Child and adolescent psychiatric patients and later criminality

<p>Abstract</p> <p>Background</p> <p>Sweden has an extensive child and adolescent psychiatric (CAP) research tradition in which longitudinal methods are used to study juvenile delinquency. Up to the 1980s, results from descriptions and follow-ups of cohorts of CAP patients showed that children's behavioural disturbances or disorders and school problems, together with dysfunctional family situations, were the main reasons for families, children, and youth to seek help from CAP units. Such factors were also related to registered criminality and registered alcohol and drug abuse in former CAP patients as adults. This study investigated the risk for patients treated 1975–1990 to be registered as criminals until the end of 2003.</p> <p>Methods</p> <p>A regional sample of 1,400 former CAP patients, whose treatment occurred between 1975 and 1990, was followed to 2003, using database-record links to the Register of Persons Convicted of Offences at the National Council for Crime Prevention (NCCP).</p> <p>Results</p> <p>Every third CAP patient treated between 1975 and 1990 (every second man and every fifth woman) had entered the Register of Persons Convicted of Offences during the observation period, which is a significantly higher rate than the general population.</p> <p>Conclusion</p> <p>Results were compared to published results for CAP patients who were treated between 1953 and 1955 and followed over 20 years. Compared to the group of CAP patients from the 1950s, the results indicate that the risk for boys to enter the register for criminality has doubled and for girls, the risk seems to have increased sevenfold. The reasons for this change are discussed. Although hypothetical and perhaps speculative this higher risk of later criminality may be the result of lack of social control due to (1) rising consumption of alcohol, (2) changes in organisation of child social welfare work, (3) the school system, and (4) CAP methods that were implemented since 1970.</p

Revision of ICD – status update on feeding and eating disorders

TheWorld Health Organization is currently revising the International Classification of Diseases and Related Health Problems (ICD-10). A central goal for the revision of the ICD classification of mental and behavioural disorders is to improve its clinical utility. Global representation and cultural sensitivity and relevance are important across all mental disorders, but are especially critical to advancing our understanding, diagnosis and treatment of feeding and eating disorders (FED). This paper summarises the current status of the Eating Disorders Consultation Group (EDCG) considerations regarding diagnostic categories for FEDs in ICD-11 and represents work in progress. The recommendations of the EDCG are informed by relevant research evidence, and the consultation group is striving to find a balance between clinical utility and diagnostic purity. Provisional recommendations of the EDCG include: (1) merger of previous FEDs categories in one group; (2) inclusion of six main FED categories that include anorexia nervosa (AN), bulimia nervosa (BN), pica, regurgitation disorder, binge-eating disorder (BED) and avoidant/restrictive food intake disorder, the last two representing new categories; (3) broadening of categories with the aim of reducing the use of the unspecified ED category (e.g. dropping the amenorrhea requirement, increasing the body mass index cut-off for low weight and rewording the cognitive and behavioural features of AN to be more culturally-sensitive). In line with this last recommendation, one point that require further analysis pertain to frequency and severity of the binge-eating and purging behaviours in BN and BED, as the EDCG is considering reducing or eliminating the frequency criterion and broadening the binge-eating criterion to include ‘subjective’ binge episodes