{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T12:04:34Z","timestamp":1791806674546,"version":"4.3.4"},"reference-count":46,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2021,8,24]],"date-time":"2021-08-24T00:00:00Z","timestamp":1629763200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,8,24]],"date-time":"2021-08-24T00:00:00Z","timestamp":1629763200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100006095","name":"Helse S\u00f8r-\u00d8st RHF","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006095","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Norwegian Centre for Addiction Research"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Epidemiol"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>People in prison have an extremely high risk of suicide. The aim of this paper is to describe all suicides in the Norwegian prison population from 2000 to 2016, during and following imprisonment; to investigate the timing of suicides; and to investigate the associations between risk of suicide and types of crime.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We used data from the Norwegian Prison Release study (nPRIS) including complete national register data from the Norwegian Prison Register and the Norwegian Cause of Death Register in the period 1.1.2000 to 31.12.2016, consisting of 96,856 individuals. All suicides were classified according to ICD-10 codes X60-X84. We calculated crude mortality rates (CMRs) per 100,000 person-years and used a Cox Proportional-Hazards regression model to investigate factors associated with suicide during imprisonment and after release reported as hazard ratios (HRs).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Suicide accounted for about 10% of all deaths in the Norwegian prison population and was the leading cause of death in prison (53% of in deaths in prison). The CMR per 100,000 person years for in-prison suicides was 133.8 (CI 100.5\u2013167.1) and was ten times higher (CMR\u2009=\u20091535.0, CI 397.9\u20132672.2) on day one of incarceration. Suicides after release (overall CMR\u2009=\u200982.8, CI 100.5\u2013167.1) also peaked on day one after release (CMR\u2009=\u2009665.7, CI 0\u20131419.1). Suicide in prison was strongly associated with convictions of homicide (HR 18.2, CI 6.5\u201350.8) and high-security prison level (HR 15.4, CI 3.6\u201365.0). Suicide after release was associated with convictions of homicide (HR 3.1, CI 1.7\u20135.5).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>There is a high risk of suicide during the immediate first period of incarceration and after release. Convictions for severe violent crime, especially homicide, are associated with increased suicide risk, both in prison and after release.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s10654-021-00782-0","type":"journal-article","created":{"date-parts":[[2021,8,24]],"date-time":"2021-08-24T05:04:20Z","timestamp":1629781460000},"page":"1075-1083","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Suicide in prison and after release: a 17-year national cohort study"],"prefix":"10.1007","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0285-5339","authenticated-orcid":false,"given":"Anne","family":"Bukten","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9324-6194","authenticated-orcid":false,"given":"Marianne Riksheim","family":"Stavseth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,8,24]]},"reference":[{"key":"782_CR1","unstructured":"WHO. Preventing suicide: a global imperative. World Health Organization; 2014."},{"issue":"12","key":"782_CR2","doi-asserted-by":"publisher","first-page":"946","DOI":"10.1016\/S2215-0366(17)30430-3","volume":"4","author":"S Fazel","year":"2017","unstructured":"Fazel S, Ramesh T, Hawton K. Suicide in prisons: an international study of prevalence and contributory factors. Lancet Psychiatry. 