Risk of Violent Crime in Individuals with Epilepsy and Traumatic Brain Injury: A 35-Year Swedish Population Study
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{"title"=>"Risk of violent crime in individuals with epilepsy and traumatic brain injury: A 35-year Swedish population study", "type"=>"journal", "authors"=>[{"first_name"=>"Seena", "last_name"=>"Fazel", "scopus_author_id"=>"7003589504"}, {"first_name"=>"Paul", "last_name"=>"Lichtenstein", "scopus_author_id"=>"7005398112"}, {"first_name"=>"Martin", "last_name"=>"Grann", "scopus_author_id"=>"7003352398"}, {"first_name"=>"Niklas", "last_name"=>"Långström", "scopus_author_id"=>"6603903034"}], "year"=>2011, "source"=>"PLoS Medicine", "identifiers"=>{"issn"=>"15491277", "isbn"=>"15491277", "pmid"=>"22215988", "scopus"=>"2-s2.0-84855170412", "doi"=>"10.1371/journal.pmed.1001150", "sgr"=>"84855170412", "pui"=>"364014896"}, "id"=>"eee68896-9ac6-3a09-853e-ac05dd099926", "abstract"=>"Background: Epilepsy and traumatic brain injury are common neurological conditions, with general population prevalence estimates around 0.5% and 0.3%, respectively. Although both illnesses are associated with various adverse outcomes, and expert opinion has suggested increased criminality, links with violent behaviour remain uncertain. Methods and Findings: We combined Swedish population registers from 1973 to 2009, and examined associations of epilepsy (n = 22,947) and traumatic brain injury (n = 22,914) with subsequent violent crime (defined as convictions for homicide, assault, robbery, arson, any sexual offense, or illegal threats or intimidation). Each case was age and gender matched with ten general population controls, and analysed using conditional logistic regression with adjustment for socio-demographic factors. In addition, we compared cases with unaffected siblings. Among the traumatic brain injury cases, 2,011 individuals (8.8%) committed violent crime after diagnosis, which, compared with population controls (n = 229,118), corresponded to a substantially increased risk (adjusted odds ratio [aOR] = 3.3, 95% CI: 3.1-3.5); this risk was attenuated when cases were compared with unaffected siblings (aOR = 2.0, 1.8-2.3). Among individuals with epilepsy, 973 (4.2%) committed a violent offense after diagnosis, corresponding to a significantly increased odds of violent crime compared with 224,006 population controls (aOR = 1.5, 1.4-1.7). However, this association disappeared when individuals with epilepsy were compared with their unaffected siblings (aOR = 1.1, 0.9-1.2). We found heterogeneity in violence risk by age of disease onset, severity, comorbidity with substance abuse, and clinical subgroups. Case ascertainment was restricted to patient registers. Conclusions: In this longitudinal population-based study, we found that, after adjustment for familial confounding, epilepsy was not associated with increased risk of violent crime, questioning expert opinion that has suggested a causal relationship. In contrast, although there was some attenuation in risk estimates after adjustment for familial factors and substance abuse in individuals with traumatic brain injury, we found a significantly increased risk of violent crime. The implications of these findings will vary for clinical services, the criminal justice system, and patient charities.", "link"=>"http://www.mendeley.com/research/risk-violent-crime-individuals-epilepsy-traumatic-brain-injury-35year-swedish-population-study", "reader_count"=>77, "reader_count_by_academic_status"=>{"Unspecified"=>6, "Professor > Associate Professor"=>4, "Student > Doctoral Student"=>7, "Researcher"=>9, "Student > Ph. D. Student"=>17, "Student > Postgraduate"=>4, "Student > Master"=>11, "Other"=>3, "Student > Bachelor"=>7, "Lecturer"=>3, "Lecturer > Senior Lecturer"=>1, "Professor"=>5}, "reader_count_by_user_role"=>{"Unspecified"=>6, "Professor > Associate Professor"=>4, "Student > Doctoral Student"=>7, "Researcher"=>9, "Student > Ph. D. Student"=>17, "Student > Postgraduate"=>4, "Student > Master"=>11, "Other"=>3, "Student > Bachelor"=>7, "Lecturer"=>3, "Lecturer > Senior Lecturer"=>1, "Professor"=>5}, "reader_count_by_subject_area"=>{"Unspecified"=>8, "Medicine and Dentistry"=>24, "Agricultural and Biological Sciences"=>4, "Arts and Humanities"=>3, "Neuroscience"=>2, "Business, Management and Accounting"=>1, "Psychology"=>28, "Social Sciences"=>5, "Computer Science"=>1, "Linguistics"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>24}, "Neuroscience"=>{"Neuroscience"=>2}, "Social Sciences"=>{"Social Sciences"=>5}, "Psychology"=>{"Psychology"=>28}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>4}, "Computer Science"=>{"Computer Science"=>1}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>1}, "Linguistics"=>{"Linguistics"=>1}, "Unspecified"=>{"Unspecified"=>8}, "Arts and Humanities"=>{"Arts and Humanities"=>3}}, "reader_count_by_country"=>{"Greece"=>1, "Sweden"=>1, "Malaysia"=>1, "Switzerland"=>1}, "group_count"=>1}

