A Remedy for Crime? A Systematic Review on the Effects of Pharmacological ADHD Treatment on Criminal Recidivism and Rehabilitation in Inmates With ADHD

IF 2.6 3区心理学 Q2 BEHAVIORAL SCIENCES Brain and Behavior Pub Date : 2024-11-07 DOI:10.1002/brb3.70120

A. Carlander, M. Rydell, H. Kataoka, M. Hildebrand Karlén, A.-S. Lindqvist Bagge

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Abstract

Introduction

There is a high prevalence of attention-deficit/hyperactivity disorder (ADHD) in prison populations compared to the general population, and ADHD has also been shown to be associated with criminality and antisocial behavior. This systematic review examines the effect of pharmacological ADHD treatment on criminal recidivism, ADHD symptoms, and rehabilitation in inmates with ADHD.

Methods

Adhering to PRISMA 2020 and AMSTAR guidelines, we conducted a structured search on September 6, 2023 using PubMed. We focused on original research published in peer-reviewed scientific journals, following the IMRaD format, written in English, containing the established search terms, based on participants who met the criteria for ADHD diagnosis (any edition of DSM), and who were incarcerated at the start of pharmacological treatment for ADHD. The primary outcome was criminal recidivism, the secondary outcomes were ADHD symptoms, and rehabilitation-related factors such as global function, norm-breaking/antisocial behavior, adaptation to society/institutional behavior, cognitive function, and well-being.

Results

Five studies, based on three patient cohorts, were included in this systematic review. Surprisingly, only one study investigated criminal recidivism. That study indicated that self-reported criminal recidivism was lower than expected among inmates who had received pharmacological ADHD treatment. The five studies showed varying results in the effectiveness of pharmacological ADHD treatment on ADHD symptoms and other rehabilitation-related factors. The included studies also varied regarding participant characteristics, study design, dosage, adherence to treatment, treatment regimes, and measured outcomes. All studies reported using osmotic-release oral system (OROS) methylphenidate as their drug of choice.

Conclusion

We conclude that there is limited empirical evidence to support the efficacy of pharmacological ADHD treatment on criminal recidivism in inmates diagnosed with ADHD. Still, evidence suggests that these treatments can reduce ADHD symptoms and enhance rehabilitation outcomes, which may, in turn, lower the rate of reoffending. We point to the need for more targeted research in this area.

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犯罪的良药？关于药物治疗ADHD对ADHD患者重犯和改造的影响的系统性综述。

导言：与普通人群相比，注意力缺陷/多动障碍（ADHD）在监狱人群中的发病率很高，ADHD还被证明与犯罪和反社会行为有关。本系统性综述研究了药物治疗ADHD对ADHD患者的犯罪再犯、ADHD症状和康复的影响：根据 PRISMA 2020 和 AMSTAR 指南，我们于 2023 年 9 月 6 日使用 PubMed 进行了结构化检索。我们将重点放在同行评审科学期刊上发表的原创性研究上，这些研究采用 IMRaD 格式，以英语撰写，包含既定的检索词，以符合多动症诊断标准（DSM 的任何版本）、在开始接受多动症药物治疗时被监禁的参与者为基础。研究的主要结果是再犯罪率，次要结果是ADHD症状和康复相关因素，如整体功能、违反规范/反社会行为、适应社会/机构行为、认知功能和幸福感：本系统综述共纳入了五项研究，分别基于三个患者队列。令人惊讶的是，只有一项研究调查了刑事累犯问题。该研究表明，接受过药物治疗多动症的囚犯自我报告的犯罪再犯率低于预期。五项研究显示，药物治疗ADHD对ADHD症状和其他康复相关因素的效果各不相同。所纳入的研究在参与者特征、研究设计、剂量、治疗依从性、治疗方案和测量结果方面也各不相同。所有研究均报告使用渗透释放口服系统（OROS）哌醋甲酯作为首选药物：我们的结论是，只有有限的经验证据支持药物治疗多动症对被诊断为多动症的囚犯的犯罪再犯的疗效。尽管如此，仍有证据表明，这些治疗方法可以减轻多动症症状，提高康复效果，进而降低再犯罪率。我们指出需要在这一领域开展更有针对性的研究。

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来源期刊

Brain and Behavior BEHAVIORAL SCIENCES-NEUROSCIENCES

CiteScore

5.30

自引率

0.00%

发文量

352

审稿时长

14 weeks

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