Sexual Abuse: A Journal of Research and Treatment [saj] pp1085-sebu-478694 April 6, 2004 19:8 Style ﬁle version Nov 28th, 2002
Sexual Abuse: A Journal of Research and Treatment, Vol. 16, No. 2, April 2004 (
Psychiatric Disorders and Recidivism
in Sexual Offenders
and Martin Grann
Research on psychiatricmorbidity in sexual offenders (SOs) has mostly been based
on small, selected samples. We studied psychiatric disorders and their relationship
with criminal recidivism in a nationwide, representative cohort of SOs. Data on
ICD-9 and -10 psychiatricand neurologic morbidity diagnosed during hospital ad-
missions 1987–1997, butprior to sexualoffending, were retrieved for all adult male
SOs released from Swedish prisons 1993–1997(N = 1215).Preoffending disorder
prevalence and associations between morbidity and criminal reconvictions during
a 5-year postdetainment follow-up were explored. Alcohol use disorder was the
most frequent diagnosis, followed by drug use disorder, personality disorder, and
psychosis. Morbidity requiring admission to hospital was more common in rapists
as compared to child molesters. Alcohol use disorder, drug use disorder, person-
ality disorder, and psychosis all increased the risk for sexual recidivism whereas
alcohol use disorder and personality disorder predicted violent nonsexual recidi-
vism. Controlling for sociodemographicconfounds changed the risk estimates only
marginally. Because disorders were identiﬁed among only those who had been ad-
mitted to psychiatric hospitals as inpatients, underestimation of true prevalence
rates was inevitable. However, our ﬁndings support psychiatric consultation for
improved assessment and management of mental health needs and recidivism risk
KEY WORDS: psychiatric morbidity; sexual offending; criminal recidivism; risk assessment.
Preliminary results from the current study were presented as a poster at the 19th Annual Research and
Treatment Conference of the Association for the Treatment of Sexual Abusers, November 1–4, 2000,
in San Diego, CA, USA.
Centre for Violence Prevention, Karolinska Institute, Stockholm, Sweden.
To whom correspondence should be addressed at Centre for Violence Prevention, Karolinska Institute,
P.O. Box 23000, S-104 35 Stockholm, Sweden; e-mail: firstname.lastname@example.org.
2004 Plenum Publishing Corporation