Effect of Pharmacological Treatment of Attention-Deficit/Hyperactivity Disorder on Criminality - 26/03/24
, Henrik Daae Zachrisson, PhD d, Simen Markussen, PhD e, Felix Elwert, PhD f, Ingvild Lyhmann, CandPsychol a, b, Ashmita Chaulagain, MPH a, b, Ingvar Bjelland, MD, PhD a, b, Anne Halmøy, MD, PhD a, b, Knut Rypdal, CandJur a, Arnstein Mykletun, PhD a, b, cAbstract |
Objective |
Criminality rates are higher among persons with attention-deficit/hyperactivity disorder (ADHD), and evidence that medication reduces crime is limited. Medication rates between clinics vary widely even within universal health care systems, partly because of providers’ treatment preferences. We used this variation to estimate causal effects of pharmacological treatment of ADHD on 4-year criminal outcomes.
Method |
We used Norwegian population-level registry data to identify all unique patients aged 10 to 18 years diagnosed with ADHD between 2009 and 2011 (n = 5,624), their use of ADHD medication, and subsequent criminal charges. An instrumental variable design, exploiting variation in provider preference for ADHD medication between clinics, was used to identify causal effects of ADHD medication on crime among patients on the margin of treatment, that is, patients who receive treatment because of their provider’s preference.
Results |
Criminality was higher in patients with ADHD relative to the general population. Medication preference varied between clinics and strongly affected patients’ treatment. Instrumental variable analyses supported a protective effect of pharmacological treatment on violence-related and public-order−related charges with numbers needed to treat of 14 and 8, respectively. There was no evidence for effects on drug-, traffic-, sexual-, or property-related charges.
Conclusion |
This is the first study to demonstrate causal effects of pharmacological treatment of ADHD on some types of crimes in a population-based natural experiment. Pharmacological treatment of ADHD reduced crime related to impulsive-reactive behavior in patients with ADHD on the margin of treatment. No effects were found on crimes requiring criminal intent, conspiracy, and planning.
Study preregistration information |
The ADHD controversy project: Long-term effects of ADHD medication; www.isrctn.com/; 11891971.
Le texte complet de cet article est disponible en PDF.Key words : ADHD, pharmacological treatment, quasi-experiment
Plan
| TW is supported by funding from the Western Norway Regional Health Authority (912197), Research Council of Norway (288585/IAR), and Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital. HZ, SM, FE, IL, and AC were supported by Research Council Norway (288585/IAR). AM is supported by Research Council Norway (288585/IAR) and Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital. HZ is also supported by funding from the European Research Council Consolidator Grant ERC-CoG-2018 EQOP [grant number 818425]. |
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| The research was performed with permission from the Regional Committees for Medical and Health Research Ethics. |
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| This work has been prospectively registered: ISRCTN11891971. |
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| Statistical experts for this research: Dr. Markussen is an econometrician. Prof. Elwert is a sociologist and statistician. Prof. Zachrisson is a methodologist with expertise in causal inference. |
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| Author Contributions TW: Conceptualization, methodology, data curation, formal analysis, visualization, funding acquisition, project administration, writing-original draft, writing-review & editing. HZ: Conceptualization, supervision, methodology, writing-review & editing. SM: Conceptualization, supervision, methodology, writing-review & editing. FE: Conceptualization, methodology, writing-review & editing. IL: writing-review & editing. AC: writing-review & editing. IB: Conceptualization, supervision, writing-review & editing. AH: Conceptualization, supervision, writing-review & editing. KR: Conceptualization, writing-review & editing. AM: Conceptualization, funding acquisition, methodology, supervision, project administration, writing-review & editing. |
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| Disclosure: Prof. Zachrisson, Dr. Markussen, Profs. Elwert and Bjelland, Dr. Halmøy, Prof. Mykletun, Mr. Widding-Havneraas, Mss. Lyhmann and Chaulagain, and Mr. Rypdal have reported no biomedical financial interests or potential conflicts of interest. |
Vol 63 - N° 4
P. 433-442 - avril 2024 Retour au numéro
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