Faculty of Law and Criminology, Ghent University, Ghent, Belgium.
Division of Psychology and Mental Health, University of Manchester, Manchester, UK.
Clin Psychol Rev. 2022 Nov;97:102190. doi: 10.1016/j.cpr.2022.102190. Epub 2022 Aug 8.
Suicidal behaviour represents a substantial burden of morbidity and mortality in prisons worldwide. We aimed to synthesise the evidence on prevalence and risk factors for suicide attempts during incarceration. In this systematic review and meta-analysis, we searched four bibliographic databases for studies (published up to May 31, 2022) reporting on adults sampled from the general prison population who attempted suicide while incarcerated and an unselected comparison group. A total of 20 studies comprising 19,882 individuals (6.5% women) in 20 countries were eligible for inclusion. The pooled prevalence of suicide attempts during incarceration was 8.6% (95% CI 6.1-11.2) in men and 12.2% (95% CI 7.1-17.2) in women. Across all 36 risk factors studied, the strongest associations were found for suicidal ideation, previous self-harm, and markers of psychiatric morbidity. Prison-related risk factors included solitary confinement, victimisation, and poor social support while incarcerated. Sensitivity analyses indicate that risk factors for near-lethal suicide attempts are similar to those for suicide attempts more generally. In addition to providing a synthesis of previous work, our systematic review highlights several key limitations of the extant literature, which provide directions for future research.
自杀行为在全球监狱中造成了相当大的发病率和死亡率负担。我们旨在综合有关监禁期间自杀未遂的患病率和风险因素的证据。在这项系统评价和荟萃分析中，我们在四个文献数据库中搜索了（截至 2022 年 5 月 31 日）发表的研究报告，这些研究报告涉及从一般监狱人群中抽样的成年人，他们在监禁期间试图自杀，并与未选择的对照组进行了比较。共有 20 项研究符合纳入标准，共纳入了来自 20 个国家的 19882 名个体（6.5%为女性）。男性在监禁期间自杀未遂的总患病率为 8.6%（95%CI 6.1-11.2），女性为 12.2%（95%CI 7.1-17.2）。在所有研究的 36 个风险因素中，与自杀意念、既往自残和精神疾病标志物的关联最强。与监狱相关的风险因素包括单独监禁、受害和监禁期间社会支持不足。敏感性分析表明，接近致命自杀企图的风险因素与一般自杀企图的风险因素相似。除了对以往工作进行综合外，我们的系统评价还突出了现有文献的几个关键局限性，为未来的研究提供了方向。
