Health - ADHD treatment 'mayreduce risk of criminal behaviour'

People with attention-deficit hyperactivity disorder who are involved
in crime are less likely to reoffend when on treatment than not, a
Swedish study shows.
Earlier studies suggest people with ADHD are more likely to commit
offences than the general population.
Providing better access to medication may reduce crime and save money,
experts and support groups say.
Researchers say the benefits of the drugs must be weighed against harms.
In the UK 3% of childrenhave a diagnosis of ADHD, with half of them
continuing to have the condition in adult life.
People with the disorder have to deal with problems with
concentration, hyperactivity and impulsiveness.
Estimates suggest between 7-40% of people in the criminal justice
system may haveADHD and other similar disorders, though in many cases
the condition is not formally recognised.
We want people to have personal choice...no one is trying to force
peopleto take drugs
Prof Philip Asherson, Psychiatrist
Researchers from the Karolinska Institute looked at data from over
25,000 people with ADHD in Sweden.
Less impulsiveness
They found people withADHD were more likely to commit crime (37% of
men and 15% of women) than adults without the condition (9% of men and
2% women).
The study published in the New England Journal of Medicine found when
people took their medication they were 32-41% less likely to be
convicted ofa crime than when theywere off medication fora period of
six months or more.
Dr Seena Fazel, an author of the study and from Oxford University,
says medication may reduce impulsive choices and may enablepeople to
better organise their lives - allowing them to stay inemployment and
maintain relationships.
Co-author Prof Paul Lichtenstein says: "It is said that roughly 30 to
40% of long-serving criminals have ADHD. If their chances of
recidivism can be reduced by 30%, it would clearly affect the total
crime numbers in many societies."
'Personal responsibility'
Prof Philip Asherson, a psychiatrist and president of the UK Adult
ADHD network, who was not involved in the study says: "We want people
to have personal choice and personal responsibility -no-one is trying
to force people to take drugs."
He points out it costs £100-£300 a month to provide medication for
someone with ADHD, and taking into accountthe costs of unemployment
and the criminal justice system, these would "vastly outweigh" the
costs of medication, he says.
The authors caution that the side effects of the drugs used, such as
Ritalin, must be taken into account.
"There are of course a lot of people with ADHD in the population who
are not involved in crime.
"But for some people with the condition - if you don't treat them,
they will try to treat themselves with street drugs," says Andrea
Bilbow, founder of the National Attention Deficit Disorder Information
and Support Service, Addis.
"A referral to specialist adult services can cost £1,500 - compare
this with the amount of money you can save if you keep people out of
prison - it's a no brainer."
'Better support'
The researchers looked at a variety of crimes - from petty crime to
violent crime, finding a reduction in all of thesewhen people took
medication.
They acknowledge when offered medication, individuals may also get
more attention from other support services - this could contribute to
the reduction in criminal behaviour.
Prof Sue Bailey, president of the Royal College of Psychiatry,
welcomes the study saying it "reminds us in an era of psychological
therapies that medication can have a positive impact too".
The authors of the study point out ADHD can exist alongside other
conditions such as conduct disorders, calling for further work to
untangle the contribution these may make to criminal behaviour.
They feel the Swedish findings are applicable to the UK and much of
Western Europe where rates of ADHD in children and the medication
prescribed are broadly similar.

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