Crime growth: early mental ills fuel young-adult offending.

A new study offers a rare glimpse of the psychiatric profiles of children most likely to commit crimes as young adults. It also suggests that childhood mental disorders substantially contribute to criminal behavior by adults.

Youngsters who exhibited emotional ailments, such as depression and anxiety disorders, along with substance abuse or other behavior problems had the greatest chance of getting arrested for serious and violent crimes by age 21, say psychologist William E. Copeland of Duke University Medical Center in Durham, N.C., and his colleagues.

Prior studies of small groups of children, which typically didn't monitor an array of psychiatric disorders, had linked pervasive misbehavior, often diagnosed as conduct disorder, and substance abuse to later law-breaking. The new data indicate that kids who combine behavior problems with certain emotional maladies show an especially strong propensity to commit serious crimes as adults.

Another childhood mental condition linked to behavior problems, attention-deficit hyperactivity disorder, displayed only a weak connection to later criminal acts, Copeland's group reports in the November American Journal of Psychiatry.

Among mainly white, rural participants, 21 percent of female crime and 15 percent of male crime in young adulthood stemmed from childhood mental disorders, the investigators estimate.

"These results suggest that prevention or psychiatric management of substance use among youths with emotional mental disorders has special significance," comments psychologist Thomas Grisso of the University of Massachusetts Medical School in Worcester.

Copeland and his coworkers analyzed data from a study of 1,420 children living in 11 predominantly rural counties of North Carolina. Initial psychiatric assessments of the youngsters, based on home interviews with each child and his or her parents, occurred at age 9, 11, or 13. Annual follow-up interviews were conducted through age 16. The researchers consulted court records to identify any criminal offenses committed by each volunteer between ages 16 and 21.

Nearly one-third of the participants committed one or more crimes in young adulthood. These acts included minor offenses, such as shoplifting; moderate offenses, such as drug-related crimes; and serious offenses, such as sexual assault and armed robbery.

Overall, 51 percent of male offenders and 44 percent of female offenders had one or more childhood psychiatric disorders.

Childhood delinquency exerted no special influence on the tendency to break laws as an adult. Youths who had a criminal record in addition to a mental disorder committed no more offenses as adults than did those who had a mental disorder but no juvenile criminal record.

Combinations of childhood emotional and behavioral disorders showed a particularly strong relationship to serious forms of adult lawbreaking. For instance, 13 percent of depressed children who also abused drugs committed serious offenses as young adults.

Mental-health treatment targeted at such children may reduce crime rates, the researchers suggest. Fewer than half of children with multiple psychiatric disorders receive any mental-health care.

Copeland's team cautions that childhood mental disorders are only one of many influences on criminal behavior. More than half of the study participants who committed crimes as young adults displayed no psychiatric problems as children. And most participants with a childhood mental disorder did not get arrested as young adults.