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Child and adolescent psychiatric patients and later criminality
Mid Sweden University, Faculty of Human Sciences, Department of Social Work.ORCID iD: 0000-0001-7740-9910
Responsible organisation
2007 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 7, no 147, 221- p.Article in journal (Refereed) Published
Abstract [en]

Background Sweden has an extensive child and adolescent psychiatric (CAP) research tradition in which longitudinal methods are used to study juvenile delinquency. Up to the 1980s, results from descriptions and follow-ups of cohorts of CAP patients showed that children´s behavioural disturbances or disorders and school problems, together with dysfunctional family situations, were the main reasons for families, children, and youth to seek help from CAP units. Such factors were also related to registered criminality and registered alcohol and drug abuse in former CAP patients as adults. This study investigated the risk for patients treated 1975-1990 to be registered as criminals until the end of 2003. Methods A regional sample of 1,400 former CAP patients, whose treatment occurred between 1975 and 1990, was followed to 2003, using database-record links to the Register of Persons Convicted of Offences at the National Council for Crime Prevention (NCCP). Results Every third CAP patient treated between 1975 and 1990 (every second man and every fifth woman) had entered the Register of Persons Convicted of Offences during the observation period, which is a significantly higher rate than the general population. Conclusions Results were compared to published results for CAP patients who were treated between 1953 and 1955 and followed over 20 years. Compared to the group of CAP patients from the 1950s, the results indicate that the risk for boys to enter the register for criminality has doubled and for girls, the risk seems to have increased sevenfold. The reasons for this change are discussed. Although hypothetical and perhaps speculative this higher risk of later criminality may be the result of lack of social control due to (1) rising consumption of alcohol, (2) changes in organisation of child social welfare work, (3) the school system, and (4) CAP methods that were implemented since 1970.

Place, publisher, year, edition, pages
2007. Vol. 7, no 147, 221- p.
Keyword [en]
Child, adolescent, psychiatry, criminality
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:miun:diva-4297DOI: 10.1186/1471-2458-7-221ISI: 000253051800001PubMedID: 17727714Scopus ID: 2-s2.0-38849121480Local ID: 5097OAI: oai:DiVA.org:miun-4297DiVA: diva2:29329
Note

VR-Neuroscience

Available from: 2008-12-09 Created: 2008-11-23 Last updated: 2016-10-11Bibliographically approved
In thesis
1. Suicides, psychotic disorders and criminality among former child and adolescent psychiatric patients followed into adulthood
Open this publication in new window or tab >>Suicides, psychotic disorders and criminality among former child and adolescent psychiatric patients followed into adulthood
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim was to provide information about child and adolescent psychiatric (CAP) patients and their outcome as adults: Were their difficulties in childhood due to mental illness, disablement and/or behaviour disorders? What happened to them as adults? Who were the patients in need of psychiatric care (GenP) in adulthood that had not had previous contact with CAP? Did this group differ from the former CAP group? Methods: Paper I-III: 1,400 CAP patients admitted 1975-1990 to inpatient or outpatient CAP care in Jämtland County, Sweden were followed until 2003. Paper IV: A sample of 167 GenP patients not treated in CAP was compared to GenP patients with a history of CAP care. Hospital records at CAP were reassessed according to a study specific protocol. Outcome was measured in relation to register data on mortality, suicides, psychiatric/somatic care, and criminal convictions. CAP records were examined for those treated for psychosis either at CAP and or in GenP. Results: Every third CAP patient has later received GenP care. They constituted a small part of the GenP patients in the same age-groups. The CAP patients showed an elevated rate of early death. Two of the 19 who later committed suicide had been initially admitted because of attempted suicide. Every third CAP patient had a criminal record. Over the past 50 years, the percentage of Swedish boys admitted to CAP care and later registered as criminals seems to have doubled while the corresponding percentage for girls has increased almost seven times. Behavioural disorders as a reason for CAP care were the most substantial risk factor for later criminality. Sixty-two former CAP patients (4.4%) received a psychosis diagnosis during the observation time 48 of them within the Schizophrenia categories and 14 with Psychotic Mood Disorder. Mean age at first onset was 21.4 years. Changes in behaviour, including social isolation, refusal to go to school, loneliness and odd behaviour in general were the initial signs and symptoms most frequently observed prior or upon admission to CAP-care. The GenP patients with and without a previous history in CAP care had similar problems as adults. Both groups had a larger need of somatic hospital inpatient-care before the age of 18 years when compared to the general population. More than a third of the treatment occasions occurred in paediatric care. Conclusions: Psychosocial risk factors and social maladjustment in childhood seem to be the most important predictors of early death, including suicide. The increased risk of later criminality is hypothetically the result of rising alcohol consumption in Sweden, the comorbid use of illegal drugs, and changes in the organization of child social welfare work, the school system, and CAP methods that has occurred since 1970. Patients with onset of schizophrenia before 13-17 years of age showed typical symptoms upon admission to CAP care; while late-onset psychosis among former CAP could not be predicted from information gathered during CAP care. There is a group of patients treated in paediatrics and in CAP during childhood and adolescence before becoming later patients in GenP. These patients can most likely be identified during childhood if a closer collaboration is developed between paediatrics and CAP services. Hypothetically, the need of GenP care as adults in the larger group of GenP patients without a previous CAP history may develop from accumulated stressful life-events.

Place, publisher, year, edition, pages
Stockholm: Karolinska institutet, 2009
Keyword
Psychiatry, child, adolescent, adult, mortality, suicide, crime, mental disorders, psychotic disorders, paediatrics, longitudinal studies
National Category
Psychiatry
Identifiers
urn:nbn:se:miun:diva-9118 (URN)978-91-7409-519-7 (ISBN)
Public defence
2009-06-12, Stockholm, 09:00 (English)
Available from: 2009-06-08 Created: 2009-06-08 Last updated: 2009-06-08Bibliographically approved

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