title: Mentally disordered offenders in Sweden: differentiating recidivists from non-recidivists in a 10-year follow-up study.
abstract: BACKGROUND
  Forensic psychiatric patients present a challenge as they manifest severe mental disorders together with criminal behaviour. There are well-known risk factors for criminal behaviour in the general population, yet knowledge of what predicts reconviction in the Swedish forensic population in the long-term perspective is still insufficient.
  
  
  OBJECTIVE
  The study aims to (1) describe background and clinical characteristics of forensic psychiatric patients in a 10-year follow-up, (2) analyse risk factors associated with recidivism, and (3) test the predictive validity of risk factors for general and violent criminality.
  
  
  METHODS
  Detailed information on all offenders from the Malmö University Hospital catchment area sentenced to forensic psychiatric in-patient treatment from 1999-2005 (n = 125) was collected. Court decisions were collected up until the end of 2008 (median follow-up time = 6.2 years, range = 0.6-9.7 years).
  
  
  RESULTS
  Relapse in general crime (n = 30) was predicted by low educational attainment, mental disorder in a first degree relative, and low age at first sentenced crime. Relapse in violent crime (n = 16) was predicted by low educational attainment and low GAF scores. Patients with a restriction order were less likely to relapse in both crime categories.
  
  
  CONCLUSIONS
  Signs of childhood adversities together with early debut in criminality appeared as important risk factors for general and violent recidivism. Forensic psychiatric treatment combined with a restriction order was demonstrated as a protective factor against recidivism, suggesting that the risk of recidivism is strongly related to the level of supervision. Although the low number of recidivism cases is highly desirable, it unfortunately reduces the power of the analyses in this paper.
authors.affiliation: a Lund University, Department of Clinical Sciences , Lund , Sweden.
authors.forename: Hedvig
authors.initials: H
authors.lastname: Krona
authors.affiliation: a Lund University, Department of Clinical Sciences , Lund , Sweden.
authors.forename: Marielle
authors.initials: M
authors.lastname: Nyman
authors.affiliation: a Lund University, Department of Clinical Sciences , Lund , Sweden.
authors.forename: Helena
authors.initials: H
authors.lastname: Andreasson
authors.affiliation: a Lund University, Department of Clinical Sciences , Lund , Sweden.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Vicencio
authors.affiliation: b Institute of Neuroscience and Physiology, Department of Forensic Psychiatry and Center of Ethics, Law and Mental Health , University of Gothenburg , Sweden.
authors.forename: Henrik
authors.initials: H
authors.lastname: Anckarsäter
authors.affiliation: a Lund University, Department of Clinical Sciences , Lund , Sweden.
authors.forename: Märta
authors.initials: M
authors.lastname: Wallinius
authors.affiliation: b Institute of Neuroscience and Physiology, Department of Forensic Psychiatry and Center of Ethics, Law and Mental Health , University of Gothenburg , Sweden.
authors.forename: Thomas
authors.initials: T
authors.lastname: Nilsson
authors.affiliation: a Lund University, Department of Clinical Sciences , Lund , Sweden.
authors.forename: Björn
authors.initials: B
authors.lastname: Hofvander
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003415:Crime / Q000706:statistics & numerical data*; D057237:Criminals / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D005555:Forensic Psychiatry; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D014754:Violence / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Forensic psychiatry; prediction; risk assessment; violent recidivism