Jakobsson Joakim, Karlsson Anna, Håkansson Anders, Hofvander Björn
Lund Clinical Research on Externalizing and Developmental Psychopathology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
Centre of Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden.
Front Psychiatry. 2024 Dec 6;15:1455343. doi: 10.3389/fpsyt.2024.1455343. eCollection 2024.
Understanding violent criminality and its impact on health and eventually the risk of premature mortality is important for efficient future interventions. This study aimed to explore the effect violent criminality had on premature mortality (i.e., death before the age of 65) among individuals with substance use disorders (SUDs).
The cohort was created by identifying all Swedish patients diagnosed with SUD between the first of January 2013 and 31st of December 2014. The individuals were split into three age categories.
There were significant differences in standard mortality rates (SMR) in the cohort compared to the general Swedish population across the three age categories. We found differences between the SMRs for individuals convicted of violent and nonviolent crimes in the two younger age categories [age 15-29: violent crime (42.4) vs. non-violent crime (36.6), age 30-44: violent crime (28.0) vs. non-violent crime (23.0)]. A Cox regression analysis showed that each conviction of a violent crime increased the hazard ratio (HR) of premature mortality significantly [age 15-29; HR = 1.10 (95% CI: 1.04-1.17), age 30-44; HR =1.06 (95% CI: 1.03-1.09)]. After correcting for non-violent crimes, the increased risk only remained for the youngest group [HR = 1.06 (95% CI: 1.00-1.13)].
This study suggests that criminal behavior constitutes a proxy for the risk behaviors that increase the risk of premature mortality among young individuals with SUD even after controlling for confounders. Longitudinal studies, examining time-dependent risks and protective influences, are needed to explain the different pathways and processes leading to the amplified premature mortality in the groups.
了解暴力犯罪及其对健康的影响以及最终过早死亡的风险，对于未来有效的干预措施至关重要。本研究旨在探讨暴力犯罪对患有物质使用障碍（SUD）的个体过早死亡（即65岁之前死亡）的影响。
该队列通过识别2013年1月1日至2014年12月31日期间所有被诊断患有SUD的瑞典患者而创建。这些个体被分为三个年龄类别。
与瑞典总人口相比，该队列在三个年龄类别中的标准死亡率（SMR）存在显著差异。我们发现两个较年轻年龄类别中因暴力犯罪和非暴力犯罪被定罪的个体的SMR之间存在差异[15 - 29岁：暴力犯罪（42.4）与非暴力犯罪（36.6），30 - 44岁：暴力犯罪（28.0）与非暴力犯罪（23.0）]。Cox回归分析表明，每次暴力犯罪定罪都会显著增加过早死亡的风险比（HR）[15 - 29岁；HR = 1.10（95%置信区间：1.04 - 1.17），30 - 44岁；HR = 1.06（95%置信区间：1.03 - 1.09）]。在对非暴力犯罪进行校正后，增加的风险仅在最年轻的组中仍然存在[HR = 1.06（95%置信区间：1.00 - 1.13）]。
本研究表明，即使在控制混杂因素之后，犯罪行为仍是增加患有SUD的年轻个体过早死亡风险的风险行为的一个代表。需要进行纵向研究，检查随时间变化的风险和保护影响，以解释导致这些组中过早死亡率升高的不同途径和过程。
