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Short-term effects of psychiatric symptoms and interpersonal stressors on criminal violence

A case-crossover study

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Abstract

Background

The aim of the study was to analyse the triggering or acute risk effect of psychiatric symptoms and interpersonal stressors on criminal violence.

Method

One hundred and thirty three violent offenders were recruited from a forensic psychiatric evaluation (FPE) unit and a national prison evaluation unit in Sweden during 2002–2003, and were interviewed about trigger exposures. A case-crossover design was used eliminating long-term within individual confounding.

Results

Suicidal ideation or parasuicide within 24 h before the violent event conferred a ninefold risk increase. In contrast, violent ideation did not trigger criminal violence. Hallucinations yielded a fourfold risk increase, whereas paranoid thoughts were associated with a small and statistically non-significant risk increase. Acute conflicts with others and being denied psychiatric care within 24 h before violence also increased the risk of acting violently.

Conclusions

Some tested psychiatric symptoms and stressors triggered criminal violence, whereas others did not. The case-crossover design may be particularly useful for the study of triggers of violence.

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Notes

  1. In Sweden, offenders are referred to forensic psychiatric evaluation (FPE) at the discretion of the criminal court, if they suspect that the offender may fulfil criteria for medico-legal insanity. Approximately half of those undergoing a FPE are declared insane in the medico-legal sense and referred to compulsory in-patient forensic psychiatric care.

  2. All male offenders sentenced to more than four years in prison are referred to the national risk assessment unit at the Kumla high security prison, where risk assessments are made attending to placement requirements and offender risk/need profiles.

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Acknowledgement

We acknowledge financial support from the Vårdal, the Söderström-Königska, and the Bror Gadelius’ Memorial Foundations and the National Board of Forensic Medicine

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Authors and Affiliations

  1. Dept. of Clinical Neuroscience Centre for Violence Prevention, Karolinska Institutet, P.O. Box 23000, 104 35, Stockholm, Sweden

    Ulrika Haggård-Grann & Niklas Långström

  2. Dept. of Public Health Sciences Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden

    Johan Hallqvist & Jette Möller

Authors
  1. Ulrika Haggård-Grann
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  2. Johan Hallqvist
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  3. Niklas Långström
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  4. Jette Möller
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Correspondence to Ulrika Haggård-Grann.

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Haggård-Grann, U., Hallqvist, J., Långström, N. et al. Short-term effects of psychiatric symptoms and interpersonal stressors on criminal violence. Soc Psychiat Epidemiol 41, 532–540 (2006). https://doi.org/10.1007/s00127-006-0056-0

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