Risk factors for self-harm in prison: a systematic review and meta-analysis.
Identifieur interne : 000117 ( Main/Exploration ); précédent : 000116; suivant : 000118Risk factors for self-harm in prison: a systematic review and meta-analysis.
Auteurs : Louis Favril [Belgique] ; Rongqin Yu [Royaume-Uni] ; Keith Hawton [Royaume-Uni] ; Seena Fazel [Royaume-Uni]Source :
- The lancet. Psychiatry [ 2215-0374 ] ; 2020.
Descripteurs français
- KwdFr :
- Comportement auto-agressif (mortalité), Comportement auto-agressif (psychologie), Droit pénal (organisation et administration), Facteurs de risque (MeSH), Femelle (MeSH), Humains (MeSH), Idéation suicidaire (MeSH), Mâle (MeSH), Prisonniers (psychologie), Prisonniers (statistiques et données numériques), Santé mentale (normes), Tentative de suicide (prévention et contrôle), Tentative de suicide (statistiques et données numériques), Trouble de la personnalité limite (psychologie), Trouble dépressif majeur (psychologie), Troubles mentaux (épidémiologie), Victimes de crimes (psychologie), Études cas-témoins (MeSH), Études d'évaluation comme sujet (MeSH), Études observationnelles comme sujet (MeSH).
- MESH :
- mortalité : Comportement auto-agressif.
- normes : Santé mentale.
- organisation et administration : Droit pénal.
- prévention et contrôle : Tentative de suicide.
- psychologie : Comportement auto-agressif, Prisonniers, Trouble de la personnalité limite, Trouble dépressif majeur, Victimes de crimes.
- statistiques et données numériques : Prisonniers, Tentative de suicide.
- épidémiologie : Troubles mentaux.
- Facteurs de risque, Femelle, Humains, Idéation suicidaire, Mâle, Études cas-témoins, Études d'évaluation comme sujet, Études observationnelles comme sujet.
English descriptors
- KwdEn :
- Borderline Personality Disorder (psychology), Case-Control Studies (MeSH), Crime Victims (psychology), Criminal Law (organization & administration), Depressive Disorder, Major (psychology), Evaluation Studies as Topic (MeSH), Female (MeSH), Humans (MeSH), Male (MeSH), Mental Disorders (epidemiology), Mental Health (standards), Observational Studies as Topic (MeSH), Prisoners (psychology), Prisoners (statistics & numerical data), Risk Factors (MeSH), Self-Injurious Behavior (mortality), Self-Injurious Behavior (psychology), Suicidal Ideation (MeSH), Suicide, Attempted (prevention & control), Suicide, Attempted (statistics & numerical data).
- MESH :
- epidemiology : Mental Disorders.
- mortality : Self-Injurious Behavior.
- organization & administration : Criminal Law.
- prevention & control : Suicide, Attempted.
- psychology : Borderline Personality Disorder, Crime Victims, Depressive Disorder, Major, Prisoners, Self-Injurious Behavior.
- standards : Mental Health.
- statistics & numerical data : Prisoners, Suicide, Attempted.
- Case-Control Studies, Evaluation Studies as Topic, Female, Humans, Male, Observational Studies as Topic, Risk Factors, Suicidal Ideation.
Abstract
BACKGROUND
Self-harm is a leading cause of morbidity in prisoners. Although a wide range of risk factors for self-harm in prisoners has been identified, the strength and consistency of effect sizes is uncertain. We aimed to synthesise evidence and assess the risk factors associated with self-harm inside prison.
METHODS
In this systematic review and meta-analysis, we searched four electronic databases (PubMed, Embase, Web of Science, and PsycINFO) for observational studies on risk factors for self-harm in prisoners published from database inception to Oct 31, 2019, supplemented through correspondence with authors of studies. We included primary studies involving adults sampled from general prison populations who self-harmed in prison and a comparison group without self-harm in prison. We excluded studies with qualitative or ecological designs, those that reported on lifetime measures of self-harm or on selected samples of prisoners, and those with a comparison group that was not appropriate or not based on general prison populations. Data were extracted from the articles and requested from study authors. Our primary outcome was the risk of self-harm for risk factors in prisoners. We pooled effect sizes as odds ratios (OR) using random effects models for each risk factor examined in at least three distinct samples. We assessed study quality on the basis of the Newcastle-Ottawa Scale and examined between-study heterogeneity. The study protocol was registered with PROSPERO, CRD42018087915.
