Fazel Seena, Favril Louis
Department of Psychiatry, University of Oxford, Oxford, UK.
Oxford Health NHS Foundation Trust, Oxford, UK.
Crim Behav Ment Health. 2024 Jun;34(3):339-346. doi: 10.1002/cbm.2337. Epub 2024 Apr 3.
Previous meta-analyses may have overestimated the prevalence of attention-deficit hyperactivity disorder (ADHD) in prisoners by including data from selected samples.
To estimate the prevalence of ADHD in unselected samples of adults in prison and examine potential sources of heterogeneity by meta-regression and subgroup analyses.
We assessed all studies included in a 2018 systematic review for eligibility and updated the literature search to include studies published up to September 2023.
A total of 11 studies reporting robust diagnostic data on ADHD in 3919 unselected adults in prison were included. In meta-regression, ADHD prevalence did not differ between men and women but it was significantly higher in studies using a two-phase design. In random sampling studies, the pooled prevalence of ADHD was 8.3% (95% CI: 3.8-12.8) which was further halved after the removal of an outlier.
One in 12 adults in prison have been diagnosed with ADHD. Our findings highlight the importance of using clear and consistent inclusion criteria in meta-analyses of prevalence.
以往的荟萃分析可能通过纳入特定样本的数据高估了囚犯中注意力缺陷多动障碍（ADHD）的患病率。
估计未经过筛选的成年囚犯样本中ADHD的患病率，并通过元回归和亚组分析检查潜在的异质性来源。
我们评估了2018年系统评价中纳入的所有研究的 eligibility，并更新了文献检索，以纳入截至2023年9月发表的研究。
共纳入了11项研究，这些研究报告了3919名未经过筛选的成年囚犯中关于ADHD的可靠诊断数据。在元回归中，ADHD患病率在男性和女性之间没有差异，但在采用两阶段设计的研究中显著更高。在随机抽样研究中，ADHD的合并患病率为8.3%（95%CI：3.8-12.8），在去除一个异常值后进一步减半。
每12名成年囚犯中有1人被诊断患有ADHD。我们的研究结果强调了在患病率的荟萃分析中使用明确和一致的纳入标准的重要性。
