Suicide is a leading cause of death during imprisonment. This systematic review aimed to synthesise available evidence of prison suicide incidence worldwide. We systematically searched the scientific literature, data repositories, and prison system reports, supplemented by correspondence with prison administrations. We included reports on people living in prison but excluded studies in preselected groups (by age or offence type). Absolute numbers and incidence rates of suicide mortality per 100 000 person-years by sex and country were extracted from 2000 to 2021. IQRs were used to describe the suicide incidence in different world regions. Incidence rate ratios comparing suicides of people living in prison with age-standardised general populations were calculated. We conducted meta-regression analyses on national-level and prison-level factors to examine heterogeneity. The study protocol was pre-registered with PROSPERO, CRD42021296819. We included three scientific studies, 124 official reports, and 11 datasets from email correspondence. Between 2000 and 2021, there were 29 711 reported suicides during 91·2 million person-years of imprisonment in 82 jurisdictions worldwide (sex-specific data available for 13 289 individuals: 12 544 [94·4%] male and 745 [5·6%] female individuals). There were large variations between countries, with most studies reporting suicide rates in the range of 24–89 per 100 000 person-years in both sexes (22–86 in male individuals and 25–107 in female individuals). In meta-regression analyses, Europe ( other regions), high-income countries ( low-income and middle-income countries), and countries with lower incarceration rates ( those with higher incarceration rates) had higher suicide rates. Incidence rate ratios between people who are incarcerated and age-standardised general populations in the same jurisdictions were typically in the range of 1·9–6·0 in male and 10·4–32·4 in female individuals. Prison services worldwide, and particularly in Europe, should prioritise suicide prevention. Assessment and management of suicide risk in female individuals living in prison need particular attention due to excess mortality relative to community-based populations. Interpretation of synthesised data needs to be done with caution due to high heterogeneity between jurisdictions. Agencia Nacional de Investigación y Desarrollo, Economic and Social Research Council, and Wellcome Trust.

中文翻译：

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全球监狱自杀发生率：荟萃回归分析的系统评价


自杀是监禁期间死亡的主要原因。这项系统评价旨在综合全世界监狱自杀发生率的现有证据。我们系统地检索了科学文献、数据存储库和监狱系统报告，并辅以与监狱管理部门的通信。我们纳入了有关监狱中囚犯的报告，但排除了预先选定的群体（按年龄或犯罪类型）的研究。提取了 2000 年至 2021 年按性别和国家/地区划分的每 10 万人年自杀死亡率的绝对人数和发生率。IQR 用于描述世界不同地区的自杀发生率。计算了监狱中的自杀者与年龄标准化的一般人群的自杀率比率。我们对国家层面和监狱层面的因素进行了元回归分析，以检验异质性。该研究方案已在 PROSPERO 预先注册，CRD42021296819。我们纳入了三项科学研究、124 份官方报告和 11 个来自电子邮件通信的数据集。 2000 年至 2021 年间，全球 82 个司法管辖区有 29 711 人报告在 91·200 万人年的监禁期间自杀（可获取 13 289 人的具体性别数据：12 544 [94·4%] 男性和 745 [5· 6%]女性个体）。各国之间存在很大差异，大多数研究报告，男女自杀率在每 10 万人年 24-89 人之间（男性为 22-86 人，女性为 25-107 人）。在元回归分析中，欧洲（其他地区）、高收入国家（低收入和中等收入国家）以及监禁率较低的国家（监禁率较高的国家）的自杀率较高。 同一辖区的被监禁者与年龄标准化一般人群之间的发病率比率通常在男性 1·9–6·0 范围内，女性在 10·4–32·4 范围内。世界各地的监狱服务，特别是欧洲的监狱服务，应优先考虑预防自杀。由于相对于社区人口而言死亡率过高，因此需要特别关注监狱中女性自杀风险的评估和管理。由于司法管辖区之间的高度异质性，需要谨慎地解释合成数据。 Agencia Nacional de Investigación y Desarrollo、经济和社会研究理事会以及 Wellcome Trust。