FINDINGS
We identified 35 independent studies from 20 countries comprising a total of 663 735 prisoners, of whom 24 978 (3·8%) had self-harmed in prison. Across the 40 risk factors examined, the strongest associations with self-harm in prison were found for suicide-related antecedents, including current or recent suicidal ideation (OR 13·8, 95% CI 8·6-22·1; I
INTERPRETATION
The wide range of risk factors across clinical and custody-related domains underscores the need for a comprehensive, prison-wide approach towards preventing self-harm in prison. This approach should incorporate both population and targeted strategies, with multiagency collaboration between the services for mental health, social care, and criminal justice having a key role.
FUNDING
Wellcome Trust.
DOI: 10.1016/S2215-0366(20)30190-5
PubMed: 32711709
PubMed Central: PMC7606912
Affiliations:
- Belgique, Royaume-Uni
- Angleterre, Oxfordshire, Province de Flandre-Orientale, Région flamande
- Gand, Oxford
- Université d'Oxford, Université de Gand
Links toward previous steps (curation, corpus...)
Le document en format XML
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Although a wide range of risk factors for self-harm in prisoners has been identified, the strength and consistency of effect sizes is uncertain. We aimed to synthesise evidence and assess the risk factors associated with self-harm inside prison.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>In this systematic review and meta-analysis, we searched four electronic databases (PubMed, Embase, Web of Science, and PsycINFO) for observational studies on risk factors for self-harm in prisoners published from database inception to Oct 31, 2019, supplemented through correspondence with authors of studies. We included primary studies involving adults sampled from general prison populations who self-harmed in prison and a comparison group without self-harm in prison. We excluded studies with qualitative or ecological designs, those that reported on lifetime measures of self-harm or on selected samples of prisoners, and those with a comparison group that was not appropriate or not based on general prison populations. Data were extracted from the articles and requested from study authors. Our primary outcome was the risk of self-harm for risk factors in prisoners. We pooled effect sizes as odds ratios (OR) using random effects models for each risk factor examined in at least three distinct samples. We assessed study quality on the basis of the Newcastle-Ottawa Scale and examined between-study heterogeneity. The study protocol was registered with PROSPERO, CRD42018087915.</p></div><div type="abstract" xml:lang="en"><p><b>FINDINGS</b></p><p>We identified 35 independent studies from 20 countries comprising a total of 663 735 prisoners, of whom 24 978 (3·8%) had self-harmed in prison. Across the 40 risk factors examined, the strongest associations with self-harm in prison were found for suicide-related antecedents, including current or recent suicidal ideation (OR 13·8, 95% CI 8·6-22·1; I</p></div><div type="abstract" xml:lang="en"><p><b>INTERPRETATION</b></p><p>The wide range of risk factors across clinical and custody-related domains underscores the need for a comprehensive, prison-wide approach towards preventing self-harm in prison. This approach should incorporate both population and targeted strategies, with multiagency collaboration between the services for mental health, social care, and criminal justice having a key role.</p></div><div type="abstract" xml:lang="en"><p><b>FUNDING</b></p><p>Wellcome Trust.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32711709</PMID><DateCompleted><Year>2020</Year><Month>08</Month><Day>07</Day></DateCompleted><DateRevised><Year>2021</Year><Month>01</Month><Day>10</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">2215-0374</ISSN><JournalIssue CitedMedium="Internet"><Volume>7</Volume><Issue>8</Issue><PubDate><Year>2020</Year><Month>08</Month></PubDate></JournalIssue><Title>The lancet. Psychiatry</Title><ISOAbbreviation>Lancet Psychiatry</ISOAbbreviation></Journal><ArticleTitle>Risk factors for self-harm in prison: a systematic review and meta-analysis.</ArticleTitle><Pagination><MedlinePgn>682-691</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S2215-0366(20)30190-5</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/S2215-0366(20)30190-5</ELocationID><Abstract><AbstractText Label="BACKGROUND">Self-harm is a leading cause of morbidity in prisoners. Although a wide range of risk factors for self-harm in prisoners has been identified, the strength and consistency of effect sizes is uncertain. We aimed to synthesise evidence and assess the risk factors associated with self-harm inside prison.