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International Journal of Eating Disorders
ORIGINAL ARTICLE

Risk of being convicted of theft and other crimes in anorexia nervosa and bulimia nervosa: A prospective cohort study in a Swedish female population

Shuyang Yao MSc

Corresponding Author

E-mail address:shuyang.yao@ki.se

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

Correspondence Shuyang Yao, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, Stockholm, Sweden. Email:

shuyang.yao@ki.se

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Ralf Kuja‐Halkola PhD

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

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Laura M. Thornton PhD

Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

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Claes Norring PhD

Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden

Stockholm Center for Eating Disorders, Stockholm Health Care Services, Stockholm, Sweden

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Catarina Almqvist MD, PhD

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden

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Brian M. D'Onofrio PhD

Department of Psychological and Brain Science, Indiana University, Bloomington, Indiana

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Paul Lichtenstein PhD

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

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Niklas Långström MD, PhD

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

Department of Neuroscience, Uppsala University, Uppsala, Sweden

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Cynthia M. Bulik PhD

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

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Henrik Larsson PhD

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

School of Medical Sciences, Örebro University, Örebro, Sweden

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First published: 09 August 2017

Funding information China Scholarship Council (S.Y.); Swedish Research Council (C.M.B.), Grant Number: VR Dnr: 538‐2013‐8864; Swedish Research Council, Grant Number: 2011‐3060; Swedish Initiative for Research on Microdata in the Social and Medical Sciences (SIMSAM) framework, Grant Number: 340‐2013‐5867.

Abstract

Objective

We examined epidemiological associations between anorexia nervosa (AN) and bulimia nervosa (BN) and risks of committing theft and other crimes in a nationwide female population.

Method

Females born in Sweden during 1979–1998 (N = 957,106) were followed from age 15 for up to 20 years using information on clinically diagnosed AN and BN (exposures), convictions of theft and other crimes (outcomes), psychiatric comorbidities, and familial relatedness from Swedish national registers. We estimated hazard ratios (HRs) of criminality in exposed versus unexposed females using Cox proportional hazards regressions and explored how comorbidities and unmeasured familial factors explained the associations.

Results

The cumulative incidence of convictions of theft (primarily petty theft) and other crimes was higher in exposed females (AN: 11.60% theft, 7.39% other convictions; BN: 17.97% theft, 13.17% other convictions) than in unexposed females (∼5% theft, ∼6% other convictions). The significantly increased risk of being convicted of theft in exposed females (AN: HR = 2.51, 95% confidence interval = [2.29, 2.74], BN: 4.31 [3.68, 5.05]) was partially explained by comorbidities; unmeasured familial factors partially explained the association with convictions of theft in BN but not in AN. Females with BN had a doubled risk of convictions of other crimes, which was partially explained by comorbidities.

Discussion

Individuals with eating disorders had increased risk for convictions of theft and potentially other crimes. Results underscore the importance of regular forensic screening and encourage research on mechanisms underlying the relation between crime and eating disorder psychopathology and efforts to determine how best to address such relation in treatment.