Department of Psychiatry, Wollo University, College of Medicine and Health Sciences, Dessie, Ethiopia.
BMC Psychiatry. 2020 Jun 5;20(1):281. doi: 10.1186/s12888-020-02662-5.
The burden of depression in prisoners is increasing and factors such as co-existence of medical illness, lack of social support and longer duration of sentences are contributing to it. However, no pooled evidence on the magnitude and factors of depression in prisoners existed in Ethiopia. The current meta-analysis was therefore aimed to have aggregate evidence on the magnitude and factors of depression in prisoners of Ethiopia.
A search of databases on PubMed, Scopus, and EMBASE was carried out systematically. Besides, grey literature sources were extensively investigated. Moreover, the reference lists of the articles selected were searched. Random effects and quality-effects models were used to describe the pooled prevalence of depressive symptoms with 95% CI. We also detect heterogeneity between studies using Cochran's Q- statistic and the Higgs I test. A sensitivity analysis was also implemented. Publication bias was checked with Egger's test and funnel plots visually.
Among 232 papers identified through the specified database searches only 17 full-text articles were assessed for eligibility and only nine (9) studies fulfilled the prespecified criteria and incorporated in the final meta-analysis. The pooled prevalence of Depressive symptoms among prisoners was 53.40%(95% CI: 41.33, 65.46). The pooled prevalence of Depressive symptoms in prisoners was 41.9% in Southwest Ethiopia, 44.43% in North West of Ethiopia, 59.05% in Addis Ababa, and 72.7% Southern Ethiopia. Besides, the pooled Depression symptoms prevalence among prisoners was 51.24% as measured with PHQ-9 and 56.15% with BDI-II. Besides, studies that utilized a relatively large sample size (≥350) yields a smaller pooled prevalence of Depression symptoms, 51.93% than those which utilized smaller sample sizes (< 350); 54.13%.
The pooled magnitude of depression in prisoner's population is very high, 53.40%. This pooled effect size for the Depression symptoms was significantly higher in the southern region of the country than in the southwest region. Besides, the pooled prevalence was significantly higher as measured by the BDI-II tool than by PHQ-9. Also, studies that utilized a larger sample size provided a significantly lower pooled magnitude of symptoms of depression than studies that utilized a smaller sample size.
囚犯中的抑郁负担正在增加，共存的医疗疾病、缺乏社会支持和刑期延长等因素都促成了这一负担。然而，在埃塞俄比亚，没有关于囚犯中抑郁程度和相关因素的综合证据。因此，目前的荟萃分析旨在提供关于埃塞俄比亚囚犯中抑郁程度和相关因素的综合证据。
我们系统地在 PubMed、Scopus 和 EMBASE 数据库上进行了搜索。此外，还广泛调查了灰色文献来源。此外，还检索了所选文章的参考文献列表。使用随机效应和质量效应模型，以 95%置信区间（CI）描述抑郁症状的汇总患病率。我们还使用 Cochran 的 Q 统计量和 Higgs I 检验来检测研究之间的异质性。还进行了敏感性分析。使用 Egger 检验和漏斗图来检查发表偏倚。
在通过指定数据库搜索确定的 232 篇论文中，只有 17 篇全文文章被评估为符合入选标准，只有 9 项研究符合预定标准并纳入最终荟萃分析。囚犯中抑郁症状的汇总患病率为 53.40%（95%CI：41.33，65.46）。在埃塞俄比亚西南部，囚犯中抑郁症状的汇总患病率为 41.9%，在埃塞俄比亚西北部为 44.43%，在亚的斯亚贝巴为 59.05%，在南部为 72.7%。此外，使用 PHQ-9 测量的囚犯中抑郁症状的汇总患病率为 51.24%，使用 BDI-II 测量的患病率为 56.15%。此外，利用较大样本量（≥350）的研究产生的抑郁症状汇总患病率较小，为 51.93%，而利用较小样本量（<350）的研究产生的汇总患病率较高，为 54.13%。
囚犯人群中抑郁的总体程度非常高，为 53.40%。与该国西南部地区相比，该国南部地区的这一汇总效应大小明显更高。此外，使用 BDI-II 工具测量的汇总患病率明显高于使用 PHQ-9 工具测量的患病率。此外，利用较大样本量的研究提供的抑郁症状汇总幅度明显低于利用较小样本量的研究。
