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.

自杀行为是全世界监狱中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流行率和危险因素的证据。在本系统综述中和荟萃分析，我们搜索了四个书目数据库的研究（发布至 2022 年 5 月 31 日），这些研究报告了从普通监狱人口中抽取的在监禁期间企图自杀的成年人和一个未选择的对照组。共有 20 项研究符合纳入条件，包括 20 个国家的 19,882 人（6.5% 为女性）。监禁期间自杀未遂的综合患病率男性为 8.6%（95% CI 6.1-11.2），女性为 12.2%（95% CI 7.1-17.2）。在研究的所有 36 个风险因素中，发现自杀意念、以前的自残和精神病发病率标志物的关联性最强。监狱相关风险因素包括孤独监禁、受害和缺乏社会支持。敏感性分析表明，近乎致命的自杀企图的危险因素与更普遍的自杀企图相似。除了提供以前工作的综合之外，我们的系统评价还强调了现有文献的几个关键局限性，为未来的研究提供了方向。