Mortality and aggressiveness in a 30-year follow-up study in child guidance clinics in Stockholm.

The mortality rate and aggressiveness in a cohort of 2364 former patients of the child guidance clinics in Stockholm were studied during a 30-year follow-up period; 106 died during this observation period. This frequency is significantly higher than the calculated mortality rate in a reference population. In all, 82% of the total deaths were caused by suicide, accidents, or abuse of alcohol or drugs. Among the patients that died of suicide and abuse, more mental disorders, abuse and criminality were found in their parents during the initial evaluation. Significantly more males than females died as a result of accidents and alcohol or drug abuse. Aggressive feelings and acts, both against oneself and others, were overrepresented in the initial contacts with the child guidance clinics. To prevent these deaths, an alternative approach during the first contact with a child psychiatric centre is discussed, as well as more extensive help and intervention at an early stage.