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Development of serious mental illness in young adult violent offenders : Early-life risk factors and long-term adverse outcomes

Tärnhäll, André LU orcid ; Björk, Jonas LU orcid ; Wallinius, Märta LU ; Billstedt, Eva and Hofvander, Björn LU (2025) In Psychiatry Research 346.
Abstract

This study explored serious mental illness (SMI) in young adult offenders imprisoned for violent or sexual crimes, estimating the effects of neurodevelopmental disorders and early-life risk factors on the development of SMI, and its prospective long-term adverse outcomes. An all-male cohort of 266 violent offenders, assessed during imprisonment when aged 18–25 years (M = 21.8, SD = 1.9), was followed prospectively (Myears = 6.2, SD = 1.3) in Swedish national registers together with a general population group (n = 10,000). The baseline prevalence of SMI in late adolescence or young adulthood was 10 % (n = 26) in the violent offender cohort. Childhood-onset conduct disorder (OR 2.7 [1.0–7.1]) was associated with SMI in... (More)

This study explored serious mental illness (SMI) in young adult offenders imprisoned for violent or sexual crimes, estimating the effects of neurodevelopmental disorders and early-life risk factors on the development of SMI, and its prospective long-term adverse outcomes. An all-male cohort of 266 violent offenders, assessed during imprisonment when aged 18–25 years (M = 21.8, SD = 1.9), was followed prospectively (Myears = 6.2, SD = 1.3) in Swedish national registers together with a general population group (n = 10,000). The baseline prevalence of SMI in late adolescence or young adulthood was 10 % (n = 26) in the violent offender cohort. Childhood-onset conduct disorder (OR 2.7 [1.0–7.1]) was associated with SMI in multivariable logistic regression analyses. Prospectively, violent offenders with, versus without, SMI exhibited heightened total crime rate (IRR 1.4 [1.0–2.2]), prison reconvictions (IRR 1.5 [1.0–2.1]), and psychiatric inpatient care (IRR 3.7 [1.6–8.4]), in zero-inflated Poisson regression models. The usage of outpatient psychiatric and somatic care was low in violent offenders with SMI, even relative to the general population group. The results emphasize the need for early identification of at-risk children, such as those with childhood-onset conduct disorder, and challenges with engaging violent offenders with SMI in healthcare.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Adverse childhood experiences, Conduct disorder, Healthcare utilization, Neurodevelopmental disorders, Prisoners, Recidivism
in
Psychiatry Research
volume
346
article number
116384
publisher
Elsevier
external identifiers
  • pmid:39923331
  • scopus:85217117403
ISSN
0165-1781
DOI
10.1016/j.psychres.2025.116384
language
English
LU publication?
yes
id
f497a1ed-f9b0-41bf-9469-ca2fffdb25ae
date added to LUP
2025-03-20 13:39:16
date last changed
2025-07-10 22:22:55
@article{f497a1ed-f9b0-41bf-9469-ca2fffdb25ae,
  abstract     = {{<p>This study explored serious mental illness (SMI) in young adult offenders imprisoned for violent or sexual crimes, estimating the effects of neurodevelopmental disorders and early-life risk factors on the development of SMI, and its prospective long-term adverse outcomes. An all-male cohort of 266 violent offenders, assessed during imprisonment when aged 18–25 years (M = 21.8, SD = 1.9), was followed prospectively (M<sub>years</sub> = 6.2, SD = 1.3) in Swedish national registers together with a general population group (n = 10,000). The baseline prevalence of SMI in late adolescence or young adulthood was 10 % (n = 26) in the violent offender cohort. Childhood-onset conduct disorder (OR 2.7 [1.0–7.1]) was associated with SMI in multivariable logistic regression analyses. Prospectively, violent offenders with, versus without, SMI exhibited heightened total crime rate (IRR 1.4 [1.0–2.2]), prison reconvictions (IRR 1.5 [1.0–2.1]), and psychiatric inpatient care (IRR 3.7 [1.6–8.4]), in zero-inflated Poisson regression models. The usage of outpatient psychiatric and somatic care was low in violent offenders with SMI, even relative to the general population group. The results emphasize the need for early identification of at-risk children, such as those with childhood-onset conduct disorder, and challenges with engaging violent offenders with SMI in healthcare.</p>}},
  author       = {{Tärnhäll, André and Björk, Jonas and Wallinius, Märta and Billstedt, Eva and Hofvander, Björn}},
  issn         = {{0165-1781}},
  keywords     = {{Adverse childhood experiences; Conduct disorder; Healthcare utilization; Neurodevelopmental disorders; Prisoners; Recidivism}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Psychiatry Research}},
  title        = {{Development of serious mental illness in young adult violent offenders : Early-life risk factors and long-term adverse outcomes}},
  url          = {{http://dx.doi.org/10.1016/j.psychres.2025.116384}},
  doi          = {{10.1016/j.psychres.2025.116384}},
  volume       = {{346}},
  year         = {{2025}},
}