Risk of being convicted of theft and other crimes in anorexia nervosa and bulimia nervosa: A prospective cohort study in a Swedish female population.

ABSTRACT

OBJECTIVE: We examined epidemiological associations between anorexia nervosa (AN) and bulimia nervosa (BN) and risks of committing theft and other crimes in a nationwide female population. METHOD: Females born in Sweden during 1979-1998 (N = 957,106) were followed from age 15 for up to 20 years using information on clinically diagnosed AN and BN (exposures), convictions of theft and other crimes (outcomes), psychiatric comorbidities, and familial relatedness from Swedish national registers. We estimated hazard ratios (HRs) of criminality in exposed versus unexposed females using Cox proportional hazards regressions and explored how comorbidities and unmeasured familial factors explained the associations. RESULTS: The cumulative incidence of convictions of theft (primarily petty theft) and other crimes was higher in exposed females (AN 11.60% theft, 7.39% other convictions; BN 17.97% theft, 13.17% other convictions) than in unexposed females (∼5% theft, ∼6% other convictions). The significantly increased risk of being convicted of theft in exposed females (AN HR = 2.51, 95% confidence interval = [2.29, 2.74], BN 4.31 [3.68, 5.05]) was partially explained by comorbidities; unmeasured familial factors partially explained the association with convictions of theft in BN but not in AN. Females with BN had a doubled risk of convictions of other crimes, which was partially explained by comorbidities. DISCUSSION: Individuals with eating disorders had increased risk for convictions of theft and potentially other crimes. Results underscore the importance of regular forensic screening and encourage research on mechanisms underlying the relation between crime and eating disorder psychopathology and efforts to determine how best to address such relation in treatment.