The burden for clinical services of persons with an intellectual disability or mental disorder convicted of criminal offences: A birth cohort study of 14,605 persons followed to age 64.

BACKGROUND: Intellectual disability (ID), schizophrenia spectrum disorder (SSD), bipolar disorder (BD), substance use disorder (SUD), and other mental disorders (OMDs) are associated with increased risks of criminality relative to sex-matched individuals without these conditions (NOIDMD). To resource psychiatric, addiction, and social services so as to provide effective treatments, further information is needed about the size of sub-groups convicted of crimes, recidivism, timing of offending, antecedents, and correlates. Stigma of persons with mental disorders could potentially be dramatically reduced if violence was prevented. METHODS: A birth cohort of 14,605 persons was followed to age 64 using data from Swedish national health, criminal, and social registers. RESULTS: Percentages of group members convicted of violence differed significantly: males NOIDMD, 7.3%, ID 29.2%, SSD 38.6%, BD 30.7%; SUD 44.0%, and OMD 19.3%; females NOIDMD 0.8%, ID 7.7%, SSD 11.2%, BD 2.4%, SD 17.0%, and OMD 2.1%. Violent recidivism was high. Most violent offenders in the diagnostic groups were also convicted of non-violent crimes. Prior to first diagnosis, convictions (violent or non-violent) had been acquired by over 90% of the male offenders and two-thirds of the female offenders. Physical victimization, adult comorbid SUD, childhood conduct problems, and adolescent substance misuse were each associated with increased risks of offending. CONCLUSION: Sub-groups of cohort members with ID or mental disorders were convicted of violent and non-violent crimes to age 64 suggesting the need for treatment of primary disorders and for antisocial/aggressive behavior. Many patients engaging in violence could be identified at first contact with clinical services.

Processes of intermittency in criminal careers: notes from a Swedish study on life courses and crime.

This article explores the concept of "intermittency" and uses qualitative life history narratives with male offenders from The Stockholm Life Course Project to distinguish between two qualitatively different forms of intermittent offending. Findings suggest that one form of intermittency can be characterized by "breaks" and "pauses" in offending, where the offender for a period of time "holds up" but without attempting to commit to any long-term change in trajectory. The second form can best be understood as incomplete or aborted attempts at desistance, where attempts to change are present but not realized. Perceived or experienced failure to enter conventional roles and engage in conventional practices is highly relevant to understand these attempts. The intermittent zigzag patterns of offending observed in quantitative studies of criminal careers can thus actually entail qualitatively different life course processes of continuity and change. Implications for policy and future research are highlighted.