Knecht Carlos, de Alvaro Raquel, Martinez-Raga Jose, Balanza-Martinez Vicent
Int J Adolesc Med Health. 2015 May;27(2):163-75. doi: 10.1515/ijamh-2015-5007.
The association between attention-deficit hyperactivity disorder (ADHD) and criminality has been increasingly recognized as an important societal concern. Studies conducted in different settings have revealed high rates of ADHD among adolescent offenders. The risk for criminal behavior among individuals with ADHD is increased when there is psychiatric comorbidity, particularly conduct disorder and substance use disorder. In the present report, it is aimed to systematically review the literature on the epidemiological, neurobiological, and other risk factors contributing to this association, as well as the key aspects of the assessment, diagnosis, and treatment of ADHD among offenders. A systematic literature search of electronic databases (PubMed, EMBASE, and PsycINFO) was conducted to identify potentially relevant studies published in English, in peer-reviewed journals. Studies conducted in various settings within the judicial system and in many different countries suggest that the rate of adolescent and adult inmates with ADHD far exceeds that reported in the general population; however, underdiagnosis is common. Similarly, follow-up studies of children with ADHD have revealed high rates of criminal behaviors, arrests, convictions, and imprisonment in adolescence and adulthood. Assessment of ADHD and comorbid condition requires an ongoing and careful process. When treating offenders or inmates with ADHD, who commonly present other comorbid psychiatric disorder complex, comprehensive and tailored interventions, combining pharmacological and psychosocial strategies are likely to be needed.
注意缺陷多动障碍（ADHD）与犯罪之间的关联日益被视为一个重要的社会问题。在不同环境中开展的研究显示，青少年罪犯中ADHD的发病率很高。当存在精神共病，尤其是品行障碍和物质使用障碍时，ADHD患者的犯罪行为风险会增加。在本报告中，旨在系统回顾有关导致这种关联的流行病学、神经生物学及其他风险因素的文献，以及罪犯中ADHD评估、诊断和治疗的关键方面。对电子数据库（PubMed、EMBASE和PsycINFO）进行了系统的文献检索，以识别在同行评审期刊上发表的、以英文撰写的潜在相关研究。在司法系统内不同环境以及许多不同国家开展的研究表明，患有ADHD的青少年和成年囚犯的比例远远超过一般人群中的报告比例；然而，诊断不足的情况很常见。同样，对ADHD儿童进行的随访研究显示，他们在青少年期和成年期的犯罪行为、被捕、定罪和监禁率很高。对ADHD及其共病状况的评估需要一个持续且细致的过程。在治疗患有ADHD的罪犯或囚犯时，他们通常还存在其他复杂的共病精神障碍，可能需要结合药物和心理社会策略的全面且量身定制的干预措施。
