ADHD in adults and criminal behavior: The role of psychiatric comorbidities and clinical and sociodemographic factors in a clinical sample

IF 1.4 4区医学 Q1 LAW

International Journal of Law and Psychiatry Pub Date : 2025-03-05 DOI:10.1016/j.ijlp.2025.102088

Martina Nicole Modesti , Silvia Gubbini , Pietro De Rossi , Agostino Manzi , Giuseppe Nicolò , Barbara Adriani , Simone Pallottino , Giovanna Parmigiani , Antonio Del Casale , Cecilia Guariglia , Stefano Ferracuti

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引用次数: 0

Abstract

Introduction

ADHD is a neurodevelopmental disorder associated with functional, behavioral, and relational difficulties. Its onset is in childhood, before the age of 12, and it often persists into adulthood. This study investigates the link between ADHD in adulthood, psychiatric comorbidities, and the risk of criminal behavior, analyzing the impact of clinical and sociodemographic variables.

Methods

This cross-sectional study included a sample of 308 patients diagnosed with ADHD, treated at the ADHD Outpatient Clinic of SS Gonfalone Hospital in Monterotondo between 2019 and 2024. Diagnoses and comorbidities were assessed through structured interviews and standardized diagnostic tools (ASRS, DIVA-5). Information on legal status and types of crimes was collected through individual interviews. Statistical analysis was performed using t-tests, chi-square tests, and stepwise logistic regression models.

Results

In the sample, 8.1 % of patients with ADHD had committed crimes, with a male prevalence (92 %). Significant predictors of criminal behavior included male gender (OR = 1.899, p = 0.004) and alcohol use disorder (OR = 4.59, p = 0.002). Additionally, oppositional defiant disorder, ADHD diagnosis before the age of 18, and unemployment showed a potential association with risky criminal behavior. Lifetime prescription of antipsychotics (61.4 %) and antiepileptics (48.7 %) was more frequent among participants who committed crimes, while no significant differences were found in the use of atomoxetine and methylphenidate.

Conclusions

Adult ADHD, particularly in males, with combined presentation and in the presence of comorbidities such as oppositional defiant disorder and alcohol use disorder, is associated with an increased risk of criminal behavior. The findings highlight the need for personalized and multimodal interventions to mitigate these risks. Future studies should adopt longitudinal designs to explore causal dynamics and evaluate the effectiveness of therapeutic strategies in forensic contexts.

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成人ADHD与犯罪行为：精神合并症、临床和社会人口因素在临床样本中的作用

adhd是一种与功能、行为和关系困难相关的神经发育障碍。它的发病是在儿童时期，在12岁之前，并且经常持续到成年。本研究调查了成年期ADHD、精神合并症和犯罪行为风险之间的联系，分析了临床和社会人口学变量的影响。方法：本横断面研究包括2019年至2024年间在蒙特罗通多SS Gonfalone医院ADHD门诊接受治疗的308例ADHD患者样本。通过结构化访谈和标准化诊断工具（ASRS, DIVA-5）评估诊断和合并症。通过个别面谈收集了有关法律地位和罪行类型的资料。采用t检验、卡方检验和逐步logistic回归模型进行统计分析。结果8.1%的ADHD患者有过犯罪行为，其中男性占92%。犯罪行为的显著预测因子包括男性性别（OR = 1.899, p = 0.004）和酒精使用障碍（OR = 4.59, p = 0.002）。此外，18岁前的对立违抗性障碍、ADHD诊断和失业显示出与危险犯罪行为的潜在关联。终身服用抗精神病药物（61.4%）和抗癫痫药物（48.7%）的比例在犯罪参与者中更为常见，而使用阿托莫西汀和哌醋甲酯的比例无显著差异。结论：成人ADHD，特别是男性，合并表现并伴有对立违抗性障碍和酒精使用障碍等合并症，与犯罪行为风险增加有关。研究结果强调需要个性化和多模式干预措施来减轻这些风险。未来的研究应该采用纵向设计来探索因果动态和评估在法医环境下治疗策略的有效性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Law and Psychiatry Multiple-

CiteScore

4.70

自引率

8.70%

发文量

审稿时长

41 days

期刊介绍： The International Journal of Law and Psychiatry is intended to provide a multi-disciplinary forum for the exchange of ideas and information among professionals concerned with the interface of law and psychiatry. There is a growing awareness of the need for exploring the fundamental goals of both the legal and psychiatric systems and the social implications of their interaction. The journal seeks to enhance understanding and cooperation in the field through the varied approaches represented, not only by law and psychiatry, but also by the social sciences and related disciplines.