Prevalence of adult adhd in italian prison: a pilot study

Abstract

ADHD (Attention Deficit Hyperactivity Disorder) is an inherited disorder that frequently persists in adulthood, leading an impairment in daily life. Several international studies estimate a high prevalence of ADHD in inmates (among 25-45%): we conducted a pilot study in Milano-Bollate prison to investigate the prevalence of ADHD in Italian male prison population. According to literature, we also investigated the association between ADHD and substance abuse and ADHD and the length of sentence. Inmates were progressively enrolled among those entering in Bollate and accepting to be screened for ADHD as a part of the clinical psychological assessment. Good Italian comprehension and the absence of acute psy-chiatric disorder were excluding criteria. ADHD assessment was based on ASRS (Adult ADHD Self-Report Scale) and WURS (Wender Utah Rating Scale for the Attention Deficit Hyperactivity Disorder) scales, that evaluate symptoms respec-tively in adulthood and in childhood. Comorbid disorders and differential diagnosis were investigated by the means of BDI-II (Beck Depression Inventory–Second Edition) and HCL-32 (Hypomania Check List- modified questionnaire). 59 sub-jects were recruited: the overall prevalence of ADHD in childhood and/ or adulthood among inmates was estimated at 23.7%. Of this percentage, 64.3% reported ADHD symptoms in adulthood. Substance abuse was reported in 71% of ADHD sample and a significant association was identified between abuse and ASRS (χ2= 13.85 df 6 p<.01). There wasn’t found a significant association between the type of crime and ADHD (χ2= 2,601 df 2 p>0.05). A positive correlation was identified between ASRS and BDI-II (r= 0,511 p<.001), whereas no correlation was found between ADHD scales and HCL-32. Our findings confirm the high rate of ADHD prevalence in inmate, according to the literature data. We founded high comorbidity rate of adult ADHD with substances abuse and depressive symptoms, whereas no association between the length of sentence and ADHD was confirmed. These results, although preliminary, highlight the necessity of appropriate treatment for ADHD in prison: a psychoeducational intervention may modify dysfunctional behaviours and enhance interpersonal skills and it also may be protective against the use of substances and the risk of recidivism.