Mental health among young adults in prison: The importance of childhood-onset conduct disorder

Abstract

BackgroundThe psychiatric health burden of prisoners is substantial. However, there is a lack of high-quality studies of psychiatric disorders among young adults with a high risk of reoffending.AimsTo investigate the lifetime prevalence of psychiatric disorders and use of mental health services among young male violent offenders and the impact of childhood-onset conduct disorder (COCD).MethodA nationally representative cohort (n = 270, age 18–25) of male offenders was followed back in medical records and clinically assessed by gold standard methods. Lifetime prevalences are presented together with odds ratios (ORs) as risk estimates in relation to COCD.ResultsPrevious use of psychiatric services among the participants was high but their lifetime psychiatric morbidity was even higher, with 93% meeting criteria for at least one Axis I disorder. The COCD group was overrepresented in most clinical categories and carried five times higher odds (OR = 5.1, 95% CI 2.0–12.8) of a psychotic disorder, three times higher odds (OR = 3.2, 95% CI 1.2–8.5) of a substance use disorder and two times higher odds of a mood disorder (OR = 2.3, 95% CI 1.3–4.0) or anxiety disorder (OR = 2.0, 95% CI 1.1–3.5).ConclusionsThe mental health burden is substantial among young violent offenders, and COCD is an important indicator of future mental health problems which must be a priority for public health efforts.Declaration of interestNone.Copyright and usage© The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.

Severe conduct problems in adolescence and risk of schizophrenia in early adulthood

“…For adults, a previous large-scale study among prisoners has shown the prevalence for psychosis to be around 4% (Fazel & Seewald, 2012). The risk is further increased for adult violent perpetrators, 5-fold compared to general population (Hofvander, Anckarsäter, Wallinius, & Billstedt, 2017).…”

“…For adults, a previous large‐scale study among prisoners has shown the prevalence for psychosis to be around 4% (Fazel & Seewald, ). The risk is further increased for adult violent perpetrators, 5‐fold compared to general population (Hofvander, Anckarsäter, Wallinius, & Billstedt, ). The polygenic risk for schizophrenia associates with oppositional defiant disorder/conduct disorder (ODD/CD) (Nivard et al, ), and there is evidence for both common and specific risk factors for schizophrenia and violence, ranging from genetic variants linked to stress regulation and adversity (Hodgins, ) to neurodevelopmental deficits (Dalteg et al, ).…”

Personality and Cognitive Functions in Violent Offenders – Implications of Character Maturity?

“…In this study, due to design considerations, we did not include any measures of hot executive functions and thus had no opportunity to study potential associations with hot executive functions. Third, since the present study group is a subgroup of a larger cohort (e.g., Hofvander et al, 2017), it is possible that the participants might represent different developmental trajectories of aggressive antisocial behaviors, affecting their levels of cognitive impairment and personality deviations. Since the participants in both the total DAABS cohort and in the current subgroup are still young, we have no abilities at the moment to determine different developmental trajectories to control for this; however, we did report differences between the study subgroup and the total DAABS cohort.…”

“…All male inmates aged 18-25 were invited to participate in the study; inmates with insufficient language skills and those who were relocated before the data could be safely collected were excluded. The participation rate was 71% of all who met inclusion criteria, and in-depth descriptions of the total DAABS cohort (n = 269) are available in previous publications (e.g., Wallinius et al, 2016;Billstedt et al, 2017;Hofvander et al, 2017). In the total DAABS cohort, the majority of the offenders had a non-sexual violent history, with only n = 31 offenders reporting an offense history of sexual offenses .…”

Prevalence and risk factors for mental health problems and suicidal expressions among young male prisoners in Cambodia: A cross-sectional study

“…A study from Australia revealed that the prevalence of suicide expression among the incarcerated youths was much higher compared to the general population with one-third of the prisoners reporting suicidal ideation and one-fifth reporting suicide attempts (11). Hofvander et al (2017) reported that almost 93% of their respondents met criteria for at least one Axis I disorder (emotional and behavioural disorders) while mood disorder (54%) and anxiety disorder (52%) were the most common mental health problems in the their study in Sweden (12).…”