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Serious criminal offending and mental disorder.

We extracted information on all individuals discharged from hospitals from Jan. 1, 1988, to Dec. 31, 2000, with any principal diagnosis of a severe mental illness who were ages 15 and older (the age of legal responsibility in Sweden). We included two groups of patients: those with schizophrenia (diagnostic codes 295.0–6, 295.8–9, and F20–21) and those with other psychoses (schizoaffective disorder [295.7, F25], affective psychoses [296], paranoid states [297], other nonorganic psychoses [298, F28, F29], persistent and induced delusional disorders [F22, F24], acute and transient psychotic disorders [F23], manic episode [F30], bipolar affective disorder with psychotic symptoms [F31.2, F31.5], and depressive disorders with psychotic symptoms [F32.3, F33.3]). Both groups included patients with comorbid diagnoses, such as substance abuse. We chose these diagnostic categories in part because research has found that this register is valid and reliable for diagnoses of severe mental illness; 86% of those diagnosed with schizophrenia corresponded with a file-based review by psychiatrists (17) . Consequently, the register has been used in recent epidemiological investigations (18 , 19) . Sweden experienced de-institutionalization in the 1970s, in line with other Western countries.