</AbstractText><AbstractText Label="METHODS">In this systematic review and meta-analysis, we searched four electronic databases (PubMed, Embase, Web of Science, and PsycINFO) for observational studies on risk factors for self-harm in prisoners published from database inception to Oct 31, 2019, supplemented through correspondence with authors of studies. We included primary studies involving adults sampled from general prison populations who self-harmed in prison and a comparison group without self-harm in prison. We excluded studies with qualitative or ecological designs, those that reported on lifetime measures of self-harm or on selected samples of prisoners, and those with a comparison group that was not appropriate or not based on general prison populations. Data were extracted from the articles and requested from study authors. Our primary outcome was the risk of self-harm for risk factors in prisoners. We pooled effect sizes as odds ratios (OR) using random effects models for each risk factor examined in at least three distinct samples. We assessed study quality on the basis of the Newcastle-Ottawa Scale and examined between-study heterogeneity. The study protocol was registered with PROSPERO, CRD42018087915.</AbstractText><AbstractText Label="FINDINGS">We identified 35 independent studies from 20 countries comprising a total of 663 735 prisoners, of whom 24 978 (3·8%) had self-harmed in prison. Across the 40 risk factors examined, the strongest associations with self-harm in prison were found for suicide-related antecedents, including current or recent suicidal ideation (OR 13·8, 95% CI 8·6-22·1; I<sup>2</sup>=49%), lifetime history of suicidal ideation (8·9, 6·1-13·0; I<sup>2</sup>=56%), and previous self-harm (6·6, 5·3-8·3; I<sup>2</sup>=55%). Any current psychiatric diagnosis was also strongly associated with self-harm (8·1, 7·0-9·4; I<sup>2</sup>=0%), particularly major depression (9·3, 2·9-29·5; I<sup>2</sup>=91%) and borderline personality disorder (9·2, 3·7-22·5; I<sup>2</sup>=81%). Prison-specific environmental risk factors for self-harm included solitary confinement (5·6, 2·7-11·6; I<sup>2</sup>=98%), disciplinary infractions (3·5, 1·2-9·7; I<sup>2</sup>=99%), and experiencing sexual or physical victimisation while in prison (3·2, 2·1-4·8; I<sup>2</sup>=44%). Sociodemographic (OR range 1·5-2·5) and criminological (1·8-2·3) factors were only modestly associated with self-harm in prison. We did not find clear evidence of publication bias.</AbstractText><AbstractText Label="INTERPRETATION">The wide range of risk factors across clinical and custody-related domains underscores the need for a comprehensive, prison-wide approach towards preventing self-harm in prison. This approach should incorporate both population and targeted strategies, with multiagency collaboration between the services for mental health, social care, and criminal justice having a key role.</AbstractText><AbstractText Label="FUNDING">Wellcome Trust.</AbstractText><CopyrightInformation>Copyright © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Favril</LastName><ForeName>Louis</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Institute for International Research on Criminal Policy, Faculty of Law and Criminology, Ghent University, Ghent, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yu</LastName><ForeName>Rongqin</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hawton</LastName><ForeName>Keith</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Centre for Suicide Research, Warneford Hospital, University of Oxford, Oxford, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fazel</LastName><ForeName>Seena</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK. Electronic address: seena.fazel@psych.ox.ac.uk.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D017418">Meta-Analysis</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType><PublicationType UI="D000078182">Systematic Review</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Lancet Psychiatry</MedlineTA><NlmUniqueID>101638123</NlmUniqueID><ISSNLinking>2215-0366</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Lancet Psychiatry. 2020 Aug;7(8):649-650</RefSource><PMID Version="1">32711695</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D001883" MajorTopicYN="N">Borderline Personality Disorder</DescriptorName><QualifierName UI="Q000523" MajorTopicYN="N">psychology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016022" MajorTopicYN="N">Case-Control Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019548" MajorTopicYN="N">Crime Victims</DescriptorName><QualifierName UI="Q000523" MajorTopicYN="N">psychology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003416" MajorTopicYN="N">Criminal Law</DescriptorName><QualifierName UI="Q000458" MajorTopicYN="N">organization & administration</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003865" MajorTopicYN="N">Depressive Disorder, Major</DescriptorName><QualifierName UI="Q000523" MajorTopicYN="N">psychology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005069" MajorTopicYN="N">Evaluation Studies as Topic</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" 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