The burden for clinical services of persons with an intellectual disability or mental disorder convicted of criminal offences: A birth cohort study of 14,605 persons followed to age 64.

BACKGROUND: Intellectual disability (ID), schizophrenia spectrum disorder (SSD), bipolar disorder (BD), substance use disorder (SUD), and other mental disorders (OMDs) are associated with increased risks of criminality relative to sex-matched individuals without these conditions (NOIDMD). To resource psychiatric, addiction, and social services so as to provide effective treatments, further information is needed about the size of sub-groups convicted of crimes, recidivism, timing of offending, antecedents, and correlates. Stigma of persons with mental disorders could potentially be dramatically reduced if violence was prevented. METHODS: A birth cohort of 14,605 persons was followed to age 64 using data from Swedish national health, criminal, and social registers. RESULTS: Percentages of group members convicted of violence differed significantly: males NOIDMD, 7.3%, ID 29.2%, SSD 38.6%, BD 30.7%; SUD 44.0%, and OMD 19.3%; females NOIDMD 0.8%, ID 7.7%, SSD 11.2%, BD 2.4%, SD 17.0%, and OMD 2.1%. Violent recidivism was high. Most violent offenders in the diagnostic groups were also convicted of non-violent crimes. Prior to first diagnosis, convictions (violent or non-violent) had been acquired by over 90% of the male offenders and two-thirds of the female offenders. Physical victimization, adult comorbid SUD, childhood conduct problems, and adolescent substance misuse were each associated with increased risks of offending. CONCLUSION: Sub-groups of cohort members with ID or mental disorders were convicted of violent and non-violent crimes to age 64 suggesting the need for treatment of primary disorders and for antisocial/aggressive behavior. Many patients engaging in violence could be identified at first contact with clinical services.

Co-Occurring Alcohol Misuse and Criminal Offending in Adolescence: Is It a Matter of Similarity, Severity, or Accumulation of Risk Factors?

OBJECTIVE: Alcohol misuse and criminal offending often co-occur, and although previous studies indicate an overlap in risk factors, this evidence originates from studies focusing on either alcohol misuse or criminal offending. Co-occurrence might also stem from the severity or accumulation of risk factors. The aim of the following study was to examine whether risk factors for developing co-occurring alcohol misuse and criminal offending in adolescence are similar or unique, and to examine whether risk factors are more severe or accumulative compared with alcohol misuse only and criminal offending only. METHOD: Data were used from the prospective longitudinal project Futura01, consisting of 4,013 randomly selected adolescents in Sweden (males: n = 1,798). Outcomes and a wide variety of risk factors were measured by self-report at two time points. Logistic regression analysis was carried out on groups of (a) no behavior (reference), (b) alcohol misuse only, (c) criminal offending only, and (d) co-occurring behaviors. RESULTS: The findings indicated that similar factors predicted co-occurring behaviors for alcohol misuse only and criminal offending only. Regarding severity, only more severe sensation seeking was associated with co-occurring behaviors compared with alcohol misuse and criminal offending only. Instead, an accumulation of risks (i.e., more risk factors present) increased the probability of co-occurring behaviors compared with alcohol misuse only and criminal offending only. CONCLUSIONS: The results indicated that the risk factors for developing co-occurring alcohol misuse and criminal offending in adolescence are similar rather than unique and that it is the accumulation of the risk factors, as opposed to their severity, that is associated with co-occurring behaviors when comparing with alcohol misuse and criminal offending only.

Poor family relationships in adolescence as a risk factor of in-patient psychiatric care across the life course: A prospective cohort study.

Background: Previous research has shown that poor family relations in childhood are associated with adverse mental health in adulthood. Yet, few studies have followed the offspring until late adulthood, and very few have had access to register-based data on hospitalisation due to psychiatric illness. The aim of this study was to examine the association between poor family relations in adolescence and the likelihood of in-patient psychiatric care across the life course up until age 55. Methods: Data were derived from the Stockholm Birth Cohort study, with information on 2638 individuals born in 1953. Information on family relations was based on interviews with the participants' mothers in 1968. Information on in-patient psychiatric treatment was derived from administrative registers from 1969 to 2008. Binary logistic regression was used. Results: Poor family relations in adolescence were associated with an increased risk of later in-patient treatment for a psychiatric diagnosis, even when adjusting for other adverse conditions in childhood. Further analyses showed that poor family relations in adolescence were a statistically significant predictor of in-patient psychiatric care up until age 36-45, but that the strength of the association attenuated over time. Conclusions: Poor family relationships during upbringing can have serious negative mental-health consequences that persist into mid-adulthood. However, the effect of poor family relations seems to abate with age. The findings point to the importance of effective interventions in families experiencing poor relationships.