ABSTRACT
PURPOSE: Juvenile offenders are at heightened risk of death in adolescence and young adulthood compared to adolescents in the general population. The current study extends previous research by testing the joint contributions of distal (historical and demographic characteristics) and proximal (closer to the time of the death) predictors of mortality. We also tested whether proximal variables were potential mediators of the effects of distal variables on mortality. METHODS: Participants were 1,354 serious juvenile offenders, 45 (3.32%) of whom were deceased by the completion of the study. Data were collected through self-reports and official records. RESULTS: Significant distal predictors of mortality were being African-American and having a history of substance use disorder. Proximal predictors that added significantly to prediction included gun carrying, gang membership, and substance use problems. Potential mediators of the effects of substance use disorder history were continuing substance use problems and gang membership. However, proximal variables could not explain the heightened risk for African-Americans. CONCLUSIONS: Gang membership, gun carrying, and substance use problems are risk factors for early mortality among juvenile offenders, but they do not explain the elevated risk for death among African-Americans. Thus, further research is needed to understand the mechanisms underlying risk for premature death among African-American adolescent offenders.
Subject(s)
Cause of Death , Juvenile Delinquency/statistics & numerical data , Mortality, Premature , Adolescent , Black or African American/statistics & numerical data , Disruptive, Impulse Control, and Conduct Disorders/mortality , Female , Firearms/statistics & numerical data , Hispanic or Latino/statistics & numerical data , Humans , Internal-External Control , Interview, Psychological , Juvenile Delinquency/ethnology , Longitudinal Studies , Male , Mental Disorders/mortality , Risk , Sex Factors , Social Identification , Socioeconomic Factors , Substance-Related Disorders/mortality , United States , Violence/statistics & numerical data , White People/statistics & numerical data , Young AdultABSTRACT
A higher than expected frequency of suicide has been reported among patients undergoing subthalamic nucleus deep brain stimulation (STN DBS) for advanced Parkinson's disease (PD). We conducted a retrospective survey of 200 patients with PD who underwent STN DBS. Two patients (1%) committed suicide and four (2%) attempted suicide, despite clear motor improvements. Suicidal patients did not differ from non-suicidal patients with respect to age, disease duration or preoperative depressive and cognitive status. Suicidal behaviour was associated with postoperative depression and/or altered impulse regulation. Suicidal behaviour is a potential hazard of STN DBS, calling for careful preoperative assessment and close postoperative psychiatric and behavioural follow-up.
