The mortality of young offenders sentenced to prison and its association with psychiatric disorders: a register study.
BACKGROUND
We studied the nationwide mortality in Finland of young offenders sentenced to prison, with the advantage of a long-term follow-up in an unselected population. In addition, we aimed to clarify the relationship between psychiatric disorders requiring hospital treatment and early death in young offenders sentenced to prison.


METHODS
All offenders sentenced to prison between 1984 and 2000 in Finland and aged 15-21 years when the crime was committed were selected for this study. The mortality of the young offenders was compared with the age- and sex-matched mortality data of the general population, obtained from Statistics Finland. Information on hospital treatment periods for psychiatric diagnoses was collected from the Finnish Health Care Register and linked to the mortality data.


RESULTS
The study population consisted of 3,743 young male and 89 young female offenders. Of these, 435 (11.4%) had died by the end of the follow-up period, including 3 girls. The standardized mortality ratio for young male prisoners was 7.4 (95% confidence interval 6.7-8.1). There was a higher mortality rate among young offenders convicted in the later years of the study period. The causes of death were mostly unnatural and often violent. Hospitalization for a psychiatric disorder or substance abuse was significantly associated with the risk of death. However, hospitalization for emotional disorders with an onset specific to childhood and adolescence were associated with a lower death risk.


CONCLUSIONS
The mortality rate in the population of young offenders sentenced to prison is alarmingly high. The high mortality in this group is associated with substance abuse and psychiatric disorders, but not with emotional disorders with an onset specific to childhood and adolescence.
Sailas
Eila S
ES
National Research and Development Centre for Welfare and Health, STAKES, Helsinki, Finland. eila.sailas@stakes.fi
Feodoroff
Benjamin
B
Lindberg
Nina C
NC
Virkkunen
Matti E
ME
Sund
Reijo
R
Wahlbeck
Kristian
K
D000293:Adolescent; D000328:Adult; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D001523:Mental Disorders; D009026:Mortality / Q000639:trends*; D011329:Prisoners / Q000523:psychology*; D012042:Registries