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  • {"files"=>["https://ndownloader.figshare.com/files/355865"], "description"=>"<div><h3>Background</h3><p>Epilepsy and traumatic brain injury are common neurological conditions, with general population prevalence estimates around 0.5% and 0.3%, respectively. Although both illnesses are associated with various adverse outcomes, and expert opinion has suggested increased criminality, links with violent behaviour remain uncertain.</p> <h3>Methods and Findings</h3><p>We combined Swedish population registers from 1973 to 2009, and examined associations of epilepsy (<em>n</em> = 22,947) and traumatic brain injury (<em>n</em> = 22,914) with subsequent violent crime (defined as convictions for homicide, assault, robbery, arson, any sexual offense, or illegal threats or intimidation). Each case was age and gender matched with ten general population controls, and analysed using conditional logistic regression with adjustment for socio-demographic factors. In addition, we compared cases with unaffected siblings.</p> <p>Among the traumatic brain injury cases, 2,011 individuals (8.8%) committed violent crime after diagnosis, which, compared with population controls (<em>n</em> = 229,118), corresponded to a substantially increased risk (adjusted odds ratio [aOR] = 3.3, 95% CI: 3.1–3.5); this risk was attenuated when cases were compared with unaffected siblings (aOR = 2.0, 1.8–2.3). Among individuals with epilepsy, 973 (4.2%) committed a violent offense after diagnosis, corresponding to a significantly increased odds of violent crime compared with 224,006 population controls (aOR = 1.5, 1.4–1.7). However, this association disappeared when individuals with epilepsy were compared with their unaffected siblings (aOR = 1.1, 0.9–1.2). We found heterogeneity in violence risk by age of disease onset, severity, comorbidity with substance abuse, and clinical subgroups. Case ascertainment was restricted to patient registers.</p> <h3>Conclusions</h3><p>In this longitudinal population-based study, we found that, after adjustment for familial confounding, epilepsy was not associated with increased risk of violent crime, questioning expert opinion that has suggested a causal relationship. In contrast, although there was some attenuation in risk estimates after adjustment for familial factors and substance abuse in individuals with traumatic brain injury, we found a significantly increased risk of violent crime. The implications of these findings will vary for clinical services, the criminal justice system, and patient charities.</p> <h3></h3><p> <em>Please see later in the article for the Editors' Summary</em></p> </div>", "links"=>[], "tags"=>["individuals", "epilepsy", "traumatic", "35-year", "swedish"], "article_id"=>130320, "categories"=>["Medicine", "Biotechnology", "Neuroscience"], "users"=>["Seena Fazel", "Paul Lichtenstein", "Martin Grann", "Niklas Långström"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001150", "stats"=>{"downloads"=>0, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Risk_of_Violent_Crime_in_Individuals_with_Epilepsy_and_Traumatic_Brain_Injury_A_35_Year_Swedish_Population_Study/130320", "title"=>"Risk of Violent Crime in Individuals with Epilepsy and Traumatic Brain Injury: A 35-Year Swedish Population Study", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-12-27 00:05:20"}
  • {"files"=>["https://ndownloader.figshare.com/files/698519"], "description"=>"a<p>Comparison with general population controls matched by age (birth year) and gender, and adjusted by income (lowest versus middle and highest thirds), marital status (single versus not single), and immigrant status (individual born outside Sweden versus not). aOR, adjusted odds ratio.</p>", "links"=>[], "tags"=>["individuals", "epilepsy", "traumatic", "sweden", "compared"], "article_id"=>368912, "categories"=>["Medicine", "Biotechnology", "Neuroscience"], "users"=>["Seena Fazel", "Paul Lichtenstein", "Martin Grann", "Niklas Långström"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001150.t002", "stats"=>{"downloads"=>0, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Risk_of_violent_crime_in_individuals_after_diagnosis_with_epilepsy_or_traumatic_brain_injury_in_Sweden_1973_8211_2009_compared_with_general_population_controls_/368912", "title"=>"Risk of violent crime in individuals after diagnosis with epilepsy or traumatic brain injury in Sweden (1973–2009) compared with general population controls.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-12-27 02:28:32"}
  • {"files"=>["https://ndownloader.figshare.com/files/698597"], "description"=>"<p>Single status was defined as being unmarried. Data on income were from the 1990 census and were not available for 4,676 individuals with epilepsy and 53,916 matched population controls, and for 5,048 individuals with traumatic brain injury and 19,278 corresponding controls. Data on single status were not available for 4,157 individuals with epilepsy and 21,052 matched population controls, and for 3,986 individuals with traumatic brain injury and 19,278 corresponding controls. No data were missing on the other variables.</p><p>n/a, not applicable; SD, standard deviation; SEK, Swedish Kronor.</p>", "links"=>[], "tags"=>["socio-demographic", "individuals", "included"], "article_id"=>368998, "categories"=>["Medicine", "Biotechnology", "Neuroscience"], "users"=>["Seena Fazel", "Paul Lichtenstein", "Martin Grann", "Niklas Långström"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001150.t001", "stats"=>{"downloads"=>0, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Baseline_socio_demographic_information_for_individuals_included_in_the_study_/368998", "title"=>"Baseline socio-demographic information for individuals included in the study.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-12-27 02:29:58"}
  • {"files"=>["https://ndownloader.figshare.com/files/698555"], "description"=>"<p>Association between epilepsy and traumatic brain injury and subsequent violent crime in Sweden (1973–2009) stratified by age of first diagnosis, clinical subtype, and severity.</p>", "links"=>[], "tags"=>["epilepsy", "traumatic", "sweden", "stratified"], "article_id"=>368952, "categories"=>["Medicine", "Biotechnology", "Neuroscience"], "users"=>["Seena Fazel", "Paul Lichtenstein", "Martin Grann", "Niklas Långström"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001150.t003", "stats"=>{"downloads"=>0, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Association_between_epilepsy_and_traumatic_brain_injury_and_subsequent_violent_crime_in_Sweden_1973_8211_2009_stratified_by_age_of_first_diagnosis_clinical_subtype_and_severity_/368952", "title"=>"Association between epilepsy and traumatic brain injury and subsequent violent crime in Sweden (1973–2009) stratified by age of first diagnosis, clinical subtype, and severity.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-12-27 02:29:12"}

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Relative Metric

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