Screening for attention-deficit hyperactivity disorder and co-morbid mental disorders among prison inmates

Attention-deficit hyperactivity disorder (ADHD) is a developmental disorder, which is associated with a number of psychiatric conditions, mostly personality disorder, substance misuse, anxiety and depression. The aim of the present study was to investigate the relationship between ADHD symptoms and associated psychiatric conditions among prisoners. The participants were 90 male prisoners in Iceland who were assessed within 10 days of admission to the prison. The Mini International Neuropsychiatric Interview (MINI) and the Standardised Assessment of Personality-Abbreviated Scale (SAPAS) were administered. Childhood ADHD symptoms were screened by the Wender-Utah Rating Scale and current adult symptoms by the DSM-IV Checklist for ADHD. Half of the prisoners (50%) were found on screening to have met criteria for ADHD in childhood and of those over half (60%) were either fully symptomatic or in partial remission of their symptoms. A logistic regression analysis revealed that the MINI Antisocial Personality Disorder scale was the single best predictor of current ADHD symptoms. Many prisoners are either fully symptomatic or in partial remission of their ADHD symptoms and have serious co-morbid problems, primarily associated with antisocial personality disorder and substance dependence. Prisoners should routinely undergo screening for ADHD in order to identify those who would benefit from a comprehensive assessment to determine who may have ADHD and associated problems.