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Medication for Attention Deficit-Hyperactivity Disorder and Criminality

Paul Lichtenstein, Ph.D., Linda Halldner, M.D., Ph.D., Johan Zetterqvist, M.Ed., Arvid Sjölander, Ph.D., Eva Serlachius, M.D., Ph.D., Seena Fazel, M.B., Ch.B., M.D., Niklas Långström, M.D., Ph.D., and Henrik Larsson, M.D., Ph.D.

N Engl J Med 2012; 367:2006-2014November 22, 2012DOI: 10.1056/NEJMoa1203241

Background

Attention deficit-hyperactivity disorder (ADHD) is a common disorder that has been associated with criminal behavior in some studies. Pharmacologic treatment is available for ADHD and may reduce the risk of criminality.

Methods

Using Swedish national registers, we gathered information on 25,656 patients with a diagnosis of ADHD, their pharmacologic treatment, and subsequent criminal convictions in Sweden from 2006 through 2009. We used stratified Cox regression analyses to compare the rate of criminality while the patients were receiving ADHD medication, as compared with the rate for the same patients while not receiving medication.

Results

As compared with nonmedication periods, among patients receiving ADHD medication, there was a significant reduction of 32% in the criminality rate for men (adjusted hazard ratio, 0.68; 95% confidence interval [CI], 0.63 to 0.73) and 41% for women (hazard ratio, 0.59; 95% CI, 0.50 to 0.70). The rate reduction remained between 17% and 46% in sensitivity analyses among men, with factors that included different types of drugs (e.g., stimulant vs. nonstimulant) and outcomes (e.g., type of crime).

Conclusions

Among patients with ADHD, rates of criminality were lower during periods when they were receiving ADHD medication. These findings raise the possibility that the use of medication reduces the risk of criminality among patients with ADHD. (Funded by the Swedish Research Council and others.)

Cite info:


TY  - JOUR

T1  - Medication for Attention Deficit-Hyperactivity Disorder and Criminality

AU  - Lichtenstein, Paul

AU  - Halldner, Linda

AU  - Zetterqvist, Johan

AU  - Sjölander, Arvid

AU  - Serlachius, Eva

AU  - Fazel, Seena

AU  - Långström, Niklas

AU  - Larsson, Henrik

Y1  - 2012/11/21

PY  - 2012

DA  - 2012/11/22

N1  - doi: 10.1056/NEJMoa1203241

DO  - 10.1056/NEJMoa1203241

T2  - New England Journal of Medicine

JF  - New England Journal of Medicine

JO  - N Engl J Med

SP  - 2006

EP  - 2014

VL  - 367

IS  - 21

PB  - Massachusetts Medical Society

SN  - 0028-4793

M3  - doi: 10.1056/NEJMoa1203241

UR  - http://dx.doi.org/10.1056/NEJMoa1203241

Y2  - 2012/11/26

ER  -