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Rauschmittelkonsum und unzureichende Hygiene sind weitverbreitet. Typische Erkrankungen im Vollzug sind Hautkrankheiten, Infektionskrankheiten wie HIV und Hepatitis sowie ern\u00e4hrungsbedingte Mangelzust\u00e4nde. H\u00e4ufig treten zudem psychische St\u00f6rungen sowie Selbst- und Fremdverletzungen auf. Der medizinische Dienst im Justizvollzug \u2013\u00a0die sogenannte Gef\u00e4ngnismedizin\u00a0\u2013 steht daher im Vergleich zur regul\u00e4ren medizinischen Versorgung au\u00dferhalb der Anstalten vor besonderen Herausforderungen, insbesondere im diagnostischen Bereich. Dies betrifft unter anderem die Beurteilung der Haftf\u00e4higkeit, die Indikation spezifischer Therapien (z.\u202fB. Sozialtherapie, Suchttherapie, Suizidpr\u00e4vention) sowie prognostische Fragestellungen, etwa im Zusammenhang mit Vollzugslockerungen und dem hierbei bestehenden Missbrauchsrisiko, das vom Gefangenen ausgeht. Aus \u00e4rztlicher Sicht ist zudem zu ber\u00fccksichtigen, dass Aggravation, also die absichtliche \u00dcbertreibung tats\u00e4chlicher Symptome, sowie die Simulation von Erkrankungen eine gewisse Rolle spielen k\u00f6nnen. Der Artikel gibt einen \u00dcberblick \u00fcber die diagnostischen Herausforderungen, insbesondere aus juristischer Perspektive.<\/jats:p>","DOI":"10.1007\/s00103-025-04150-1","type":"journal-article","created":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T13:23:20Z","timestamp":1764249800000},"page":"1368-1375","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostische Herausforderungen in der Gef\u00e4ngnismedizin","Diagnostical challenges for medicine in prisons"],"prefix":"10.1007","volume":"68","author":[{"given":"Helmut","family":"Poll\u00e4hne","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,11,27]]},"reference":[{"volume-title":"Gef\u00e4ngnismedizin","year":"2009","key":"4150_CR1","unstructured":"Keppler\u00a0K, St\u00f6ver\u00a0H (Hrsg) (2009) Gef\u00e4ngnismedizin. 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