title: Antidepressant use and violent crimes among young people: a longitudinal examination of the Finnish 1987 birth cohort.
abstract: The use of antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), has been questioned due to poor efficacy and safety. We examined whether young violent offenders were more likely antidepressant users prior to their first violent offence than other young persons.
  
  
  
  The study is a follow-up of children born in Finland in 1987 (n=59 120), linking national registers to each other using personal identity codes. Data on psychotropic drug use came from a register of reimbursed drugs and data on crimes from a register on court convictions (after the age of 14 years). Participants were followed until the age of 18 years, and for some analyses until the end of the follow-up (mean 21 years). To adjust for differences in background characteristics, regression analyses for antidepressant use were made, using the no-conviction group as the reference.
  
  
  
  Proportions of young people convicted by the age of 18 years were: 5% of boys (1.7% for violent crimes) and 1% (0.5%) of girls. Antidepressant use (both overall and for SSRIs) prior to violent crime was more common among those convicted than among those without convictions. Among boys with repeated violent crimes, it was also more common than among boys with non-violent crimes. Adjustment for differences in background characteristics decreased the associations between antidepressant use and violent crime, but did not eliminate them.
  
  
  
  The results add further evidence for caution in prescribing antidepressants among young persons. It also calls for a reanalysis of violence measures in the original trial data.
authors.affiliation: THL, Health and Social Care Systems, Helsinki, Finland.
authors.forename: Elina
authors.initials: E
authors.lastname: Hemminki
authors.affiliation: Children, Adolescents and Families Unit, THL, Oulu, Finland.
authors.forename: Marko
authors.initials: M
authors.lastname: Merikukka
authors.affiliation: Information Services, THL, Helsinki Finland.
authors.forename: Mika
authors.initials: M
authors.lastname: Gissler
authors.affiliation: Mental Health Unit, THL, Helsinki Finland.
authors.forename: Kristian
authors.initials: K
authors.lastname: Wahlbeck
authors.affiliation: Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Jukka
authors.initials: J
authors.lastname: Savolainen
authors.affiliation: Children, Adolescents and Families Unit, THL, Oulu, Finland.
authors.forename: Tiina
authors.initials: T
authors.lastname: Ristikari
authors.affiliation: Institute of Criminology and Legal Policy, University of Helsinki, Helsinki Finland.
authors.forename: Mikko
authors.initials: M
authors.lastname: Aaltonen
mesh_terms: D000293:Adolescent; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003415:Crime / Q000523:psychology* / Q000706:statistics & numerical data*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012307:Risk Factors; D014754:Violence / Q000523:psychology* / Q000706:statistics & numerical data*
chemical_list: D000928:Antidepressive Agents
keywords: DRUG SAFETY; LONGITUDINAL STUDIES; PHARMACOEPIDEMIOLOGY; PSYCHIATRY; VIOLENCE