Global Estimates of the Prevalence of Depression among Prisoners: A Systematic Review and Meta-analysis

Abstract

Background. Prison populations tend to be marginalized and disadvantaged of the rights and freedoms that other people in the community benefit from. Their separation from families, a narrow room and lack of privacy in the prison, violence between prisoners, and the uncertainty about the future result in psychological distress, for example, depression. The review has synthesized previous studies conducted on the topic and summarized to formulate recommendations for future prison health care services. Methods. We systematically searched the databases: PubMed, Psych Info, and SCOPUS, as well as manual Google Scholar searches, were conducted to retrieve published literature globally. We have included observational studies, written in English language. Estimates were pooled using a random-effects model. The study protocol was registered in PROSPERO with protocol number CRD42020156108. Subgroup and sensitivity analysis was conducted, and heterogeneity across the studies was evaluated using Q and the $I^2$ -test. Publication bias was assessed by inspection of the funnel plot and Egger’s regression test. Result. A total of 1313 studies were initially identified through the electronic database; among these, a total of 73 full-text articles were retrieved for further appraisal. Further, 32 full-text articles were included in the final systematic review and meta-analysis. In this meta-analysis, the pooled prevalence of depression among prisoners was 36.9% (95% CI; 27.3-47.6). The pooled prevalence of depression among prisoners in the developing and developed countries was 39.2% and 33.1%, respectively. Moreover, the prevalence of depression was 19.1% and 54% for the studies that used diagnostic and screen tools to diagnose or screen depression, respectively. A leave-one-out analysis revealed that the pooled prevalence of depression among prisoners was not dependent on a single study removal or addition. Thus, the pooled prevalence of depression ranges between 35.3 and 38.0%. Conclusion. The prevalence of depression among prisoners was high. Therefore, regular and continuous screening of depressive symptoms for prisoners along with its appropriate management is highly recommended.