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social maladjustment in intercountry adoptees in Sweden

We linked patients with severe mental illness to the crime register using their unique identification numbers. Thus, any patient with severe mental illness during the period from 1988 to 2000 who was convicted of a violent offense during the same time period, regardless of the timing of the hospital discharge and the violent conviction, was included. We calculated all individual counts of violent crimes from each conviction, regardless of psychiatric status, so that all violent offenses were included. For example, if someone convicted of attempted murder also committed other violent offenses at the same time, all of these different offenses would have been included in the analyses. The next step was to include all crimes over time in the same individual so that the nature and extent of re-offending were accounted for. We then calculated the population-attributable risk (the absolute difference in the rate of violent crimes in the whole population and the rate in individuals who had not been patients with severe mental illness) and the population-attributable risk fraction (the proportion of violent crimes in the whole population that could be attributed to patients with severe mental illness), according to standard methods(21) . Our choice of using individual counts of crime was to capture, as much as possible from official statistics, the public health burden of violent crime. However, we redid the analysis by studying the proportion of violent convictions that could be attributed to patients with severe mental illness and also the proportion of violent criminals who were patients