Division of Mental Health and Addiction, Oslo University Hospital, Norway.
BMC Psychiatry. 2011 Apr 11;11:57. doi: 10.1186/1471-244X-11-57.
Few longitudinal studies have explored lifetime criminality in adults with a childhood history of severe mental disorders. In the present study, we wanted to explore the association between adult delinquency and several different childhood diagnoses in an in-patient population. Of special interest was the impact of disturbance of activity and attention (ADHD) and mixed disorder of conduct and emotions on later delinquency, as these disorders have been variously associated with delinquent development.
Former Norwegian child psychiatric in-patients (n = 541) were followed up 19-41 years after hospitalization by record linkage to the National Register of Criminality. On the basis of the hospital records, the patients were re-diagnosed according to ICD-10. The association between diagnoses and other baseline factors and later delinquency were investigated using univariate and multivariate Cox regression analyses.
At follow-up, 24% of the participants had been convicted of criminal activity. In the multivariate Cox regression analysis, conduct disorder (RR = 2.0, 95%CI = 1.2-3.4) and hyperkinetic conduct disorder (RR = 2.7, 95% CI = 1.6-4.4) significantly increased the risk of future criminal behaviour. Pervasive developmental disorder (RR = 0.4, 95%CI = 0.2-0.9) and mental retardation (RR = 0.4, 95%CI = 0.3-0.8) reduced the risk for a criminal act. Male gender (RR = 3.6, 95%CI = 2.1-6.1) and chronic family difficulties (RR = 1.3, 95% CI = 1.1-1.5) both predicted future criminality.
Conduct disorder in childhood was highly associated with later delinquency both alone or in combination with hyperactivity, but less associated when combined with an emotional disorder. ADHD in childhood was no more associated with later delinquency than the rest of the disorders in the study population. Our finding strengthens the assumption that there is no direct association between ADHD and criminality.
很少有纵向研究探讨有儿童期严重精神障碍史的成年人的终身犯罪行为。在本研究中,我们希望在住院患者人群中探讨几种不同的儿童期诊断与成年后犯罪的关系。特别关注的是活动和注意力障碍(ADHD)和混合性品行和情绪障碍对以后犯罪行为的影响,因为这些障碍与犯罪行为的发展有不同程度的关联。
通过与国家犯罪登记处的记录链接,对 541 名曾在挪威儿童精神病院住院的患者进行了 19-41 年的随访。根据医院记录,按照 ICD-10 对患者进行重新诊断。使用单变量和多变量 Cox 回归分析,研究诊断和其他基线因素与以后犯罪行为的关系。
在随访时,24%的参与者被判犯有犯罪行为。在多变量 Cox 回归分析中,品行障碍(RR=2.0,95%CI=1.2-3.4)和多动性品行障碍(RR=2.7,95%CI=1.6-4.4)显著增加了未来犯罪行为的风险。广泛性发育障碍(RR=0.4,95%CI=0.2-0.9)和智力障碍(RR=0.4,95%CI=0.3-0.8)降低了犯罪行为的风险。男性(RR=3.6,95%CI=2.1-6.1)和慢性家庭困难(RR=1.3,95%CI=1.1-1.5)都预测了未来的犯罪行为。
儿童期品行障碍与以后的犯罪行为高度相关,无论是单独存在还是与多动症合并存在,但与情绪障碍合并存在时相关性较低。儿童期 ADHD 与研究人群中的其他障碍相比,与以后的犯罪行为没有更多的关联。我们的发现进一步证实了 ADHD 与犯罪行为之间没有直接关联的假设。