2017;4(12):946\u201352.","journal-title":"Lancet Psychiatry"},{"key":"782_CR3","unstructured":"WHO. Preventing Suicide in Jails and Prisons. Geneva, Switzerland, Abuse DoMHaS; 2007."},{"key":"782_CR4","doi-asserted-by":"crossref","unstructured":"Bukten A, Stavseth MR, Skurtveit S, Tverdal A, Strang J, Clausen T. High risk of overdose death following release from prison: variations in mortality during a 15\u2010year observation period. Addiction. 2017.","DOI":"10.1111\/add.13803"},{"issue":"2","key":"782_CR5","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1111\/j.1360-0443.2006.01316.x","volume":"101","author":"S Fazel","year":"2006","unstructured":"Fazel S, Bains P, Doll H. Substance abuse and dependence in prisoners: a systematic review. Addiction. 2006;101(2):181\u201391.","journal-title":"Addiction"},{"key":"782_CR6","doi-asserted-by":"crossref","unstructured":"Fazel S, Yoon IA, Hayes AJ. Substance use disorders in prisoners: an updated systematic review and meta-regression analysis in recently incarcerated men and women. Addiction. 2017.","DOI":"10.1111\/add.13877"},{"issue":"10","key":"782_CR7","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.4088\/JCP.13m08967","volume":"75","author":"A Haglund","year":"2014","unstructured":"Haglund A, Tidemalm D, Jokinen J, Langstrom N, Lichtenstein P, Fazel S, et al. Suicide after release from prison: a population-based cohort study from Sweden. J Clin Psychiatry. 2014;75(10):1047\u201353.","journal-title":"J Clin Psychiatry"},{"issue":"11","key":"782_CR8","doi-asserted-by":"publisher","first-page":"1721","DOI":"10.4088\/JCP.v69n1107","volume":"69","author":"S Fazel","year":"2008","unstructured":"Fazel S, Cartwright J, Norman-Nott A, Hawton K. Suicide in prisoners: a systematic review of risk factors. J Clin Psychiatry. 2008;69(11):1721\u201331.","journal-title":"J Clin Psychiatry"},{"issue":"6","key":"782_CR9","doi-asserted-by":"publisher","first-page":"1585","DOI":"10.1093\/ije\/dyr127","volume":"40","author":"E Bjorkenstam","year":"2011","unstructured":"Bjorkenstam E, Bjorkenstam C, Vinnerljung B, Hallqvist J, Ljung R. Juvenile delinquency, social background and suicide\u2013a Swedish national cohort study of 992,881 young adults. Int J Epidemiol. 2011;40(6):1585\u201392.","journal-title":"Int J Epidemiol"},{"issue":"3","key":"782_CR10","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1016\/j.jadohealth.2006.10.016","volume":"40","author":"MP Thompson","year":"2007","unstructured":"Thompson MP, Ho CH, Kingree JB. Prospective associations between delinquency and suicidal behaviors in a nationally representative sample. J Adolesc Health\u202f: Off Publ Soc Adolesc Med. 2007;40(3):232\u20137.","journal-title":"J Adolesc Health : Off Publ Soc Adolesc Med"},{"issue":"6","key":"782_CR11","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1001\/archgenpsychiatry.2011.7","volume":"68","author":"RT Webb","year":"2011","unstructured":"Webb RT, Qin P, Stevens H, Mortensen PB, Appleby L, Shaw J. National study of suicide in all people with a criminal justice history. Arch Gen Psychiatry. 2011;68(6):591\u20139.","journal-title":"Arch Gen Psychiatry"},{"key":"782_CR12","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1016\/j.jad.2019.08.054","volume":"259","author":"LS Too","year":"2019","unstructured":"Too LS, Spittal MJ, Bugeja L, Reifels L, Butterworth P, Pirkis J. The association between mental disorders and suicide: a systematic review and meta-analysis of record linkage studies. J Affect Disord. 2019;259:302\u201313.","journal-title":"J Affect Disord"},{"issue":"1","key":"782_CR13","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1027\/0227-5910\/a000531","volume":"40","author":"L Favril","year":"2019","unstructured":"Favril L, Wittouck C, Audenaert K, Vander LF. A 17-year national study of prison suicides in Belgium. Crisis. 