Screening for ADHD Symptoms among Criminal Offenders: Exploring the Association with Clinical Features

Abstract

Background: Attention-deficit/hyperactivity disorder (ADHD) is a disabling disorder. High rates of ADHD have been consistently reported among prisoners. The main objectives were (1) to estimate the prevalence of ADHD symptoms in a sample of male inmates and (2) to investigate the relationship between ADHD symptoms and socio-demographic/clinical features. According to the high prevalence of childhood trauma among inmates, we assessed whether exposition to childhood trauma can be related to the presence of ADHD symptoms. Methods: A total of 159 male prisoners admitted to Monza prison between January 2020 and June 2021 were included. Both Wender Utah ADHD rating scale and adult ADHD self-report scale were administered to assess ADHD symptoms. Moreover, inmates completed the childhood trauma questionnaire. Results: Data were available for 108 inmates. Thirty-five prisoners (32.4%) were found on screening to meet the criteria for symptoms of ADHD. Cocaine use disorder, prescription of mood stabilizers and a history of emotional abuse significantly increased the likelihood of having clinically significant ADHD symptoms. Furthermore, patients who experienced physical neglect resulted in meeting the criteria for ADHD symptoms. Conclusions: ADHD symptoms are widespread among inmates and are associated with specific risk factors. Screening for ADHD should be done to provide appropriate intervention strategies.

The prevalence of psychiatric comorbidities in adult ADHD compared with non-ADHD populations: A systematic literature review

“…Of the 32 studies comparing the prevalence of comorbid psychiatric disorder between subjects with and without adult ADHD, according to our classification criteria, 11 studies involved general populations, 18 studies included psychiatric populations, and three studies focused on incarcerated populations. One of the three studies dealing with incarcerated populations involved only female inmates [23], and the other one study involved only male inmates [24].…”

Sociodemographic and clinical factors associated with prescription of first- versus second-generation long-acting antipsychotics in incarcerated adult males

“…Moreover, information for other variables were lacking, including mean monthly dosage for each LAI antipsychotic, reasons for prescribing LAI antipsychotics, previously administered antipsychotic medications (including the type of previous LAI antipsychotic), age at onset, duration of illness and the presence of other comorbid psychiatric diagnoses (Barbui et al ., 2020; Pelizza et al ., 2022; Auxilia et al ., 2023). Nevertheless, other factors that may be associated with the type of prescribed LAI antipsychotic, including migration (Bani-Fatemi et al ., 2019), living in rural or urban communities (Teplin, 1990; Peritogiannis et al ., 2023) and comorbid neurodevelopmental disorders (such as autism spectrum disorder and attention deficit-hyperactivity disorder) (Iasevoli et al ., 2020; Capuzzi et al ., 2022) were not evaluated in this study for lack of reliable information. Fifth, most of the data is based on self-report, increasing the risk of recall bias and skewed self-presentation.…”

Biological Predictors of Treatment Response in Adult Attention Deficit Hyperactivity Disorder (ADHD): A Systematic Review

“…In this regard, Cupertino et al [ 58 ] reported that the G allele of rs2251214 may be related to an earlier onset of impairment due to ADHD symptoms, higher incidence of behavioral problems, and comorbid antisocial personality disorder. Nevertheless, it is noteworthy that personality disorders may be predictors of poor outcomes in ADHD and limited response to MPH [ 5 , 59 ]. Thus, we cannot completely exclude a shared genetic risk factors among ADHD and personality disorders, which are, in turn, associated with poor outcomes [ 31 ].…”

“…However, studies regarding the long-term prognosis of adult ADHD patients are lacking. Further studies with larger samples, taking into account the three presentations of the disorder (predominantly inattentive, predominantly hyperactive-impulsive, and combination) and other environmental or biological factors are needed to have a complete overview of this topic [ 5 , 82 ].…”

“…On the other hand, some patients receive a new diagnosis of ADHD during adulthood [ 4 ]. It should be highlighted that the management of ADHD in adulthood is essential to prevent poor clinical and functional outcomes associated with this condition, even if comorbidities are treated [ 5 ].…”