ADHD Plus Comorbidities May Up Risk for Criminal Behavior

TOPLINE:

Attention-deficit/hyperactivity disorder (ADHD) in adults was associated with a higher risk for criminal behavior, especially in men and those with comorbidities such as alcohol use disorder.

METHODOLOGY:

• This cross-sectional study included 308 patients diagnosed with ADHD (mean age, 34 years; 66% men) who were evaluated at a clinic in Italy between 2019 and 2024.
• Structured and semi-structured interviews along with standardized diagnostic tools, including the Adult ADHD Self-Report Scale and Diagnostic Interview for ADHD in Adults, were used.
• Crime-related and legal information was obtained through interviews with the participants.
• Factors such as sociodemographic characteristics, clinical variables, and criminal behavior were analyzed.

TAKEAWAY:

• In all, 8% of participants were criminal offenders, and 92% of these were men. Prescription patterns revealed a significantly higher use of antipsychotics (61.4%) and antiepileptics (48.7%) among participants who committed crimes than among nonoffenders.
• Male sex was a significant predictor of criminal behavior (odds ratio [OR], 5.5; P = .03), as was alcohol use disorder (OR, 4.8; P = .001), in fourth model regression analysis.
• Oppositional defiant disorder was strongly associated with criminal behavior (OR, 5.3; P < .001).
• Combined ADHD presentation and unemployment were also potential risk factors for criminal behavior, but the associations were not statistically significant.

IN PRACTICE:

“The data from our study suggest that ADHD interacts with sociodemographic, emotional, and behavioral aspects, profoundly influencing the risk of encountering legal issues,” the authors wrote.

“Specific screening programs for individuals with ADHD and their comorbidities can help identify at-risk individuals early and reduce their involvement with the judicial system,” they added.

SOURCE:

This study was led by Martina Nicole Modesti, Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy. It was published online on March 5 in International Journal of Law and Psychiatry.

LIMITATIONS:

The cross-sectional design of the study limited the ability to establish causal relationships between the variables analyzed and criminal behavior. The disproportionate subsample sizes of offenders and nonoffenders may have affected the generalizability of the findings. Any ongoing pharmacological treatments may have been potential confounding factors. In addition, reliance on clinical interviews for criminal history data may have introduced recall or concealment biases. The potential effect of dynamic environmental factors, such as family or working conditions, was not considered in the study.

DISCLOSURES:

The investigators reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.