2019;40(1):42\u201353.","journal-title":"Crisis"},{"issue":"3","key":"782_CR14","doi-asserted-by":"publisher","first-page":"e164","DOI":"10.1016\/S2468-2667(20)30233-4","volume":"6","author":"S Zhong","year":"2021","unstructured":"Zhong S, Senior M, Yu R, Perry A, Hawton K, Shaw J, et al. Risk factors for suicide in prisons: a systematic review and meta-analysis. Lancet Pub Health. 2021;6(3):e164\u201374.","journal-title":"Lancet Pub Health"},{"key":"782_CR15","doi-asserted-by":"crossref","unstructured":"Hayes LMJJoCHC. National study of jail suicide: 20 years later. 2012; 18(3):233\u201345.","DOI":"10.1177\/1078345812445457"},{"issue":"1\u20133","key":"782_CR16","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1016\/j.forsciint.2013.09.014","volume":"233","author":"G Duthe","year":"2013","unstructured":"Duthe G, Hazard A, Kensey A, Shon JL. Suicide among male prisoners in France: a prospective population-based study. Forensic Sci Int. 2013;233(1\u20133):273\u20137.","journal-title":"Forensic Sci Int"},{"key":"782_CR17","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1192\/bjp.185.6.494","volume":"185","author":"S Fruehwald","year":"2004","unstructured":"Fruehwald S, Matschnig T, Koenig F, Bauer P, Frottier P. Suicide in custody: case-control study. B J Psychiatry\u202f: J Mental Sci. 2004;185:494\u20138.","journal-title":"B J Psychiatry : J Mental Sci"},{"issue":"4","key":"782_CR18","doi-asserted-by":"publisher","first-page":"e0214936","DOI":"10.1371\/journal.pone.0214936","volume":"14","author":"D Radeloff","year":"2019","unstructured":"Radeloff D, Stoeber F, Lempp T, Kettner M, Bennefeld-Kersten K. Murderers or thieves at risk? offence-related suicide rates in adolescent and adult prison populations. PLoS One. 2019;14(4):e0214936.","journal-title":"PLoS One"},{"issue":"5","key":"782_CR19","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1027\/0227-5910\/a000394","volume":"37","author":"L Marzano","year":"2016","unstructured":"Marzano L, Hawton K, Rivlin A, Smith EN, Piper M, Fazel S. Prevention of suicidal behavior in prisons. Crisis. 2016;37(5):323\u201334.","journal-title":"Crisis"},{"issue":"1","key":"782_CR20","doi-asserted-by":"publisher","first-page":"109","DOI":"10.23907\/2016.011","volume":"6","author":"MJ Kucmanic","year":"2016","unstructured":"Kucmanic MJ, Gilson TP. Suicide in jail: a ten-year retrospective study. Acad Forensic Pathol. 2016;6(1):109\u201313.","journal-title":"Acad Forensic Pathol"},{"key":"782_CR21","doi-asserted-by":"crossref","unstructured":"Hammerlin Y. Fengselslivet som en livstruende byrde (Only in Norwegian). Suicidologi. 2018;23(3).","DOI":"10.5617\/suicidologi.6766"},{"issue":"2","key":"782_CR22","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1056\/NEJMsa064115","volume":"356","author":"IA Binswanger","year":"2007","unstructured":"Binswanger IA, Stern MF, Deyo RA, Heagerty PJ, Cheadle A, Elmore JG, et al. Release from prison\u2014a high risk of death for former inmates. N Engl J Med. 2007;356(2):157\u201365.","journal-title":"N Engl J Med"},{"issue":"7","key":"782_CR23","doi-asserted-by":"publisher","first-page":"387","DOI":"10.5694\/j.1326-5377.2007.tb01307.x","volume":"187","author":"A Kariminia","year":"2007","unstructured":"Kariminia A, Law MG, Butler TG, Levy MH, Corben SP, Kaldor JM, et al. Suicide risk among recently released prisoners in New South Wales, Australia. Med J Aust. 2007;187(7):387.","journal-title":"Med J Aust"},{"issue":"10","key":"782_CR24","doi-asserted-by":"publisher","first-page":"993","DOI":"10.1136\/jech-2014-204295","volume":"68","author":"MJ Spittal","year":"2014","unstructured":"Spittal MJ, Forsyth S, Pirkis J, Alati R, Kinner SA. Suicide in adults released from prison in Queensland, Australia: a cohort study. J Epidemiol Community Health. 