Center for Research on Environment Society and Health, School of GeoSciences, The University of Edinburgh, Edinburgh, United Kingdom.
Unit for Social and Community Psychiatry, WHO Collaborating Center for Mental Health Services Development, Queen Mary University of London, London, United Kingdom.
Epidemiol Rev. 2018 Jun 1;40(1):134-145. doi: 10.1093/epirev/mxx015.
People involved with criminal justice frequently are exposed to violence and traumatic experiences. This may lead to posttraumatic stress disorder (PTSD); however, no review, to our knowledge, has synthetized findings in this setting. We conducted a systematic review and meta-analysis to estimate prevalence rates of PTSD in prison populations. Original studies in which prevalence rates of PTSD in unselected samples of incarcerated people were reported were systematically searched between 1980 and June 2017. Data were pooled using random-effects meta-analysis, and sources of heterogeneity for prespecified characteristics were assessed by meta-regression. We identified 56 samples comprising 21,099 imprisoned men and women from 20 countries. Point prevalence of PTSD ranged from 0.1% to 27% for male, and from 12% to 38% for female prisoner populations. The random-effects pooled point prevalence was 6.2% (95% confidence interval: 3.9, 9.0) in male prisoners and 21.1% (95% confidence interval: 16.9, 25.6) in female prisoners. The heterogeneity between the included studies was very high. Higher prevalence was reported in samples of female prisoners, smaller studies (n ≤ 200), and for investigations based in high-income countries. Existing evidence shows high levels of PTSD among imprisoned people, especially women. Psychosocial interventions to prevent violence, especially against children and women, and to mitigate its consequences in marginalized communities must be improved. Trauma-informed approaches for correctional programs and scalable PTSD treatments in prisons require further consideration.
从事刑事司法工作的人经常会接触到暴力和创伤性经历。这可能导致创伤后应激障碍(PTSD);然而,据我们所知,还没有对这一领域的研究进行综述。我们进行了一项系统评价和荟萃分析,以评估监狱人群中 PTSD 的患病率。系统地检索了 1980 年至 2017 年 6 月期间未选择的被监禁人群中 PTSD 患病率的原始研究。使用随机效应荟萃分析汇总数据,并通过荟萃回归评估预先指定特征的异质性来源。我们确定了 56 个样本,这些样本来自 20 个国家的 21099 名男性和女性囚犯。男性囚犯 PTSD 的点患病率范围为 0.1%至 27%,女性囚犯为 12%至 38%。男性囚犯的随机效应汇总点患病率为 6.2%(95%置信区间:3.9,9.0),女性囚犯为 21.1%(95%置信区间:16.9,25.6)。纳入研究之间的异质性非常高。女性囚犯样本、较小的研究(n ≤ 200)和基于高收入国家的调查报告的患病率较高。现有证据表明,被监禁者,特别是女性,患有 PTSD 的比例很高。必须改善针对边缘化社区的暴力预防措施,特别是针对儿童和妇女的暴力预防措施,以及减轻暴力后果的措施。还需要进一步考虑针对矫正方案的创伤知情方法和监狱中可扩展的 PTSD 治疗方法。