SynthesisFrontiers in psychiatry2020
Shedding Light on "the Hole": A Systematic Review and Meta-Analysis on Adverse Psychological Effects and Mortality Following Solitary Confinement in Correctional Settings.
Synthesis in Frontiers in psychiatry, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Association between mental illness and disciplinary confinement and its effect on mental health: A systematic review and meta-analysis.PloS one · 2025Pooled it
- Patients' Health & Well-Being in Inpatient Mental Health-Care Facilities: A Systematic Review.Frontiers in psychiatry · 2021Pooled it
- Long-term seclusion in forensic psychiatry: Bare life, social death, and the role of the nurse.Nursing ethics · 2026Article
- Developing a conceptual framework for post-incarceration care for sexual and gender minoritized adults: a concept mapping study.AIDS care · 2026Article
- Adjudications and self-harm in prisons during COVID-19: three-year longitudinal analysis of the Offender Personality Disorder Pathway in England and Wales.BJPsych open · 2025Article
- On social health: history, conceptualization, and population patterning.Health psychology review · 2024Review
- Shrinking the footprint of the criminal legal system through policies informed by psychology and neuroscience.Communications psychology · 2024Review
- Prior incarceration, restrictive housing, and posttraumatic stress disorder symptoms in a community sample of persons who use drugs.Health & justice · 2024Article
- Evaluation of a prison violence prevention program: impacts on violent and non-violent prison infractions.Injury epidemiology · 2023Article
- Using the stress-vulnerability model to better understand suicide in prison populations.Psychiatry, psychology, and law : an interdisciplinary journal of the Australian and New Zealand Association of Psychiatry, Psychology and Law · 2023Article
- Clustering of health burdens in solitary confinement: A mixed-methods approach.SSM. Qualitative research in health · 2022Article
- Etiopathogenic Models of Psychosis Spectrum Illnesses Must Resolve Four Key Features.Biological psychiatry · 2022Review
- Rights versus Risks: The Impact of Isolation on Residents and Families in Long-Term Care.Healthcare policy = Politiques de sante · 2022Review
- Exploring the need for external input through the prism of social, material and sensation seeking input.Royal Society open science · 2022Article
- The Stigma of Criminal Legal Involvement and Health: a Conceptual Framework.Journal of urban health : bulletin of the New York Academy of Medicine · 2022Article
- Reforming solitary confinement: the development, implementation, and processes of a restrictive housing step down reentry program in Oregon.Health & justice · 2021Article
- Systematic Review on the Mental Health and Treatment Impacts of COVID-19 on Neurocognitive Disorders.Journal of personalized medicine · 2021Review
- Epidemiology, Risk Factors, and Prevention of Suicidal Thoughts and Behaviour in Prisons: A Literature Review.Psychologica Belgica · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo systematically review and meta-analyze the psychological effects and mortality rate in inmates having been exposed to solitary confinement in correctional settings.
methodsPubMed, PsycINFO, Web of Science, and Google Scholar were searched using keywords describing solitary confinement in combination with keywords for psychological or mortality outcomes. Eligible case-control studies for the systematic review met an operational definition for solitary confinement and evaluated outcomes after exposure to such confinement. Studies presenting statistical data which allowed to compute standardized mean differences for symptom scales or odds ratio for mortality were further meta-analyzed using random-effects models.
resultsSystematic review identified 13 studies for inclusion, with a total sample of 382,440 inmates (23% having been exposed to solitary confinement). Higher quality evidence showed solitary confinement was associated with an increase in adverse psychological effects, self-harm, and mortality, especially by suicide. Meta-analysis of five studies (n = 4,517) showed a standardized mean difference of 0.45 for general psychological symptomatology, which increased to 0.51 upon outlier exclusion. Small to moderate significant effects were observed for mood, psychotic, and hostility symptoms specifically. In addition, meta-analysis of two mortality studies (n = 243,050) showed a trend for a moderate effect for mortality by any or unnatural causes (i.e., suicide, homicide, overdose, and accidents).
conclusionsAnalyses showed that solitary confinement is associated with the psychological deterioration of inmates. This effect appears to be beyond that of general incarceration or presence of prior mental illness. Thus, solitary confinement may pose significant harm for inmates. Still, further studies are required to show that exposure to SC can increase risk of post-release death. Finally, add-on treatments and alternatives to solitary confinement that could alleviate the associated psychological harm are discussed.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.