Vulnerability Markers of Anxiety and Depressive Symptoms in Prisoners in Ceará, Brazil

Objective: This study aims to analyze the predictors of anxiety and depression symptoms among prisoners in Ceará, Brazil, comparing the LGBTQIA+ and cisgender heterosexual groups. Methods: This is a cross-sectional study conducted in all prison units in the state of Ceará, Brazil, from May to September 2022 with 2,097 participants, of which 1,756 were cisgender heterosexuals and 341 LGBTQIA+ individuals. Predictor variables were categorized into individual, social, and programmatic vulnerabilities based on a framework and the outcome were measured with the Hospital Anxiety and Depression Scale. Data were analyzed using the JAMOVI statistical software. The study was approved by the Research Ethics Committee under protocol number 5.379.780. Results: Anxiety symptoms were higher (74.5% vs. 73.2%) among the cisgender heterosexual prisoners and depressive symptoms higher (76.7% vs. 75.3%) in the LGBTQIA+ prison population, with no statistical difference between the two groups. Significant associations were found between anxiety, depression, and individual, social, and programmatic vulnerabilities in the incarcerated population. Conclusion: These findings contribute to a deeper understanding of the vulnerabilities which the prison population is exposed, identifying factors that may influence mental health-related outcomes in this population. Such insights aim to support interventions to improve these groups’ mental health indicators.