Attention Deficit Hyperactivity Disorder (ADHD) Among Longer-term Prison Inmates is a Prevalent, Persistent and Disabling Disorder

Ylva Ginsberg; Tatja Hirvikoski; Nils Lindefors

Disclosures

BMC Psychiatry. 2010;10(1) 

In This Article

Background

ADHD is a common, inherited and disabling developmental disorder with early onset. Most often ADHD persists across the life span, affecting 2–4% of adults.[1] The core symptoms of ADHD are inattention, hyperactivity and impulsivity. Further, deficits in executive functioning are commonplace, such as planning, organising, exerting self-control, working memory, and affect regulation. Therefore, ADHD affects educational and occupational performances, psychological functioning, and social skills. Adults with ADHD are at increased risk for unemployment, sick leave, coexisting disorders, abuse, and antisocial behaviour leading to conviction.[2,3] Nearly 80% of adults with ADHD present with at least one coexisting psychiatric disorder.[3,4] Further, studies display ADHD to be common among prison inmates.[5–9] However, little attention has been paid to profiles of ADHD symptoms and executive functions of prison inmates compared with other groups affected by ADHD, and to controls.[10] Besides, effects of pharmacological treatment for ADHD among prison inmates remain unexplored. The clinical presentation has shown to change with age, as hyperactivity declines, whereas inattention and executive dysfunction persist, thus representing the core features of adult ADHD.[11,12] However, most previous studies have excluded prison inmates, questioning how relevant these findings are to prison inmates. To gain some more information, we evaluated ADHD and criminality. The first aim of this study was to estimate the prevalence of ADHD among longer-term inmates of a high-security Swedish prison. The second aim was to describe ADHD, coexisting disorders, and executive functions among prison inmates. The final aim was to compare these findings with ADHD psychiatric outpatients and healthy controls.

We hypothesized that ADHD would be common among this group comprising mainly longer-term prison inmates, typically convicted of crimes because of violence and drugs. Also, we hypothesized that they would present more severe ADHD symptoms across the lifespan, more common coexisting psychiatric disorders, and poorer executive functions compared with the other groups.

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