Monday, 18 August 2014

ADHD in the prison population: a micropost

"Compared with published general population prevalence, there is a fivefold increase in prevalence of ADHD in youth prison populations (30.1%) and a 10-fold increase in adult prison populations (26.2%)".
"Mianly dry" apparently @ Paul Whiteley

That was the primary conclusion reached in the meta-analysis by Young and colleagues [1] looking at the collected peer-reviewed literature on "the variable prevalence of attention deficit hyperactivity disorder (ADHD) in incarcerated populations".

There is little more for me to say on this topic aside from the fact that as per the paper by Usher and colleagues [2], the presence of ADHD (including sub-threshold signs and symptoms) might have quite a few implications for things like comorbid mental health features [3] and issues like substance abuse [4]. That also: "ADHD symptoms were also found to predict institutional misconduct" is an important point to make without trying to make any sweeping generalisations.

Screening of the prison population for ADHD sounds like it might be a good idea on the basis of the collected data in this area, leading on to further discussions about possible management options. That being said, intervention might not necessarily just include the more traditional pharmacotherapy but as per the important work by Bernard Gesch and colleagues [5] overlapping with the studies from Julia Rucklidge and colleagues (see here), on how good nutrition might also be on the menu. In fact...

To close, the Foo Fighters and Learn to Fly.

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[1] Young S. et al. A meta-analysis of the prevalence of attention deficit hyperactivity disorder in incarcerated populations. Psychol Med. 2014 Apr 7:1-12.

[2] Usher AM. et al. Attention deficit hyperactivity disorder in a Canadian prison population. Int J Law Psychiatry. 2013 May-Aug;36(3-4):311-5.

[3] Kessler RC. et al. The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. Am J Psychiatry. 2006 Apr;163(4):716-23.

[4] Harstad E. et al. Attention-deficit/hyperactivity disorder and substance abuse. Pediatrics. 2014 Jul;134(1):e293-301.

[5] Gesch CB. et al. Influence of supplementary vitamins, minerals and essential fatty acids on the antisocial behaviour of young adult prisoners. Randomised, placebo-controlled trial. Br J Psychiatry. 2002 Jul;181:22-8.

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ResearchBlogging.org Young S, Moss D, Sedgwick O, Fridman M, & Hodgkins P (2014). A meta-analysis of the prevalence of attention deficit hyperactivity disorder in incarcerated populations. Psychological medicine, 1-12 PMID: 25066071