As many as 40 percent of men with long-term prison sentences suffer from undiagnosed and untreated ADHD, according to researchers from Karolinska Institutet in Stockholm. Such difficulties usually began in childhood.
Individuals with untreated ADHD are more prone to drug abuse, and in the current study, all participants with the disorder had struggled with drugs. Furthermore, other psychiatric disorders requiring treatment were over-represented, with almost half taking medication for another psychiatric illness.
Researchers, working with the Swedish Prison and Probation service, carried out a comprehensive survey of 315 inmates at Norrtälje prison serving long-term sentences; the study helped determine the severity of the inmates’ ADHD as well as appropriate therapies.
Once the inmates’ childhood and adult ADHD symptoms had been examined, 34 who had reported having ADHD in the survey were given a complete diagnostic assessment. These results were compared with those of 20 adult males in outpatient care and also 18 healthy controls. All of the participants were examined at a psychiatric outpatient clinic.
After a more thorough exam, 30 inmates were given an ADHD diagnosis; these also displayed more obvious symptoms and had a far lower educational level than the outpatient ADHD group.
“We have discovered that inmates with ADHD have greater functional impairment and more obvious symptoms than a corresponding ADHD group in outpatient psychiatric care,” said consultant psychiatrist Ylva Ginsberg, doctoral student in the Department of Clinical Neuroscience.
The ADHD inmates performed more poorly than the outpatient and control groups in many neuropsychological tests. It was common among the inmate group to have never been given proper treatment and support for their ADHD during childhood. For example, although many had needed extra support in school and had been in contact with health services during this time, very few had been examined for ADHD or other neuropsychiatric disorders, and even fewer had received therapy.
During the examination, it was also discovered that nearly 25 percent were also in the autism spectrum. Personality disorders were also common—mostly antisocial personality disorder. Psychopathy, however, was rare.
“Given the threat that untreated ADHD poses to the individual and the community, it’s imperative that the prison and probation services learn more about the condition,” said Ginsberg.
The inmate study led to a treatment study, in which researchers tested whether ADHD medication would help reduce symptoms, thus improving function and possibly reducing drug abuse and crime. Researchers said results should be presented soon.
The study is published in the scientific journal BMC Psychiatry.
Source: Karolinska Institutet