Specific mental disorders and criminality: a 26-year prospective study of the 1966 Northern Finland Birth Cohort

Department of Forensic Psychiatry, University of Kuopio, Niuvanniemi Hospital, Finland.
American Journal of Psychiatry (Impact Factor: 12.3). 07/1997; 154(6):840-5. DOI: 10.1176/ajp.154.6.840
Source: PubMed


The purpose of the study was to examine the quantitative risk of criminal behavior associated with specific mental disorders.
An unselected 1966 birth cohort (N = 12,058) in Northern Finland was prospectively studied until the end of 1992. The investigation started during the mothers' pregnancy, and the data on the subjects' family characteristics, mental and physical development, living habits, psychiatric morbidity, and criminal records were gathered at various times.
The prevalence of offenses was the highest among males with alcohol-induced psychoses and male schizophrenic subjects with coexisting alcohol abuse, and more than half of the schizophrenic offenders also had problems with alcohol. Eleven (7%) of the 165 subjects who committed violent crimes were diagnosed as psychotic. Male schizophrenic subjects had a moderately high risk for violent offenses, but the risk for other types of crimes was not elevated significantly. Odds ratios for criminal behavior were adjusted according to the socioeconomic status of the childhood family and were the same as or slightly lower than the crude odds ratios for all disorders except schizophrenia and mood disorders with psychotic features.
The results indicate that the risk of criminal behavior was significantly higher among subjects with psychotic disorders, even though the socioeconomic status of the childhood family was controlled. The higher risk for violent behavior was associated especially with alcohol-induced psychoses and with schizophrenia with coexisting substances abuse. The results suggest that schizophrenia without substance abuse may also be associated with a higher risk of offenses, but this finding is tentative and requires further investigation.

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    • "An association between schizophrenia and other psychotic disorders and an elevated risk of antisocial behaviour has been well established (Fazel et al. 2009a), although the extent to which such risk extends to nonviolent offending is less clear (Tiihonen et al. 1997). Furthermore, many studies have failed to consider the temporal nature of the relationship between the two factors – either because information was gathered cross-sectionally or because lifetime records of both psychosis and criminality were examined for association . "
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    ABSTRACT: The link between psychotic disorders and violent offending is well established; knowledge about risk of post-illness-onset offending across the full spectrum of psychiatric disorders is lacking. We aimed to compare rates of any offending and violent offending committed after the onset of illness, according to diagnostic group, with population controls. A 25% random sample of the Danish population (n = 521 340) was followed from their 15th birthday until offending occurred. Mental health status was considered as a time-varying exposure in a Poisson regression model used to examine the duration from service contact to the offence. Males with any psychiatric contact had an incidence rate ratio (IRR) of 2.91 [95% confidence interval (CI) 2.80-3.02] for any offending; 4.18 (95% CI 3.99-4.38) for violent offending. Associations were stronger for women (IRR 4.17, 95% CI 3.95-4.40 for any offending; 8.02, 95% CI 7.20-8.94 for violent offending). Risk was similar across diagnostic groups for any offending in males, while variation between diagnostic groups was seen for male violent and female offending, both any and violent. Risk of offending, particularly violent offending, was elevated across a range of mental disorders following first contact with mental health services. The extent of variation in strength of effect across diagnoses differed by gender.
    No preview · Article · Apr 2015 · Psychological Medicine
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    • "Individuals with schizophrenia have an increased risk of violence (1), but different studies report different risks (1,2). Anglo-American studies commonly report higher prevalence rates than European studies (3,4). These patients have also been reported to have up to 4-6 times higher violent behavior rate than the general population (3-5). "
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    ABSTRACT: Aim To determine predictive risk factors for violent offending in patients with paranoid schizophrenia in Croatia. Method The cross-sectional study including male in-patients with paranoid schizophrenia with (N = 104) and without (N = 102) history of physical violence and violent offending was conducted simultaneously in several hospitals in Croatia during one-year period (2010-2011). Data on their sociodemographic characteristics, duration of untreated illness phase (DUP), alcohol abuse, suicidal behavior, personality features, and insight into illness were collected and compared between the groups. Binary logistic regression model was used to determine the predictors of violent offending. Results Predictors of violent offending were older age, DUP before first contact with psychiatric services, and alcohol abuse. Regression model showed that the strongest positive predictive factor was harmful alcohol use, as determined by AUDIT test (odds ratio 37.01; 95% confidence interval 5.20-263.24). Psychopathy, emotional stability, and conscientiousness were significant positive predictive factors, while extroversion, pleasantness, and intellect were significant negative predictive factors for violent offending. Conclusion This study found an association between alcohol abuse and the risk for violent offending in paranoid schizophrenia. We hope that this finding will help improve public and mental health prevention strategies in this vulnerable patient group.
    Full-text · Article · Apr 2014 · Croatian Medical Journal
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    • "The inclusion of demographic risk factors in the prediction calculus would improve its accuracy, just as it would for those in the general population without mental illness. A series of population studies from Nordic countries [17] [18] and Australia [19] also confirmed that there is a modest but significant link between mental disorders and violence in the community. The landmark Dunedin birth cohort study reported similar findings using more sensitive measures of exposure and outcome [20]. "
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    ABSTRACT: Purpose This article describes epidemiological evidence concerning risk of gun violence and suicide linked to psychiatric disorders, in contrast to media-fueled public perceptions of the dangerousness of mentally ill individuals, and evaluates effectiveness of policies and laws designed to prevent firearms injury and mortality associated with serious mental illnesses and substance use disorders. Methods Research concerning public attitudes towards persons with mental illness is reviewed and juxtaposed with evidence from benchmark epidemiological and clinical studies of violence and mental illness and of the accuracy of psychiatrists’ risk assessments. Selected policies and laws designed to reduce gun violence in relation to mental illness are critically evaluated; evidence-based policy recommendations are presented. Results Media accounts of mass shootings by disturbed individuals galvanize public attention and reinforce popular belief that mental illness often results in violence. Epidemiological studies show that the large majority of people with serious mental illnesses are never violent. However, mental illness is strongly associated with increased risk of suicide, which accounts for over half of US firearms-related fatalities. Conclusion Policymaking at the interface of gun violence prevention and mental illness should be based on epidemiological data concerning risk, to improve the effectiveness, feasibility, and fairness of policy initiatives.
    Full-text · Article · Apr 2014 · Annals of Epidemiology
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