Stimulant treatment for attention-deficit/hyperactivity disorder and risk of first and repeat juvenile criminal
Timothy C Nielsen1,2, Ralph Nanan3,4,5, Tony Butler6
1Children's Hospital Westmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia.
Background:
Children and young adults with attention-deficit/hyperactivity disorder (ADHD) may be at increased risk of criminal offending. This study examines the risk of first-time and repeat offending among individuals with ADHD and potential effect of stimulant medication.
Methods:
A population-based, data linkage cohort study of individuals born in New South Wales, Australia between 1990 and 2005 and followed until May 2016. All individuals authorised for stimulant treatment for ADHD were frequency matched (1:10) to controls without ADHD. Proven criminal offences were identified using court records. First and repeat offences were examined separately using modified Cox regression and Prentice-Williams-Peterson models.
Results:
The cohort included 75 650 individuals with ADHD (147 855 treated and 525 595 untreated person years) and 745 634 non-ADHD controls. The risk of first offence was higher among cases, but reduced by stimulants (males 10-17 years, untreated HR 2.02, 95% CI 1.95 to 2.10; treated HR 1.52, 95% CI 1.41 to 1.62). The effect estimates for males were reduced for repeat offences (10-17 years: untreated HR 1.09, 95% CI 1.05 to 1.13; treated HR 0.97, 95% CI 0.90 to 1.04). No association with reoffending was found in females, except treated individuals aged 10-17 years had a higher risk (HR 1.26, 95% CI 1.02 to 1.56).
Conclusions:
ADHD was associated with higher risk of a first criminal offence, but stimulant prescription was associated with lower risk among individuals with ADHD. This association was reduced among repeat offenders, with only modest apparent benefit of treatment among males. Adequate treatment resources may help keep individuals with ADHD out of the criminal justice system.
More Related Videos
05:48The Adventures of Fundi Intervention Based on the Cognitive and Emotional Processing in Attention Deficit Hyperactive Disorder Patients
Published on: June 12, 2020
13:09Using Brain Activation nir-HEG/Q-EEG and Execution Measures CPTs in a ADHD Assessment Protocol
Published on: April 1, 2018
Related Concept Videos
01:30Attention-Deficit/Hyperactivity Disorder
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings....
01:23Drugs Acting on Autonomic Ganglia: Stimulants
Ganglionic stimulants activate NM nicotinic receptors in autonomic ganglia, falling into two categories: nicotine mimetics [e.g., lobeline, dimethylpiperazine, tetramethylammonium] and muscarinic receptor agonists [e.g., muscarine, methacholine]. The first category's action is rapid and blocked by nicotinic receptor antagonists, while the second category's action is delayed and blocked by atropine-like agents. Nicotine, an alkaloid, affects the heart rate by stimulating...
01:29Stimulants
Cocaine can be administered via snorting, injection, or smoking. It primarily functions by blocking the reuptake of dopamine, resulting in a euphoric high characterized by an intense sensation of happiness and...
01:24CNS Stimulants: Cocaine, Amphetamines and Cannabinoids
01:28Conduct Disorder
01:25Adrenergic Agonists: Indirect-Acting Agents
One mechanism involves depleting stored catecholamines by displacing them from synaptic vesicles. These agents, known as "displacers," are transported into vesicles at the expense of noradrenaline. Examples include amphetamine and tyramine, which lack a catechol moiety, resulting in prolonged action, improved oral...