Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Healthcare utilization and psychiatric morbidity in violent offenders : findings from a prospective cohort study

Tärnhäll, André LU orcid ; Björk, Jonas LU ; Wallinius, Märta LU ; Gustafsson, Peik LU ; Billstedt, Eva and Hofvander, Björn LU (2023) In Social Psychiatry and Psychiatric Epidemiology 58(4). p.617-628
Abstract

Purpose: Although persistent offenders with histories of imprisonment and violence have disproportionate high rates of psychiatric disorders, little is known of their psychiatric healthcare utilization (HCU) and HCU-associated factors. This study aimed to explore psychiatric HCU, psychiatric morbidity, and psychotropic prescription drugs in violent offenders with a history of incarceration. Methods: Male offenders aged 18–25 (n = 266) imprisoned for violent and/or physical sexual offenses were clinically assessed in 2010–2012 and prospectively followed in Swedish national registries through 2017. Register-based information regarding HCU, psychiatric morbidity, and psychotropic drugs was tracked and compared with a general population... (More)

Purpose: Although persistent offenders with histories of imprisonment and violence have disproportionate high rates of psychiatric disorders, little is known of their psychiatric healthcare utilization (HCU) and HCU-associated factors. This study aimed to explore psychiatric HCU, psychiatric morbidity, and psychotropic prescription drugs in violent offenders with a history of incarceration. Methods: Male offenders aged 18–25 (n = 266) imprisoned for violent and/or physical sexual offenses were clinically assessed in 2010–2012 and prospectively followed in Swedish national registries through 2017. Register-based information regarding HCU, psychiatric morbidity, and psychotropic drugs was tracked and compared with a general population group (n = 10,000) and across offending trajectory groups. Baseline risk factors were used to explain prospective psychiatric HCU in violent offenders. Results: Violent offenders used less general healthcare and psychiatric outpatient care, but more psychiatric inpatient care and were more often given psychiatric diagnoses and psychotropic drugs than the general population. Participants previously assigned to persisting offending trajectory groups had higher rates of psychiatric HCU than those assigned to a desisting trajectory. In multivariable regression models, psychiatric HCU was associated with anxiety disorders, prior psychiatric contact, placement in a foster home, psychopathic traits, low intellectual functioning, and persistent offending. Conclusions: Violent offenders are burdened by extensive and serious psychiatric morbidity and typically interact with psychiatric healthcare as inpatients rather than outpatients. Knowledge about their backgrounds, criminal behaviors, and psychiatric statuses can aid the planning of psychiatric services for this troublesome group.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Criminal behavior, Healthcare utilization, Psychiatric morbidity, Psychotropic drugs, Violent offenders
in
Social Psychiatry and Psychiatric Epidemiology
volume
58
issue
4
pages
617 - 628
publisher
Steinkopff
external identifiers
  • scopus:85144831137
  • pmid:36574014
ISSN
0933-7954
DOI
10.1007/s00127-022-02408-6
language
English
LU publication?
yes
id
31b6e798-f782-4184-b759-49cc442dde4a
date added to LUP
2023-01-23 12:29:00
date last changed
2024-04-16 12:24:00
@article{31b6e798-f782-4184-b759-49cc442dde4a,
  abstract     = {{<p>Purpose: Although persistent offenders with histories of imprisonment and violence have disproportionate high rates of psychiatric disorders, little is known of their psychiatric healthcare utilization (HCU) and HCU-associated factors. This study aimed to explore psychiatric HCU, psychiatric morbidity, and psychotropic prescription drugs in violent offenders with a history of incarceration. Methods: Male offenders aged 18–25 (n = 266) imprisoned for violent and/or physical sexual offenses were clinically assessed in 2010–2012 and prospectively followed in Swedish national registries through 2017. Register-based information regarding HCU, psychiatric morbidity, and psychotropic drugs was tracked and compared with a general population group (n = 10,000) and across offending trajectory groups. Baseline risk factors were used to explain prospective psychiatric HCU in violent offenders. Results: Violent offenders used less general healthcare and psychiatric outpatient care, but more psychiatric inpatient care and were more often given psychiatric diagnoses and psychotropic drugs than the general population. Participants previously assigned to persisting offending trajectory groups had higher rates of psychiatric HCU than those assigned to a desisting trajectory. In multivariable regression models, psychiatric HCU was associated with anxiety disorders, prior psychiatric contact, placement in a foster home, psychopathic traits, low intellectual functioning, and persistent offending. Conclusions: Violent offenders are burdened by extensive and serious psychiatric morbidity and typically interact with psychiatric healthcare as inpatients rather than outpatients. Knowledge about their backgrounds, criminal behaviors, and psychiatric statuses can aid the planning of psychiatric services for this troublesome group.</p>}},
  author       = {{Tärnhäll, André and Björk, Jonas and Wallinius, Märta and Gustafsson, Peik and Billstedt, Eva and Hofvander, Björn}},
  issn         = {{0933-7954}},
  keywords     = {{Criminal behavior; Healthcare utilization; Psychiatric morbidity; Psychotropic drugs; Violent offenders}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{617--628}},
  publisher    = {{Steinkopff}},
  series       = {{Social Psychiatry and Psychiatric Epidemiology}},
  title        = {{Healthcare utilization and psychiatric morbidity in violent offenders : findings from a prospective cohort study}},
  url          = {{http://dx.doi.org/10.1007/s00127-022-02408-6}},
  doi          = {{10.1007/s00127-022-02408-6}},
  volume       = {{58}},
  year         = {{2023}},
}