13030-015-0040-6
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