Background

Psychiatric diagnoses are important risk factors for criminal convictions, but few longitudinal studies have examined comorbidity patterns in relation to youth criminal convictions.

Aim

To explore associations between specific psychiatric diagnoses (substance use disorder (SUD), ADHD, depression, PTSD, intellectual disabilities (ID), and autism spectrum disorders (ASD)) and comorbidities of internalizing, externalizing, or neurodevelopmental diagnoses (NDD) in relation to risk of non-violent or violent criminal convictions in youth, including potential sex differences.

Methods

Data on 1,411,538 individuals born in Sweden (1985–1998) were obtained from national population-based registers. Exposure was psychiatric diagnoses and outcome was criminal convictions between ages 15 and 20.

Results

17% of individuals had a psychiatric diagnosis, of whom 20% were convicted of a crime. All diagnoses, except ID and ASD, increased the risk of non-violent and violent crimes. Comorbidities of externalizing and internalizing diagnoses heightened the risk compared to single diagnoses. NDD increased the risk among SUD, depression, and PTSD, while NDD comorbid with another NDD decreased the risk for criminal convictions.

Conclusion

Of the three comorbidity categories, externalizing disorders heightened risk the most, followed by internalizing disorders. This study highlights specific risk patterns for criminal convictions related to comorbidities, and to crime type and sex.

中文翻译：

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青少年的精神病诊断和刑事定罪：基于人群的诊断合并症研究

背景

精神病学诊断是刑事定罪的重要风险因素，但很少有纵向研究考察与青少年刑事定罪相关的共病模式。

目的

探讨特定精神疾病诊断（药物使用障碍 (SUD)、ADHD、抑郁症、创伤后应激障碍 (PTSD)、智力障碍 (ID) 和自闭症谱系障碍 (ASD)）与内化、外化或神经发育诊断 (NDD) 合并症之间的关联青少年非暴力或暴力刑事定罪的风险，包括潜在的性别差异。

方法

瑞典出生的 1,411,538 人（1985-1998 年）的数据来自国家人口登记册。暴露是精神病学诊断，结果是 15 岁至 20 岁之间的刑事定罪。

结果

17% 的人被诊断为精神病，其中 20% 的人被判有罪。除智力障碍和自闭症谱系障碍外，所有诊断都会增加非暴力和暴力犯罪的风险。与单一诊断相比，外化和内化诊断的合并症增加了风险。NDD 增加了 SUD、抑郁症和 PTSD 的风险，而 NDD 与另一种 NDD 共病则降低了刑事定罪的风险。

结论

在三种合并症类别中，外化障碍的风险最高，其次是内化障碍。这项研究强调了与合并症、犯罪类型和性别相关的刑事定罪的具体风险模式。