Editorial: Does a Diagnosis of Attention-Deficit/Hyperactivity Disorder in Childhood Determine an Increased Risk for Future Criminality?

Problems with occupational performance, emotional adjustment, legal involvement, and educational attainment are common in adults who had been diagnosed during childhood with attention-deficit/hyperactivity disorder. The National Institute of Health (NIMH) Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder (ADHD) (MTA study) reported that of their cohort of 579 youth diagnosed with ADHD, combined type, age 7 to 9 years, half endorsed 4 persistent symptoms of ADHD when evaluated 16 years later at a mean age of 24.7 years. In fact, 41% persisted in meeting full ADHD symptomatic and impairment criteria as adults. This subgroup continued to experience problems with incomplete postsecondary education, job instability, lower current income, receipt of public assistance, and risky sexual behavior. Although the persistence of ADHD symptoms in the MTA study follow-up study was not associated with increased jail time, other studies concluded that a childhood diagnosis of ADHD was associated with a two- to threefold increased risk of later arrests, convictions, and incarcerations. Furthermore, although ADHD medications were not associated with better outcomes after 16 years of follow-up of the MTA cohort, Lichtenstein et al. reported that ADHD medication exerted a possible protective effect against incarceration.