title: Mental health among young adults in prison: the importance of childhood-onset conduct disorder.
abstract: BACKGROUND
  The psychiatric health burden of prisoners is substantial. However, there is a lack of high-quality studies of psychiatric disorders among young adults with a high risk of reoffending.
  
  
  OBJECTIVE
  To investigate the lifetime prevalence of psychiatric disorders and use of mental health services among young male violent offenders and the impact of childhood-onset conduct disorder (COCD).
  
  
  METHODS
  A nationally representative cohort (n= 270, age 18-25) of male offenders was followed back in medical records and clinically assessed by gold standard methods. Lifetime prevalences are presented together with odds ratios (ORs) as risk estimates in relation to COCD.
  
  
  RESULTS
  Previous use of psychiatric services among the participants was high but their lifetime psychiatric morbidity was even higher, with 93% meeting criteria for at least one Axis I disorder. The COCD group was overrepresented in most clinical categories and carried five times higher odds (OR = 5.1, 95% CI 2.0-12.8) of a psychotic disorder, three times higher odds (OR = 3.2, 95% CI 1.2-8.5) of a substance use disorder and two times higher odds of a mood disorder (OR = 2.3, 95% CI 1.3-4.0) or anxiety disorder (OR = 2.0, 95% CI 1.1-3.5).
  
  
  CONCLUSIONS
  The mental health burden is substantial among young violent offenders, and COCD is an important indicator of future mental health problems which must be a priority for public health efforts.
  
  
  BACKGROUND
  None.
  © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.
authors.affiliation: , PhD, Department of Clinical Sciences, Lund, Child and Adolescent Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden; Division of Forensic Psychiatry, Region Skåne, Kristianstad, Sweden; Department of Psychiatry, Autism Research Centre, University of Cambridge, Cambridge, UK.
authors.forename: Björn
authors.initials: B
authors.lastname: Hofvander
authors.affiliation: , MD, Department of Forensic Psychiatry, Centre of Ethics, Law and Mental Health, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Henrik
authors.initials: H
authors.lastname: Anckarsäter
authors.affiliation: , PhD, Department of Clinical Sciences, Lund, Child and Adolescent Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden; Regional Forensic Psychiatric Clinic, Växjö, Sweden.
authors.forename: Märta
authors.initials: M
authors.lastname: Wallinius
authors.affiliation: , PhD, Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Billstedt