Aalborg University Hospital and Aalborg University, Denmark.
Aalborg University Hospital, Denmark; Novo Nordisk, Aalborg, Denmark.
J Am Acad Child Adolesc Psychiatry. 2019 Apr;58(4):443-452. doi: 10.1016/j.jaac.2018.11.016. Epub 2019 Feb 11.
To determine the risk of long-term conviction and incarceration associated with childhood attention-deficit/hyperactivity disorder (ADHD), and to identify risk and protective factors including associations with active treatment with ADHD medication.
All participants with ADHD who were 4 to 15 years of age during 1995 to 2005 were matched by year of birth and sex to a random sample of participants without ADHD from the Danish population using nationwide registers. Using Cox proportional hazard models, we estimated the risk of conviction and incarceration associated with ADHD in childhood and estimated associations with active treatment and outcome.
The ADHD cohort were followed up at a mean of 22.0 (SD = 5.8) years. Of 4,231 individuals with ADHD, 1,355 (32.0%) had received at least one conviction, compared to 3,059 (15.6%) of the 19,595 participants without ADHD (p < 0.001). ADHD was significantly associated with conviction (hazard ratio [HR] = 2.4, 95% CI = 2.3-2.6) and incarceration (HR = 3.0, 95% CI = 2.8-3.3). Subsequent to adjustment for various risk factors, ADHD exposure was still significantly related to conviction (HR = 1.6, 95% CI = 1.5-1.8) and incarceration (HR = 1.7, 95% CI = 1.5-1.9). Comorbidity with substance use disorder, oppositional-defiant disorder/conduct disorder, low family socioeconomic status, parental incarceration, and parental relationship status all significantly increased the risk of conviction and incarceration. Crime rates increased with the number of associated risks but were reduced during periods of taking ADHD medication.
In addition to ADHD, a broad range of individual, familial, and social factors increase the risk of antisocial development. The findings imply that ADHD medication may contribute to crime prevention.
确定儿童注意缺陷多动障碍（ADHD）与长期定罪和监禁的风险，并确定风险和保护因素，包括与 ADHD 药物治疗的关联。
通过全国性登记册，按照出生年份和性别，将 1995 年至 2005 年期间年龄在 4 至 15 岁的所有 ADHD 患者与丹麦人群中无 ADHD 的随机样本相匹配。使用 Cox 比例风险模型，我们估计了 ADHD 儿童期与定罪和监禁相关的风险，并估计了与积极治疗和结果的关联。
ADHD 队列的平均随访时间为 22.0（SD=5.8）年。在 4231 名患有 ADHD 的患者中，有 1355 名（32.0%）至少被判有罪，而在 19595 名无 ADHD 的参与者中，有 3059 名（15.6%）被判有罪（p<0.001）。ADHD 与定罪（危险比[HR]=2.4，95%置信区间[CI]=2.3-2.6）和监禁（HR=3.0，95%CI=2.8-3.3）显著相关。在调整各种风险因素后，ADHD 暴露仍与定罪（HR=1.6，95%CI=1.5-1.8）和监禁（HR=1.7，95%CI=1.5-1.9）显著相关。与物质使用障碍、对立违抗性障碍/品行障碍、家庭社会经济地位低、父母监禁和父母关系状况的合并症均显著增加了定罪和监禁的风险。犯罪率随着相关风险的增加而增加，但在服用 ADHD 药物期间会降低。
除 ADHD 外，广泛的个体、家庭和社会因素会增加反社会发展的风险。研究结果表明，ADHD 药物治疗可能有助于预防犯罪。
