Psychiatric Disorders & Violent Reoffending: A National Cohort Study of Convicted Prisoners in Sweden
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...
Diagnosed
psychiatric disorders were associated with an increased hazard of violent
reoffending in male and female prisoners, and these associations were independent of measured
sociodemographic and criminological factors, and, in men, remained substantial
after adjustment for unmeasured familial factors. However,
findings differed between individual diagnoses and sex. We found some evidence
of stronger effects on violent reoffending of alcohol and drug use disorders
and bipolar disorder than of other psychiatric disorders. Alcohol use disorder
seemed to have a greater effect in women than in men. The overall effects of psychiatric disorders did not differ
with severity of crime. The hazard of violent reoffending increased
in a stepwise way with the number of diagnosed psychiatric disorders. Assuming
causality, up to 20% of violent reoffending in men and 40%
in women was attributable to the diagnosed psychiatric disorders that
we investigated.
Certain
psychiatric disorders are associated with a substantially increased hazard of
violent reoffending. Because these disorders are prevalent and mostly
treatable, improvements to prison mental health services could counteract the
cycle of reoffending and improve both public health and safety. National
violence prevention strategies should consider the role of prison health.
Read more at: http://ht.ly/S88T2
By: Chang Z1, Larsson H2, Lichtenstein P2, Fazel S3.
- 1Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
- 2Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
- 3Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK.
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