2014;68(10):993\u20138.","journal-title":"J Epidemiol Community Health"},{"key":"782_CR25","doi-asserted-by":"crossref","unstructured":"Spittal MJ, Forsyth S, Borschmann R, Young JT, Kinner SA. Modifiable risk factors for external cause mortality after release from prison: a nested case-control study. Epidemiol Psychiatr Sci. 2019;28(2):224\u201333.","DOI":"10.1017\/S2045796017000506"},{"issue":"9530","key":"782_CR26","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1016\/S0140-6736(06)69002-8","volume":"368","author":"D Pratt","year":"2006","unstructured":"Pratt D, Piper M, Appleby L, Webb R, Shaw J. Suicide in recently released prisoners: a population-based cohort study. Lancet. 2006;368(9530):119\u201323.","journal-title":"Lancet"},{"issue":"3","key":"782_CR27","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1007\/s00127-010-0184-4","volume":"46","author":"S Fazel","year":"2011","unstructured":"Fazel S, Grann M, Kling B, Hawton K. Prison suicide in 12 countries: an ecological study of 861 suicides during 2003\u20132007. Soc Psychiatry Psychiatr Epidemiol. 2011;46(3):191\u20135.","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"key":"782_CR28","unstructured":"WPB. International Centre of Prison Studies 2020 [cited 2018 11.08.2020]. Available from: http:\/\/www.prisonstudies.org\/."},{"key":"782_CR29","unstructured":"The Norwegian Correctional Services, Annual statistics 2019 (Only in Norwegian). Oslo, Norway2019."},{"key":"782_CR30","unstructured":"The Norwegian Correctional Services, Annual statistics 2018 (Only in Norwegian). Oslo, Norway: Kriminalomsorgen 2018."},{"key":"782_CR31","unstructured":"The Norwegian Correctional Services (Only in Norwegian: Kriminalomsorgens sentrale datasystemer) 2015 [cited 2021 13.07]. Available from: http:\/\/www.kriminalomsorgen.no\/kriminalomsorgens-sentrale-datasystemer.4454702.html."},{"key":"782_CR32","unstructured":"WHO. The ICD-10 Classification of mental and Behavioural Disorders. Clinical descriptions and diagnostic guidelines: World Health Organization; 1993 1993."},{"issue":"8","key":"782_CR33","doi-asserted-by":"publisher","first-page":"768","DOI":"10.4045\/tidsskr.14.1065","volume":"135","author":"AG Pedersen","year":"2015","unstructured":"Pedersen AG, Ellingsen CL. Data quality in the causes of death registry. Tidsskrift for den Norske laegeforening\u202f: tidsskrift for praktisk medicin, ny raekke. 2015;135(8):768\u201370.","journal-title":"Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke"},{"key":"782_CR34","unstructured":"Statistics Norway. Classification of type of offence 2020 [Available from: https:\/\/www.ssb.no\/en\/klass\/klassifikasjoner\/146."},{"key":"782_CR35","unstructured":"Rothman K, Greenland, Lash T. Modren Epidemiology: Lippincott Williams & Wilkinis; 2008 2008."},{"key":"782_CR36","first-page":"2010","volume-title":"An Introduction to Survival Analysis Using Stata","author":"M Cleves","year":"2010","unstructured":"Cleves M, Gutierrez RG, Gould W, Marchenko YV. An Introduction to Survival Analysis Using Stata. 3rd ed. Texas: Stata Press; 2010. p. 2010.","edition":"3"},{"issue":"5","key":"782_CR37","doi-asserted-by":"publisher","first-page":"1260","DOI":"10.1111\/1556-4029.12454","volume":"59","author":"AE Austin","year":"2014","unstructured":"Austin AE, van den Heuvel C, Byard RW. Prison suicides in South Australia: 1996\u20132010. J Forensic Sci. 2014;59(5):1260\u20132.","journal-title":"J Forensic Sci"},{"issue":"3\u20134","key":"782_CR38","first-page":"73","volume":"239","author":"J Petersen","year":"2017","unstructured":"Petersen J, Kunze S, Thiel A, Fiedler G, Briken P, Puschel K. Deaths in Hamburg prisons 1996\u20132012 - recommendations on suicide prevention in prison custody. Arch Kriminol. 2017;239(3\u20134):73\u201386.","journal-title":"Arch Kriminol"},{"issue":"2","key":"782_CR39","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1007\/s00787-014-0568-1","volume":"24","author":"D Radeloff","year":"2015","unstructured":"Radeloff D, Lempp T, Herrmann E, Kettner M, Bennefeld-Kersten K, Freitag CM. National total survey of German adolescent suicide in prison. Eur Child Adolesc Psychiatry. 