The association between psychiatric diagnosis and violent re-offending in adult offenders in the community (original) (raw)
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The lancet. Psychiatry, 2015
Reoffending and presence of psychiatric disorders are common in prisoners worldwide. However, whether psychiatric disorders are risk factors for reoffending is still unknown. We aimed to examine the association between psychiatric disorders, including substance use disorder, and violent reoffending. We did a longitudinal cohort study of 47 326 prisoners who were imprisoned since Jan 1, 2000, and released before Dec 31, 2009, in Sweden. We obtained data for diagnosed psychiatric disorders from both inpatient and outpatient registers, and sociodemographic and criminological factors from other population-based registers. We calculated hazard ratios (HRs) for violent reoffending with Cox regression. To control for potential familial confounding, we compared sibling prisoners with and without psychiatric disorders. We calculated population attributable fraction to assess the population effect. Diagnosed psychiatric disorders were associated with an increased hazard of violent reoffending...
Nordic journal of psychiatry, 2016
Forensic psychiatric patients present a challenge as they manifest severe mental disorders together with criminal behaviour. There are well-known risk factors for criminal behaviour in the general population, yet knowledge of what predicts reconviction in the Swedish forensic population in the long-term perspective is still insufficient. The study aims to (1) describe background and clinical characteristics of forensic psychiatric patients in a 10-year follow-up, (2) analyse risk factors associated with recidivism, and (3) test the predictive validity of risk factors for general and violent criminality. Detailed information on all offenders from the Malmö University Hospital catchment area sentenced to forensic psychiatric in-patient treatment from 1999-2005 (n = 125) was collected. Court decisions were collected up until the end of 2008 (median follow-up time = 6.2 years, range = 0.6-9.7 years). Relapse in general crime (n = 30) was predicted by low educational attainment, mental d...
On lifetime violent criminality in a Swedish forensic psychiatric cohort
Lund University, Faculty of Medicine Doctoral Dissertation Series; (2020:42) (2020), 2020
Introduction The pathway from childhood adversity through delinquent behaviour in adolescence to an antisocial adult lifestyle has interested for researchers for the past decades. Recovery from mental health problems and the prevention of future criminal behaviour may be complicated by the combination of mental illness and criminality. Identifying crucial risk factors and enhancing risk prediction is important in reducing criminal recidivism and improving mental health. Aims and Methods The overall aim of this thesis is to explore a total cohort of 125 individuals in the catchment area of the Skåne University Hospital, Malmö, who were sentenced to forensic psychiatric in-patient treatment between 1999 and 2005. Specific aims were: (1) to identify the background and clinical characteristics of the cohort; (2) to investigate the relationships between risk assessments, prevalence of adverse events and length of stay in forensic psychiatric care; (3) to explore risk factors for criminal recidivism and persistence over the lifespan , and (4) to examine whether neuroimaging data improves the prediction of criminal recidivism. Results Two thirds of the cohort (n=84, 67 %) received forensic psychiatric treatment with SCS. The majority suffered from psychotic disorders (n=91, 73 %). Length of stay was predicted by previous contact with child-and adolescent psychiatry, violent index crime, psychotic disorders, substance use and absconding during in-patient treatment. Risk factors for recidivism in crime after in-patient treatment were childhood adversities and early-onset criminality. In a lifetime perspective of crime and criminal careers, a subgroup of individuals who were more criminally active than the others were characterised by childhood adversities, neurodevelopmental disorders, and substance use disorders. When data from neuroimaging investigations were added to already well-known risk factors, accuracy was improved in identifying those who relapsed to crime. Conclusions These findings emphasise the importance of identifying early those children and adolescents who experience childhood adversities, are diagnosed with neurodevelopmental disorders, and have an early debut in substance use as these may increase the risk of an antisocial lifestyle and a long criminal career. Violent crime predicts a longer stay in a forensic psychiatric setting regardless of any underlying disorder. Adding neuroimaging data may enhance risk prediction of recidivism in crime.
Violent Offences, Mental Disorder and Substance-use Disorders
Sociology and Anthropology, 2016
Introduction: The relationship between violent offences, mental disorder and substance-use disorders has been widely analyzed but has produced contradictory results. Studies examining this relationship in prison populations are scarce. Objectives: The aim of the study was to analyze the relationship between violent crime, substance-use disorders and mental disorder. Method: This is a descriptive, cross-sectional, epidemiological study of 707 male prisoners. Socio-demographic, clinical and penal data were collected by trained interviewers. Penal data were confirmed using penitentiary records. The clinical version of the Structured Clinical Interview (SCID 1) for DSM-IV Axis I Disorders was used for diagnosis of Axis I mental disorders (including substance-use disorders). Inmates who have lifetime substance-use disorders were classified by type and number of substances used. We considered violent offences: homicide and attempted homicide, aggravated assault, common assault, robbery, threatening behavior, harassment, arson and any sexual offence. Results: Violent offences in inmates who used drugs (n=370) were more prevalent than in inmates who did not (84.6% vs.15,3%, p<0.0001).The risk of committing a violent crime is double for people using a substance compared to those who do not and those who are not repeat offenders (OR= 2.03 CI 95%: 1.08-3.78). This risk increases when considering repeat offenders and those who use more than one substance (OR= 5.35 CI 95%: 1.26-10.05). The presence of a mental disorder turns out not to be significant (OR= 1.38 CI 95%: 0.98-1.95). Conclusions: In our study, the greatest risk factors for committing a violent offence were being a re-offender and using more than one substance. Mental disorder was not found to be a risk factor for violent offences.
