title: A meta-analysis and systematic review of the risks associated with childhood attention-deficit hyperactivity disorder on long-term outcome of arrests, convictions, and incarcerations.
abstract: The primary aim of this study was to systematically review and estimate the risk of arrests, convictions, and incarcerations associated with childhood Attention Deficit/Hyperactivity Disorder (ADHD) in long-term outcome studies. In addition, all included studies were qualitatively and systematically reviewed for predictors of long-term crimes. The databases Pubmed, PsycINFO and Embase were searched for all controlled studies that included children and adolescents (age 4-15) with ADHD who had been followed longitudinally and reported the frequency of arrests, convictions or incarcerations based on data from official sources. Using random-effects models, the relative risk (RR) with 95% confidence intervals (95% CI) was estimated. A total of 15,442 individuals with childhood ADHD from nine unique samples were included. Childhood ADHD was significantly associated with adolescent and adulthood arrests (RR: 2.2, 95% CI: 1.3-3.5), convictions (RR: 3.3, 95% CI: 2.1-5.2) and incarcerations (RR: 2.9, 95% CI: 1.9-4.3). Individuals with ADHD had a younger age at onset of antisocial involvement and an increased risk of criminal recidivism. The most frequently committed criminal offenses were theft, assault, drug- and weapon-related crimes. Early antisocial behavior problems, childhood maltreatment, sex, and IQ were identified as potentially relevant predictors for antisocial outcomes. The findings support a substantial long-term risk associated with ADHD for later antisocial involvement. Early intensive and specifically targeted multimodal intervention including psychosocial, and pharmacological treatment is warranted to alter these negative long-term developmental trajectories.
authors.affiliation: Research Unit of Child and Adolescent Psychiatry, Aalborg Psychiatric Hospital, Aalborg University Hospital, Denmark. Electronic address: christina.j@rn.dk.
authors.forename: Christina
authors.initials: C
authors.lastname: Mohr-Jensen
authors.affiliation: Research Unit of Child and Adolescent Psychiatry, Aalborg Psychiatric Hospital, Aalborg University Hospital, Denmark; Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Switzerland; Department of Child and Adolescent Psychiatry, University of Zurich, Switzerland.
authors.forename: Hans-Christoph
authors.initials: HC
authors.lastname: Steinhausen
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000523:psychology*; D002648:Child; D002649:Child Abuse / Q000523:psychology*; D002675:Child, Preschool; D003415:Crime / Q000523:psychology*; D057237:Criminals / Q000523:psychology*; D006801:Humans; D012306:Risk; D012737:Sex Factors
keywords: ADHD; Crime; Longitudinal; Meta-analysis