Department of Public Health Sciences, Division of Social Medicine, Karolinska Institute, Stockholm, Sweden.
Int J Epidemiol. 2011 Dec;40(6):1585-92. doi: 10.1093/ije/dyr127. Epub 2011 Sep 14.
As the suicide rates in young adults do not show a clear decline, it is important to elucidate possible risk factors. Juvenile delinquency has been pointed out as a possible risk behaviour.
This register-based cohort study comprises the birth cohorts between 1972 and 1981 in Sweden. We followed 992,881 individuals from the age of 20 years until 31 December 2006, generating 10 210 566 person-years and 1482 suicides. Juvenile delinquency was defined as being convicted of a crime between the ages of 15 and 19 years. Estimates of risk of suicide were calculated as incidence rate ratio (IRR) with 95% confidence intervals (CIs) using Poisson regression analysis with adjustment for potential confounding by their own and their parents' mental illness or substance abuse, parental education, single parenthood, social assistance, adoption and foster care.
Among females, 5.9%, and among males, 17.9%, had at least one conviction between the ages 15 and 19 years. In the fully adjusted model, females with one conviction had a suicide risk of 1.7 times higher (95% CI 1.2-2.4), the corresponding IRR for men was 2.0 (95% CI 1.7-2.4) and 5.7 (95% CI 2.5-13.1) and 6.6 (95% CI 5.2-8.3), for women and men with five or more convictions. The effect of severe delinquency on suicide was independent of parental educational level.
This study supports the hypothesis that individuals with delinquent behaviour in late adolescence have an increased risk of suicide as young adults. Regardless of causality issues, repeated juvenile offenders should be regarded by professionals in health, social and correctional services who come into contact with this group as a high-risk group for suicide.
年轻人的自杀率并未明显下降，因此阐明可能的风险因素很重要。青少年犯罪已被指出是一种可能的风险行为。
这是一项基于登记的队列研究，包含了瑞典 1972 年至 1981 年出生的队列人群。我们对 992881 名个体进行了随访，随访时间从 20 岁持续到 2006 年 12 月 31 日，共产生了 10210566人年和 1482 例自杀。青少年犯罪的定义是在 15 至 19 岁期间被判有罪。使用泊松回归分析，调整个体及其父母的精神疾病或药物滥用、父母教育程度、单亲家庭、社会救助、领养和寄养等潜在混杂因素后，计算自杀风险的发生率比（IRR）及其 95%置信区间（CI）。
女性中有 5.9%，男性中有 17.9%在 15 至 19 岁期间至少被判过一次罪。在完全调整的模型中，有一次犯罪记录的女性自杀风险是无犯罪记录女性的 1.7 倍（95%CI 1.2-2.4），相应的男性 IRR 为 2.0（95%CI 1.7-2.4）和 5.7（95%CI 2.5-13.1）和 6.6（95%CI 5.2-8.3），女性和男性分别有 5 次或更多次犯罪记录。严重犯罪对自杀的影响独立于父母的教育水平。
本研究支持了这样一种假设，即青春期后期有犯罪行为的个体在成年早期自杀的风险增加。无论是否存在因果关系问题，与这一群体接触的卫生、社会和惩教服务专业人员都应将反复违法的青少年视为自杀的高危人群。
