title: Attention-deficit-hyperactivity disorder and associated functional impairments in mentally disordered offenders.
abstract: This study examines the rate of attention-deficit-hyperactivity disorder (ADHD) and associated functional impairments in mentally disordered offenders (MDOs). One hundred and thirty-one male MDOs with a primary diagnosis of either severe mental illness (SMI) or personality disorder (PD) completed screening questionnaires for ADHD. If positive, they were invited for a comprehensive diagnostic interview. Additional data pertaining to self-rated impairments, and objective records of critical incidents and episodes of seclusion were obtained from patient records. Twenty-six patients screened positive (7 with SMI, 19 with PD). On further assessment, no SMI patients met criteria for ADHD. Four PD patients met criteria for persistent 'syndromatic' ADHD, whereas six met 'symptomatic' ADHD criteria, giving overall prevalence estimates of 8.6% and 12.9% respectively. Greater functional impairments were self-reported by the PD+ADHD screener positive group, compared with screener negative peers, with large effect sizes. A significant but small effect was found for spending longer in seclusion. Compared with population norms, a high rate of ADHD and associated impairments are present in MDO's with a primary diagnosis of PD. These individuals have complex needs and both pharmacological and non-pharmacological interventions are required for their rehabilitation.
authors.affiliation: Centre for Mental Health, Division of Brain Sciences, Department of Medicine, Imperial College London, 37 Claybrook Road, London W6 8LN, UK; Broadmoor Hospital, West London Mental Health Trust, Crowthorne, Berkshire RG45 7EG, UK. Electronic address: susan.young1@imperial.ac.uk.
authors.forename: Susan
authors.initials: S
authors.lastname: Young
authors.affiliation: Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, UK; Broadmoor Hospital, West London Mental Health Trust, Crowthorne, Berkshire RG45 7EG, UK.
authors.forename: Gisli
authors.initials: G
authors.lastname: Gudjonsson
authors.affiliation: Centre for Mental Health, Division of Brain Sciences, Department of Medicine, Imperial College London, 37 Claybrook Road, London W6 8LN, UK.
authors.forename: Linda
authors.initials: L
authors.lastname: O'Rourke
authors.affiliation: Centre for Mental Health, Division of Brain Sciences, Department of Medicine, Imperial College London, 37 Claybrook Road, London W6 8LN, UK.
authors.forename: Emma
authors.initials: E
authors.lastname: Woodhouse
authors.affiliation: Centre for Mental Health, Division of Brain Sciences, Department of Medicine, Imperial College London, 37 Claybrook Road, London W6 8LN, UK.
authors.forename: Karen
authors.initials: K
authors.lastname: Ashwood
authors.affiliation: Centre for Mental Health, Division of Brain Sciences, Department of Medicine, Imperial College London, 37 Claybrook Road, London W6 8LN, UK.
authors.forename: Declan
authors.initials: D
authors.lastname: Murphy
authors.affiliation: Centre for Mental Health, Division of Brain Sciences, Department of Medicine, Imperial College London, 37 Claybrook Road, London W6 8LN, UK.
authors.forename: Philip
authors.initials: P
authors.lastname: Asherson
mesh_terms: D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D015897:Comorbidity; D057237:Criminals; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D008875:Middle Aged; D010554:Personality Disorders / Q000523:psychology*; D015995:Prevalence; D057566:Self Report; D006113:United Kingdom / Q000453:epidemiology
keywords: Forensic; Offenders; Outcomes; Personality disorder (PD)