Archives of General Psychiatry, 1996
Background: Evidence has accumulated since the mid 1960s from a number of different countries indicating an association between mental disorder and crime and lence.ularly between the major mental disorders and violence. Registries in Denmark were used to identify a birth cohort and to document all psychiatric admissions and all criminal proceedings of the 324 401 members of this cohort up to the age of 43 years. Methods: Persons who had been admitted to a psychiatric ward were assigned to a diagnostic category according to a hierarchy of principal discharge diagnoses. They were compared with persons never admitted to a psychiatric ward as to the prevalence, type, and frequency of criminal convictions. Results: Women and men who had been hospitalized in psychiatric wards were more likely to have been convicted of a criminal offense than persons with no history of psychiatric hospitalization. The offenders who were hospitalized committed all types and, on average, as many offenses as did the never-hospitalized group of the same sex. Conclusions: These findings confirm those from 2 other post-World War II Scandinavian birth cohorts that have found an association between psychiatric hospitalization and criminal convictions. They also concur with findings that patients discharged from psychiatric wards are more likely than other persons living in the same community to commit crimes and with results from North America showing elevated rates of major mental disorders among incarcerated offenders. Generalization of these findings is limited to nations with similar criminal justice, mental health, and social welfare systems.
Assessment of the criminal recidivism among individuals with mental disorders
Prilozi, 2010
Epidemiological studies conducted in various regions through the world point to an increased risk of violence among individuals with mental disorders. Violent behaviour occurs in a certain social system that involves a whole person with a certain history of life, with a certain state of health or disease, and interaction with other socal circumastances. There are different methods of risk assessment, but basically two broad categories of methods determine assessment of the risk: clinical and statistical. The main purpose of the investigation is by using the statistical scale to determine risk factors of a psychopathological and social nature as well as individual traits that determine violent behaviour. The investigation has been conducted in psychiatric hospitals in Macedonia. The experimental group--perpetrators of a criminal act (PCA)--encompasses 89 patients, admitted to psychiatric hospitals in Macedonia as forensic patients. These patients have committed criminal acts. Accordi...
Frontiers in Psychiatry, 2021
Background: Treatment of mentally disordered offenders (MDOs) is challenging as their behavior and clinical conditions can be traced to a complex constellation of major mental disorders, substance use and antisocial lifestyle. Finding subgroups of these offenders, which could guide treatment and risk assessment, is desirable. There are few long-term, prospective studies of risk factors for persistent criminal behavior among MDOs.Aims: The aims are (1) to provide a map of lifetime criminality in MDOs, (2) to identify subgroups of offenders, and (3), if such clusters exist, to test whether they differ in lifetime criminality and patterns of negative events during in-patient treatment.Methods: Background data on all offenders from the Malmö University Hospital catchment area sentenced to forensic psychiatric in-patient treatment 1999–2005 (n = 125) was collected. Data on negative events during treatment (violence, threats, absconding and substance use) from date of admittance until dis...
Gender differences in re-offending among psychiatrically examined Swedish offenders
Criminal Behaviour and Mental Health, 2010
Background The gender gap for violent offending is narrowing in the general population. Substance abuse and mental health problems are known risk factors for criminality. While substance abuse treatment has been associated with reduced risk of re-offending, women seem less likely to engage than men. People misusing substances tend to be high users of emergency room (ER) services. Such use may be an indicator both of treatment failure for substance misuse and offending. Little is known about gender differences in this respect. Aims This study aims to test for gender differences in re-offending, use of substance abuse treatment, and hospital ER visits among offenders referred for forensic psychiatric assessment in Sweden. Method The study used a longitudinal retrospective design. Data on all 31 women from a 2-year (2000-2001) cohort of serious offenders referred for forensic psychiatric assessment in Stockholm county, and 31 men from the same cohort, were extracted from forensic service and national records. Selection of the men was by initial random sampling followed by matching on age and substance misuse. The two resulting samples were compared on health service use and re-offending data between release and the census date (30 April 2004). Results There were no gender differences for violent re-offending or for engagement in planned substance abuse treatment, in spite of longer time at risk for the men. Re-offending was reduced for women but not men who did not present in the ER with physical health problems. Conclusions Our study is limited by sample size, although it included all women referred to the specialist forensic psychiatric service over 2 years, but it does indicate that differences between men and women in this situation are likely, and worthy of further study. The only way of achieving adequate sample sizes is likely to be through multi-centre collaboration.
DO PREVIOUS OFFENCES PREDICT VIOLENT ACTS IN PSYCHIATRIC PATIENTS? A RETROSPECTIVE STUDY IN HUNGARY
Ideggyógyászati szemle, 2015
To investigate the presence of offences in the previous past history of perpetrators of violent acts who have undergone forced medical treatment. The documentation of all patients released over a 10-year period from the National Institute of Forensic Psychiatry (IMEI) was reviewed. A comparison was drawn between patients who were convicted of any type of offense before the violent act (patients with previous offences-PPO) and those who were not (patients with no previous offences-PNO). Eighty-six (29%) and 208 (71%) patients formed the PPO and PNO groups, respectively. Prior contact with psychiatric services was significantly higher in the PPO group (p=0.038) and this group was also more likely to offend under the influence of a psychoactive substance (p<0.001). Exceptional brutality and other qualifying factors were more frequent in the PNO group (p=0.019). As IMEI is the only forensic institution in Hungary, the picture presented here reflects the situation in the entire countr...