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Purpose: This study investigated the utility of the risk assessment "Structured Assessment of Violence Risk in Youth" (SAVRY) within the social services in Stockholm County, Sweden. Method: SAVRY assessments of 56 adolescents were compared to assessments guided by another instrument (Adolescent Drug Abuse Diagnosis [ADAD]; n = 38) and assessments without support of a structured method (n = 38). Results: The results showed that social workers conducting SAVRY assessments documented a significantly larger number of risk and protective factors compared to the other assessments, and these factors predicted, with a few exceptions, reoffending to a larger extent. SAVRY summary risk rating significantly predicted the occurrence of serious violent crimes (area under the curve [AUC] = 0.80, p < 0.01) and less serious violence (AUC = 0.70, p < 0.05). Conclusions: SAVRY performed at least as well in naturalistic settings as in previous studies conducted in more controlled environments. Furthermore, the SAVRY performed better than the other structured instrument (ADAD).

Background Although selective serotonin reuptake inhibitors (SSRIs) are widely prescribed, associations with violence are uncertain. Methods and Findings From Swedish national registers we extracted information on 856,493 individuals who were prescribed SSRIs, and subsequent violent crimes during 2006 through 2009. We used stratified Cox regression analyses to compare the rate of violent crime while individuals were prescribed these medications with the rate in the same individuals while not receiving medication. Adjustments were made for other psychotropic medications. Information on all medications was extracted from the Swedish Prescribed Drug Register, with complete national data on all dispensed medications. Information on violent crime convictions was extracted from the Swedish national crime register. Using within-individual models, there was an overall association between SSRIs and violent crime convictions (hazard ratio [HR] = 1.19, 95% C11.08-1.32, p < 0.001, absolute risk = 1.0%). With age stratification, there was a significant association between SSRIs and violent crime convictions for individuals aged 15 to 24 y (HR = 1.43, 95% CI 1.19-1.73, p < 0.001, absolute risk = 3.0%). However, there were no significant associations in those aged 25-34 y (HR = 1.20, 95% CI 0.95-1.52, p = 0.125, absolute risk = 1.6%), in those aged 35-44 y (HR = 1.06, 95% CI 0.83-1.35, p = 0.666, absolute risk = 1.2%), or in those aged 45 y or older (HR = 1.07, 95% CI 0.84-1.35, p = 0.594, absolute risk = 0.3%). Associations in those aged 15 to 24 y were also found for violent crime arrests with preliminary investigations (HR = 1.28, 95% CI 1.16-1.41, p < 0.001), non-violent crime convictions (HR = 1.22, 95% CI 1.10-1.34, p < 0.001), non-violent crime arrests (HR = 1.13, 95% C11.07-1.20, p < 0.001), non-fatal injuries from accidents (HR = 1.29, 95% CI 1.22-1.36, p < 0.001), and emergency inpatient or outpatient treatment for alcohol intoxication or misuse (HR = 1.98, 95% CI 1.76-2.21, p < 0.001). With age and sex stratification, there was a significant association between SSRIs and violent crime convictions for males aged 15 to 24 y (HR = 1.40, 95% CI 1.13-1.73, p = 0.002) and females aged 15 to 24 y (HR = 1.75, 95% CI 1.08-2.84, p = 0.023). However, there were no significant associations in those aged 25 y or older. One important limitation is that we were unable to fully account for time-varying factors. Conclusions The association between SSRIs and violent crime convictions and violent crime arrests varied by age group. The increased risk we found in young people needs validation in other studies., Introduction Selective serotonin reuptake inhibitors (SSRIs) are among the most widely prescribed psychiatric medications in many countries [1-6]. At the same time, concerns about their adverse effects, including suicide and [...]

Purpose: This study investigated the utility of the risk assessment “Structured Assessment of Violence Risk in Youth” (SAVRY) within the social services in Stockholm County, Sweden. Method: SAVRY assessments of 56 adolescents were compared to assessments guided by another instrument (Adolescent Drug Abuse Diagnosis [ADAD]; n = 38) and assessments without support of a structured method (n = 38). Results: The results showed that social workers conducting SAVRY assessments documented a significantly larger number of risk and protective factors compared to the other assessments, and these factors predicted, with a few exceptions, reoffending to a larger extent. SAVRY summary risk rating significantly predicted the occurrence of serious violent crimes (area under the curve [AUC] = .80, p < .01) and less serious violence (AUC = .70, p < .05). Conclusions: SAVRY performed at least as well in naturalistic settings as in previous studies conducted in more controlled environments. Furthermore, the SAVRY performed better than the other structured instrument (ADAD). [ABSTRACT FROM AUTHOR]

Objective: To examine associations between varenicline and the incidence of a range of adverse outcomes., Design: Population based cohort study using within person analyses to control for confounding by indication., Setting: Whole population of Sweden., Participants: 7,917,436 people aged 15 and over, of whom 69,757 were treated with varenicline between 2006 and 2009., Main Outcome Measures: Incidence of new psychiatric conditions, suicidal behaviour, suspected and convicted criminal offending, transport accidents, and suspected and convicted traffic offences., Results: In the whole population, 337,393 new psychiatric conditions were diagnosed during follow-up. In addition, 507,823 suspected and 338,608 convicted crimes, 40,595 suicidal events, 124,445 transport accidents, and 99,895 suspected and 57,068 convicted traffic crimes were recorded. Within person analyses showed that varenicline was not associated with significant hazards of suicidal behaviour, criminal offending, transport accidents, traffic offences, or psychoses. However, varenicline was associated with a small increase in the risk of anxiety conditions (hazard ratio 1.23, 95% confidence interval 1.01 to 1.51) and mood conditions (1.31, 1.06 to 1.63), which was only seen in people with pre-existing psychiatric disorders., Conclusions: Concerns that varenicline is associated with an increased risk of many adverse outcomes, including suicidality and accidents, are not supported in this observational study. The small increase in risk of two psychiatric conditions in people with pre-existing psychiatric disorders needs to be confirmed using other research designs., (© Molero et al 2015.)