Abstract：
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.
摘要：
自杀行为是全世界监狱发病率和死亡率的沉重负担。我们旨在综合有关监禁期间自杀未遂的患病率和危险因素的证据。在这篇系统综述和荟萃分析中，我们搜索了4个书目数据库(截至2022年5月31日发表)的研究报告,这些研究报告来自在被监禁期间自杀未遂的一般监狱人口和未经选择的对照组.共有20项研究，包括20个国家的19,882名个体（6.5%为女性），符合纳入条件。监禁期间自杀未遂的合并患病率男性为8.6％（95％CI6.1-11.2），女性为12.2％（95％CI7.1-17.2）。在所有研究的36个危险因素中，自杀意念的关联最强,以前的自我伤害，和精神病发病率的标志。监狱相关的危险因素包括单独监禁，受害,以及在被监禁期间得不到的社会支持.敏感性分析表明，几乎致命的自杀企图的危险因素与更普遍的自杀企图的危险因素相似。除了提供以前工作的综合，我们的系统综述强调了现有文献的几个关键局限性，这为今后的研究提供了方向。
