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People with bipolar disorder and comorbid substance abuse are six times more likely to be convicted of violent crime than the general population

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Question

Question

Is bipolar disorder associated with violent crime?

Population

3743 individuals with two or more discharge diagnoses of bipolar disorder, and 4059 unaffected full siblings of 2570 of these individuals, plus 37 429 general population controls. General population controls were randomly selected from the population, with about 10 age- and gender-matched controls selected for each person with bipolar disorder.

Setting

Population-based registers in Sweden from January 1, 1973, to December 31, 2004.

Prognostic factors

Bipolar disorder discharge diagnoses according to the International Classification of Diseases, ICD-8, ICD-9 or ICD-10. Data on sociodemographic factors was also obtained, and significant confounders adjusted for in the analyses (age, gender, income, marital status and immigrant status).

Outcomes

Convictions of violent crime, including homicide, assault, robbery, arson, any sexual offense (rape, sexual coercion, child molestation, indecent exposure or sexual harassment), illegal threats or intimidation. Attempted and aggravated forms of offences were also included where applicable. Only offences which occurred after the diagnoses of bipolar disorder were included.

Methods

Design

Cohort study plus a systematic review and meta analysis (see Notes below).

Follow-up period

Up to 31 years.

Main results

The prevalence of convictions for violent crime among people …

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