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Licensed Unlicensed Requires Authentication Published by De Gruyter November 20, 2014

Attention-deficit hyperactivity disorder (ADHD), substance use disorders, and criminality: a difficult problem with complex solutions

  • Carlos Knecht , Raquel de Alvaro , Jose Martinez-Raga EMAIL logo and Vicent Balanza-Martinez


The association between attention-deficit hyperactivity disorder (ADHD) and criminality has been increasingly recognized as an important societal concern. Studies conducted in different settings have revealed high rates of ADHD among adolescent offenders. The risk for criminal behavior among individuals with ADHD is increased when there is psychiatric comorbidity, particularly conduct disorder and substance use disorder. In the present report, it is aimed to systematically review the literature on the epidemiological, neurobiological, and other risk factors contributing to this association, as well as the key aspects of the assessment, diagnosis, and treatment of ADHD among offenders. A systematic literature search of electronic databases (PubMed, EMBASE, and PsycINFO) was conducted to identify potentially relevant studies published in English, in peer-reviewed journals. Studies conducted in various settings within the judicial system and in many different countries suggest that the rate of adolescent and adult inmates with ADHD far exceeds that reported in the general population; however, underdiagnosis is common. Similarly, follow-up studies of children with ADHD have revealed high rates of criminal behaviors, arrests, convictions, and imprisonment in adolescence and adulthood. Assessment of ADHD and comorbid condition requires an ongoing and careful process. When treating offenders or inmates with ADHD, who commonly present other comorbid psychiatric disorder complex, comprehensive and tailored interventions, combining pharmacological and psychosocial strategies are likely to be needed.

Corresponding author: Jose Martinez-Raga, MD, PhD, Unidad Docente de Psiquiatria y Psicologia Medica, Hospital Universitario Dr. Peset, Avda. Gaspar Aguilar, 90, 46017 Valencia, Spain, E-mail: ; and Teaching Unit of Psychiatry and Psychological Medicine, University Hospital Doctor Peset and University of Valencia, and University Cardenal Herrera CEU, Valencia, Spain


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Received: 2014-6-27
Accepted: 2014-8-15
Published Online: 2014-11-20
Published in Print: 2015-5-1

©2015 by De Gruyter

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