Attention Deficit Hyperactivity Disorder (ADHD) in personality disordered offenders and the association with disruptive behavioural problems

Abstract

In this study the authors aim to establish the proportion of personality disordered patients that meet screening criteria for adult ADHD, and examine whether they are more disruptive and present with greater behavioural problems in hospital compared with a Non-ADHD Symptomatic personality disordered group. ADHD symptomology was assessed using two screening measures: (1) the Wender-Utah Rating Scale (WURS) measuring childhood symptoms, and (2) the DSM-IV Checklist of Symptoms measuring symptoms in adulthood. Behavioural problems were examined by a specially designed questionnaire administered to the participants' primary nurse and critical incidents recorded in participants' medical records. The participants were 69 males who were legally detained in hospital with a primary diagnosis of personality disorder. Fifty-four (78%) participants obtained scores consistent with a diagnosis of ADHD in childhood, but only three (6%) of them were likely to meet DSM-IV criteria for adult ADHD. Twenty (29%) of adults were classified in partial remission. The ADHD and the partial remission groups were compared with the non-ADHD and in remission groups. The symptomatic group had a significantly greater number of critical incidents of aggression than the non-symptomatic group recorded in their medical files, but there was no significant difference of staff perception of disruptive behaviour and social problems. The clinical implications of the findings are discussed in terms of how treatment for their ADHD symptoms may have a positive impact on the behavioural problems presented by this population and their long-term outcome.