2015;24(2):219\u201325.","journal-title":"Eur Child Adolesc Psychiatry"},{"issue":"7","key":"782_CR40","doi-asserted-by":"publisher","first-page":"1177","DOI":"10.1007\/s00127-012-0632-4","volume":"48","author":"N Humber","year":"2013","unstructured":"Humber N, Webb R, Piper M, Appleby L, Shaw J. A national case-control study of risk factors for suicide among prisoners in England and Wales [corrected]. Soc Psychiatry Psychiatr Epidemiol. 2013;48(7):1177\u201385.","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"issue":"5\u20136","key":"782_CR41","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1016\/j.ijlp.2013.06.018","volume":"36","author":"A Opitz-Welke","year":"2013","unstructured":"Opitz-Welke A, Bennefeld-Kersten K, Konrad N, Welke J. Prison suicides in Germany from 2000 to 2011. Int J Law Psychiatry. 2013;36(5\u20136):386\u20139.","journal-title":"Int J Law Psychiatry"},{"issue":"11","key":"782_CR42","doi-asserted-by":"publisher","first-page":"e009120","DOI":"10.1136\/bmjopen-2015-009120","volume":"5","author":"IM T\u00f8llefsen","year":"2015","unstructured":"T\u00f8llefsen IM, Helweg-Larsen K, Thiblin I, Hem E, Kastrup MC, Nyberg U, et al. Are suicide deaths under-reported? Nationwide re-evaluations of 1800 deaths in Scandinavia. BMJ Open. 2015;5(11):e009120.","journal-title":"BMJ Open"},{"key":"782_CR43","unstructured":"Nations U. Sustainable Development Goals. United Nations, S-1018, New York, NY 10017. USA: United Nations Department of Public Information; 2019."},{"key":"782_CR44","unstructured":"The Norwegian Institute of Public Health Oslo, Norway2021 [cited 2021 13.07]. Available from: https:\/\/www.fhi.no\/en\/."},{"key":"782_CR45","unstructured":"The Norwegian Correctional Service Norway2021 [cited 2021 13.07]. Available from: https:\/\/www.kriminalomsorgen.no\/?cat=536003."},{"key":"782_CR46","unstructured":"The Regional Committees for Medical and Health Research Ethics Norway2021 [cited 2021 13.07]. Available from: https:\/\/rekportalen.no\/#hjem\/home."}],"container-title":["European Journal of Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10654-021-00782-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10654-021-00782-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10654-021-00782-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,24]],"date-time":"2021-10-24T22:06:25Z","timestamp":1635113185000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10654-021-00782-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,24]]},"references-count":46,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2021,10]]}},"alternative-id":["782"],"URL":"https:\/\/doi.org\/10.1007\/s10654-021-00782-0","relation":{},"ISSN":["0393-2990","1573-7284"],"issn-type":[{"value":"0393-2990","type":"print"},{"value":"1573-7284","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,24]]},"assertion":[{"value":"12 February 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 June 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 August 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no competing interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was approved by the Regional Committees for Medical and Health Research Ethics, Region South-East Norway, ref no 2012\/140. The linkage was performed by the Norwegian Institute of Public Health, who prepared the files for analysis.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"This population study was based on individual-level data from The Norwegian Prison Registry (held by the Directorate of Norwegian Correctional Service) and the Norwegian Cause of Death Register (held by the Norwegian Institute of Public Health). The ethical approval of this research project does not include permission to publicly share the raw data. Qualifying researchers can apply for access to relevant data with the Norwegian Institute of Public Health [] and the Directorate of Norwegian Correctional Service [] upon approval from the Regional Committees for Medical and Health Research Ethics [].","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Data availability"}}]}}