title: Mortality and causes of death among violent offenders and victims--a Swedish population based longitudinal study.
abstract: BACKGROUND
  Most previous studies on mortality in violent offenders or victims are based on prison or hospital samples, while this study analyzed overall and cause specific mortality among violent offenders, victims, and individuals who were both offenders and victims in a general sample of 48,834 18-20 year-old men conscripted for military service in 1969/70 in Sweden.
  
  
  METHODS
  Each person completed two non-anonymous questionnaires concerning family, psychological, and behavioral factors. The cohort was followed for 35 years through official registers regarding violent offenses, victimization, and mortality. The impact of violence, victimization, early risk factors and hospitalization for psychiatric diagnosis or alcohol and drug misuse during follow up on mortality was investigated using Cox proportional hazard regression analyses.
  
  
  RESULTS
  Repeat violent offenses were associated with an eleven fold higher hazard of dying from a substance-related cause and nearly fourfold higher hazard of dying from suicide. These figures remained significantly elevated also in multivariate analyses, with a 3.03 and 2.39 hazard ratio (HR), respectively. Participants with experience of violence and inpatient care for substance abuse or psychiatric disorder had about a two to threefold higher risk of dying compared to participants with no substance use or psychiatric disorder.
  
  
  CONCLUSIONS
  Violent offending and being victimized are associated with excess mortality and a risk of dying from an alcohol or drug-related cause or suicide. Consequently, prevention of violent behavior might have an effect on overall mortality and suicide rates. Prevention of alcohol and drug use is also warranted.
authors.affiliation: Addiction Center Stockholm, Karolinska University Hospital Solna, Building Z8, 171 76 Stockholm, Sweden. marlene.stenbacka@sll.se
authors.forename: Marlene
authors.initials: M
authors.lastname: Stenbacka
authors.forename: Tomas
authors.initials: T
authors.lastname: Moberg
authors.forename: Anders
authors.initials: A
authors.lastname: Romelsjö
authors.forename: Jussi
authors.initials: J
authors.lastname: Jokinen
mesh_terms: D000293:Adolescent; D002423:Cause of Death / Q000639:trends*; D019548:Crime Victims; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009026:Mortality / Q000639:trends*; D016016:Proportional Hazards Models; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D014754:Violence / Q000706:statistics & numerical data; D055815:Young Adult