Criminality and suicide: a longitudinal Swedish cohort study

Area of Science:

• Forensic Psychiatry
• Public Health
• Epidemiology

Background:

• Offending behavior is a known risk factor for adverse health outcomes.
• Previous research has indicated a link between criminality and suicide, but the specific impact of offense type and comorbidity requires further investigation.

Purpose of the Study:

• To examine the association between violent and non-violent offending and suicide risk.
• To determine if repeated offenses amplify suicide risk.
• To investigate the modifying effects of substance misuse and prior suicide attempts on this relationship.

Main Methods:

• A nationwide prospective cohort study of 48,834 Swedish conscripted men (1969/1970) followed for 35 years.
• Data linkage with official registers for mortality, hospitalization, and crime records.
• Cox proportional regression analyses adjusted for confounding factors including family history, psychological, and behavioral issues, substance use, and psychiatric disorders.

Main Results:

• Violent offenders had a nearly five-fold increased suicide risk (HR=4.69), and non-violent offenders had a two-fold increased risk (HR=2.08) in crude models.
• Even after full adjustment for confounders, non-violent offenders showed a significantly elevated suicide risk.
• Comorbidity with alcohol/substance use and psychiatric disorders modified the risk.

Conclusions:

• Both violent and non-violent criminality are associated with an elevated risk of suicide.
• The elevated suicide risk for non-violent offenders persists even after accounting for various confounding factors.
• Identifying offenders, particularly repeat offenders with co-occurring substance misuse and psychiatric disorders, is critical for suicide prevention efforts.