Abstract
BackgroundTo investigate the impact of adolescent violent and non-violent criminality and subsequent risk of morbidity and mortality in adulthood in a large Swedish cohort of young men conscripted for military service in 1969/70.MethodsThe cohort consisted of 49,398 18-year-old Swedish conscripts followed up for morbidity and mortality up to the age of 55 years in Swedish national registers. Information about convictions for crime before conscription was obtained from national crime registers. Data from a survey at conscription were scrutinized to get information on potential confounders.ResultsHospitalization due to alcohol and drug related diagnoses and attempted suicide were significantly more evident in the violent group compared to non-violent criminals and non-criminals. More than one fifth (21.13%) of the young violent offenders, 12.90% of the non-violent offenders and 4.96% of the non-criminals had died during the follow-up period. In Cox proportional multivariate analyses, young violent offenders had twice the hazard (HR = 4.29) of all-cause mortality than the non-violent offenders (HR = 2.16) during the follow-up period. Alcohol and drug related mortality, suicide and fatal accidents were most evident in both violent and non-violent offenders.ConclusionsMen with adolescent criminality received more inpatient care due to alcohol and drug related diagnoses and attempted suicide as adults. Mortality due to unnatural causes, alcohol, and drug related diagnoses, suicide and accidents was most evident in violent offenders, while these causes of death were much lower in non-criminals. Men with adolescent criminality are a high-risk group for multiple adverse health outcomes and for early death. Efforts for detection of substance use and psychiatric disorders in this group is important for the prevention work in both local- and community levels as well as national prevention programs.
Highlights
To investigate the impact of adolescent violent and non-violent criminality and subsequent risk of morbidity and mortality in adulthood in a large Swedish cohort of young men conscripted for military service in 1969/70
In this study, we investigated whether adolescent criminality, violent and non-violent, was associated with more inpatient care stays and higher mortality rate compared to adolescents without criminal history in a large cohort of 49,398 18–20 years old men conscripted in 1969/70 for military service in in Sweden during a 37-years follow-up period
Statistical analyses Since the study population is clearly defined (49,433 men who were compulsory conscripted to military service between 1 July in 1969 and 30 June in 1970) and no new study participants entered after that, the exposures and the potential confounders occurred before the conscription/were assessed during conscription, and we did not investigate any time-varying exposures; we used crude and multivariate Cox proportional regression analysis to calculate hazard ratios (HRs) with 95% confidence intervals for overall and cause specific mortality
Summary
To investigate the impact of adolescent violent and non-violent criminality and subsequent risk of morbidity and mortality in adulthood in a large Swedish cohort of young men conscripted for military service in 1969/70. In a clinical study of 1400 child and adolescent psychiatric patients (CAP), it was found that those who had been convicted during or prior CAP care were more often admitted to adult psychiatric care due to conduct problems than those not convicted; 34 vs 13%. It has been found that hospital stays and hospital days in psychiatric patients decrease during the time in rehabilitation community programs compared to the time before enrollment [12]. These clinical studies demonstrate the importance of prevention programs in order to reduce criminality in people with comorbidity
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