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A cross-sectional study was conducted on 215 incarcerated women. Participants were assessed using the Symptom Checklist-90-Revised (SCL-90-R) to evaluate mental health symptoms, Columbia Suicide Severity Rating Scale (C-SSRS) for suicide risk, and MULTICAGE CAD-4 to measure alcohol and drug addiction. The chi-square test and odds ratios were applied to identify associations between mental health outcomes and associated factors, with a significance level of 5%. Our findings revealed that 40% of the participants had some level of suicide risk. Alcohol consumption was reported by 36.7% of the participants; 59.5% screened positive for alcohol-related problems, and 45.6% used drugs, with 73.5% screening positive for drug-related problems. Depression (23.7%) and somatization (21.4%) were the most frequent dimensions of mental health symptoms. Younger women (aged 18\u201338 years) were significantly more vulnerable to hostility, psychoticism, and interpersonal sensitivity. The study also identified a significant relationship between substance use and suicide risk, with substance users more likely to exhibit suicidal tendencies. Our study highlights the urgent need for integrated mental health and substance use interventions in Paraguayan prisons, especially for younger women who are at higher risk of mental health disorders. Suicide prevention strategies should be prioritized by incorporating mental health and substance use treatments. Further research is needed to explore these issues longitudinally and in different prison environments.<\/jats:p>","DOI":"10.1177\/00258024251404779","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T17:02:57Z","timestamp":1766422977000},"page":"347-356","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["A first comprehensive picture of the mental health issues of female prisoners in Paraguay: Prevalence and associated factors"],"prefix":"10.1177","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3277-7036","authenticated-orcid":false,"given":"Julio","family":"Torales","sequence":"first","affiliation":[{"name":"Universidad Nacional de Asunci\u00f3n"},{"name":"Vicerrector\u00eda de Investigaci\u00f3n y Postgrado, Universidad de Los Lagos, Osorno, Chile"},{"name":"Facultad de Ciencias de la Salud, Universidad Sudamericana, Salto del Guair\u00e1, Paraguay"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gisselle","family":"Vel\u00e1zquez","sequence":"additional","affiliation":[{"name":"Universidad Nacional de Asunci\u00f3n"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gladys","family":"Estigarribia","sequence":"additional","affiliation":[{"name":"Universidad Nacional de Caaguaz\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Forrester","sequence":"additional","affiliation":[{"name":"Cardiff University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Amarilla","sequence":"additional","affiliation":[{"name":"Universidad Nacional de Asunci\u00f3n"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia R\u00edos","family":"Mujica","sequence":"additional","affiliation":[{"name":"Universidad Nacional de Caaguaz\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"Aguilar","sequence":"additional","affiliation":[{"name":"Ministerio de Salud P\u00fablica y Bienestar Social, Instituto Nacional de Salud, Asunci\u00f3n, Paraguay"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthon Daniel","family":"Torres-Romero","sequence":"additional","affiliation":[{"name":"Universidad Nacional de Asunci\u00f3n"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicol\u00e1s","family":"L\u00f3pez","sequence":"additional","affiliation":[{"name":"Universidad Nacional de Asunci\u00f3n"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sof\u00eda","family":"Gauto","sequence":"additional","affiliation":[{"name":"Universidad Nacional de Asunci\u00f3n"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo","family":"O\u2019Higgins","sequence":"additional","affiliation":[{"name":"Universidad Nacional de Asunci\u00f3n"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom\u00e1s","family":"Caycho-Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Universidad Cient\u00edfica del Sur"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3934-7007","authenticated-orcid":false,"given":"Antonio","family":"Ventriglio","sequence":"additional","affiliation":[{"name":"University of Foggia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9621-2291","authenticated-orcid":false,"given":"Jo\u00e3o Mauricio","family":"Castaldelli-Maia","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of S\u00e3o Paulo, S\u00e3o Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6843-7685","authenticated-orcid":false,"given":"Iv\u00e1n","family":"Barrios","sequence":"additional","affiliation":[{"name":"Facultad de Ciencias de la Salud, Universidad Sudamericana, Salto del Guair\u00e1, Paraguay"},{"name":"Facultad de Ciencias M\u00e9dicas, Filial Santa Rosa del Aguaray, C\u00e1tedra de Bioestad\u00edstica, Universidad Nacional de Asunci\u00f3n, Santa Rosa del Aguaray, Paraguay"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,22]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2019.00395"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.57.3.356"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1590\/1413-812320182311.30372016"},{"key":"e_1_3_3_5_2","first-page":"54","article-title":"Condiciones de vida de las mujeres recluidas en la Penitenciar\u00eda Regional de Concepci\u00f3n, a\u00f1o 2020","volume":"1","author":"Ram\u00edrez Gonz\u00e1lez KM","year":"2022","unstructured":"Ram\u00edrez Gonz\u00e1lez KM, Ara\u00fajo de Ben\u00edtez MC. 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