PDF(Pubmed)
Abstract：
UNASSIGNED: Attention-deficit/hyperactivity disorder (ADHD) is prevalent amongst offenders, increasing risks for aggressive and delinquent behaviors. Since ADHD and its symptoms can persist into adulthood, accurately diagnosing and maintaining diagnoses in offenders is crucial to ensure appropriate treatment and reduce recidivism.
UNASSIGNED: This study employed a retrospective longitudinal design to investigate ADHD amongst adult offenders with a confirmed diagnosis of ADHD during childhood or adolescence at a Swiss forensic outpatient clinic between 2008 and 2021. N = 181 patient files were reviewed, including forensic expert witness assessments and treatment reports. We charted the adulthood trajectory of patients with a confirmed childhood/adolescence ADHD diagnosis, examining the course of their diagnoses.
UNASSIGNED: Of 181 patients, evidence indicated that 12 (7%) had an ADHD diagnosis in childhood/adolescence. In 1 (8%) of these 12 cases, the diagnosis was maintained throughout the observation period. For 4 patients (33%), a diagnosis was given in the first forensic psychiatric expert witness assessment in adulthood but subsequently dropped. In another 4 cases (33%), the diagnosis was dropped in adulthood but later re-assigned, whereas in 3 cases (25%), the diagnosis was discontinued throughout the observation period. In 50% of cases with a diagnostic change, the discontinuation of an adult ADHD diagnosis coincided with a newly diagnosed personality disorder (or vice versa).
UNASSIGNED: Our findings highlighted considerable inconsistencies in the assignment of adult ADHD diagnoses amongst offenders. Whilst ADHD remission in adulthood occurs, the diagnostic variability in our results warrants detailed scrutiny. One possibility is that ADHD has similar fluctuations to conditions like depression, as argued elsewhere. Equally, diagnoses may become \"lost\", meaning they are not given even when applicable and replaced by other diagnoses. Additionally, residual symptoms may remain but beyond the diagnostic threshold. This is significant because untreated ADHD can increase re-offending risks and adverse health outcomes.
UNASSIGNED: This study employed a retrospective longitudinal design to investigate ADHD amongst adult offenders with a confirmed diagnosis of ADHD during childhood or adolescence at a Swiss forensic outpatient clinic between 2008 and 2021. N = 181 patient files were reviewed, including forensic expert witness assessments and treatment reports. We charted the adulthood trajectory of patients with a confirmed childhood/adolescence ADHD diagnosis, examining the course of their diagnoses.
UNASSIGNED: Of 181 patients, evidence indicated that 12 (7%) had an ADHD diagnosis in childhood/adolescence. In 1 (8%) of these 12 cases, the diagnosis was maintained throughout the observation period. For 4 patients (33%), a diagnosis was given in the first forensic psychiatric expert witness assessment in adulthood but subsequently dropped. In another 4 cases (33%), the diagnosis was dropped in adulthood but later re-assigned, whereas in 3 cases (25%), the diagnosis was discontinued throughout the observation period. In 50% of cases with a diagnostic change, the discontinuation of an adult ADHD diagnosis coincided with a newly diagnosed personality disorder (or vice versa).
UNASSIGNED: Our findings highlighted considerable inconsistencies in the assignment of adult ADHD diagnoses amongst offenders. Whilst ADHD remission in adulthood occurs, the diagnostic variability in our results warrants detailed scrutiny. One possibility is that ADHD has similar fluctuations to conditions like depression, as argued elsewhere. Equally, diagnoses may become \"lost\", meaning they are not given even when applicable and replaced by other diagnoses. Additionally, residual symptoms may remain but beyond the diagnostic threshold. This is significant because untreated ADHD can increase re-offending risks and adverse health outcomes.
摘要：
■注意缺陷/多动症（ADHD）在犯罪者中很普遍，增加攻击性和违法行为的风险。由于多动症及其症状可以持续到成年，准确诊断和维持罪犯的诊断对于确保适当治疗和减少累犯至关重要。
■这项研究采用了回顾性纵向设计，以调查2008年至2021年在瑞士法医门诊期间在儿童或青春期确诊为ADHD的成年罪犯中的ADHD。审查了N=181份患者档案，包括法医专家证人评估和治疗报告。我们绘制了确诊为儿童/青春期ADHD诊断的患者的成年轨迹，检查他们的诊断过程。
■181名患者,有证据表明,12例(7%)在儿童/青春期诊断为ADHD.在这12例病例中，有1例(8%)该诊断在整个观察期间得到维持.对于4名患者（33%），在成年后的第一次法医精神病学专家证人评估中给出了诊断，但随后下降。在另外4例（33%）中，诊断在成年后被放弃，但后来被重新分配，而在3例(25%)中，在整个观察期间停止诊断.在50%的诊断改变的病例中，成人ADHD诊断的终止与新诊断的人格障碍同时发生(反之亦然).
■我们的研究结果强调了在成人ADHD诊断中犯罪者的分配存在相当大的不一致。虽然成年后发生ADHD缓解，我们结果中的诊断变异性值得详细审查.一种可能性是多动症与抑郁症等疾病有类似的波动，正如其他地方所争论的那样。同样,诊断可能会变成“丢失”，这意味着即使适用，也不会给出它们，并由其他诊断代替。此外,残留症状可能仍然存在,但超过诊断阈值.这很重要，因为未经治疗的ADHD会增加再犯罪风险和不良健康结果。
■这项研究采用了回顾性纵向设计，以调查2008年至2021年在瑞士法医门诊期间在儿童或青春期确诊为ADHD的成年罪犯中的ADHD。审查了N=181份患者档案，包括法医专家证人评估和治疗报告。我们绘制了确诊为儿童/青春期ADHD诊断的患者的成年轨迹，检查他们的诊断过程。
■181名患者,有证据表明,12例(7%)在儿童/青春期诊断为ADHD.在这12例病例中，有1例(8%)该诊断在整个观察期间得到维持.对于4名患者（33%），在成年后的第一次法医精神病学专家证人评估中给出了诊断，但随后下降。在另外4例（33%）中，诊断在成年后被放弃，但后来被重新分配，而在3例(25%)中，在整个观察期间停止诊断.在50%的诊断改变的病例中，成人ADHD诊断的终止与新诊断的人格障碍同时发生(反之亦然).
■我们的研究结果强调了在成人ADHD诊断中犯罪者的分配存在相当大的不一致。虽然成年后发生ADHD缓解，我们结果中的诊断变异性值得详细审查.一种可能性是多动症与抑郁症等疾病有类似的波动，正如其他地方所争论的那样。同样,诊断可能会变成“丢失”，这意味着即使适用，也不会给出它们，并由其他诊断代替。此外,残留症状可能仍然存在,但超过诊断阈值.这很重要，因为未经治疗的ADHD会增加再犯罪风险和不良健康结果。
