Centre for Mental Health, Division of Brain Sciences, Department of Medicine, Imperial College London, 37 Claybrook Road, London W6 8LN, UK; Broadmoor Hospital, West London Mental Health Trust, Crowthorne, Berkshire RG45 7EG, UK.
Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, UK; Broadmoor Hospital, West London Mental Health Trust, Crowthorne, Berkshire RG45 7EG, UK.
Psychiatry Res. 2015 Dec 15;230(2):387-93. doi: 10.1016/j.psychres.2015.09.024. Epub 2015 Sep 15.
This study examines the rate of attention-deficit-hyperactivity disorder (ADHD) and associated functional impairments in mentally disordered offenders (MDOs). One hundred and thirty-one male MDOs with a primary diagnosis of either severe mental illness (SMI) or personality disorder (PD) completed screening questionnaires for ADHD. If positive, they were invited for a comprehensive diagnostic interview. Additional data pertaining to self-rated impairments, and objective records of critical incidents and episodes of seclusion were obtained from patient records. Twenty-six patients screened positive (7 with SMI, 19 with PD). On further assessment, no SMI patients met criteria for ADHD. Four PD patients met criteria for persistent 'syndromatic' ADHD, whereas six met 'symptomatic' ADHD criteria, giving overall prevalence estimates of 8.6% and 12.9% respectively. Greater functional impairments were self-reported by the PD+ADHD screener positive group, compared with screener negative peers, with large effect sizes. A significant but small effect was found for spending longer in seclusion. Compared with population norms, a high rate of ADHD and associated impairments are present in MDO's with a primary diagnosis of PD. These individuals have complex needs and both pharmacological and non-pharmacological interventions are required for their rehabilitation.
本研究考察了精神障碍罪犯（MDO）中注意力缺陷多动障碍（ADHD）的发生率和相关功能障碍。131 名男性 MDO 患有严重精神疾病（SMI）或人格障碍（PD）的主要诊断，完成了 ADHD 筛查问卷。如果呈阳性，他们将被邀请进行全面的诊断访谈。从患者记录中获得了与自我评估障碍以及关键事件和隔离事件的客观记录相关的其他数据。26 名患者筛查呈阳性（7 名 SMI，19 名 PD）。进一步评估后，没有 SMI 患者符合 ADHD 的标准。4 名 PD 患者符合持续性“综合征性”ADHD 的标准，而 6 名符合“症状性”ADHD 的标准，分别给出了 8.6%和 12.9%的总体患病率估计。与筛查阴性的同龄人相比，PD+ADHD 筛查阳性组自我报告的功能障碍更大，具有较大的效应量。在隔离时间方面发现了显著但较小的影响。与人口正常值相比，原发性 PD 诊断的 MDO 中存在较高的 ADHD 发生率和相关障碍。这些人有复杂的需求，需要药物和非药物干预来康复。
