1
|
Fontana BD, Reichmann F, Tilley CA, Lavlou P, Shkumatava A, Alnassar N, Hillman C, Karlsson KÆ, Norton WHJ, Parker MO. adgrl3.1-deficient zebrafish show noradrenaline-mediated externalizing behaviors, and altered expression of externalizing disorder-candidate genes, suggesting functional targets for treatment. Transl Psychiatry 2023; 13:304. [PMID: 37783687 PMCID: PMC10545713 DOI: 10.1038/s41398-023-02601-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 09/16/2023] [Accepted: 09/20/2023] [Indexed: 10/04/2023] Open
Abstract
Externalizing disorders (ED) are a cause of concern for public health, and their high heritability makes genetic risk factors a priority for research. Adhesion G-Protein-Coupled Receptor L3 (ADGRL3) is strongly linked to several EDs, and loss-of-function models have shown the impacts of this gene on several core ED-related behaviors. For example, adgrl3.1-/- zebrafish show high levels of hyperactivity. However, our understanding of the mechanisms by which this gene influences behavior is incomplete. Here we characterized, for the first time, externalizing behavioral phenotypes of adgrl3.1-/- zebrafish and found them to be highly impulsive, show risk-taking in a novel environment, have attentional deficits, and show high levels of hyperactivity. All of these phenotypes were rescued by atomoxetine, demonstrating noradrenergic mediation of the externalizing effects of adgrl3.1. Transcriptomic analyses of the brains of adgrl3.1-/- vs. wild-type fish revealed several differentially expressed genes and enriched gene clusters that were independent of noradrenergic manipulation. This suggests new putative functional pathways underlying ED-related behaviors, and potential targets for the treatment of ED.
Collapse
Affiliation(s)
- Barbara D Fontana
- School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, UK
| | - Florian Reichmann
- Division of Pharmacology, Otto Loewi Research Center, Medical University of Graz, Graz, Austria
| | - Ceinwen A Tilley
- Department of Genetics and Genome Biology, College of Medicine, Biological Sciences and Psychology, University of Leicester, Leicester, LE1 7RH, UK
| | - Perrine Lavlou
- Institut Curie, PSL Research University, CNRS UMR3215, INSERM U934, Paris, France
| | - Alena Shkumatava
- Institut Curie, PSL Research University, CNRS UMR3215, INSERM U934, Paris, France
| | - Nancy Alnassar
- School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, UK
| | - Courtney Hillman
- Surrey Sleep Research Centre, University of Surrey, Guildford, UK
| | - Karl Ægir Karlsson
- School of Science and Engineering, Reykjavik University, Reykjavik, Iceland
- Biomedical Center, University of Iceland, Reykjavik, Iceland
- 3Z, Reykjavik, Iceland
| | - William H J Norton
- Department of Genetics and Genome Biology, College of Medicine, Biological Sciences and Psychology, University of Leicester, Leicester, LE1 7RH, UK.
- Institute of Biology, Department of Genetics, ELTE Eötvös Loránd University, Budapest, Hungary.
| | - Matthew O Parker
- Surrey Sleep Research Centre, University of Surrey, Guildford, UK.
| |
Collapse
|
2
|
Hofvander B, Nilsson T, Ståhlberg O, Claesdotter E, Moberg P, Ahlbäck K, Hildebrand Karlén M. Autism Spectrum Disorders in forensic psychiatric investigations-patterns of comorbidity and criminality. Front Psychiatry 2023; 14:1168572. [PMID: 37621970 PMCID: PMC10444990 DOI: 10.3389/fpsyt.2023.1168572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 07/24/2023] [Indexed: 08/26/2023] Open
Abstract
Background There are contradictory research findings regarding whether individuals with Autism Spectrum Disorders (ASDs) are more or less likely to commit crimes. The aims of the current study were to: (1) Describe psychiatric and crime-related characteristics of a large group of offenders with ASD who had undergone a Forensic Psychiatric Investigation (FPI). (2) Identify clinical subgroups among this group of offenders. (3) Investigate associations between the identified clinical subgroups and (a) psychiatric comorbidity (b) types of crimes and (c) criminal responsibility. Methods The study cohort consists of all subjects (n = 831) who received an ASD-diagnosis at an FPI between 2002 and 2018 in Sweden. Descriptive and clinical, as well as crime related variables were obtained from the FPIs. Non-parametric (Pearson χ2, Fisher's exact and Mann-Whitney U-test) inferential statistics were used for analyses of between-group differences and effect sizes were reported. A Latent Class Analysis was used to identify homogeneous subgroups (or classes) from categorical characteristics. Results The cohort consisted of 708 men and 123 women, aged 18 to 74 yrs. Two-thirds (66.7%) of the cohort had at least one other psychiatric diagnosis, the most prevalent was substance use disorder (SUD). A severe mental disorder, equivalent to lack of criminal responsibility, was most often reported among offenders with a comorbid diagnosis of schizophrenia spectrum disorder. The most common type of crime was violent crime. Three person-oriented clinical subgroups were identified; (1) ASD with few other diagnoses; (2) ASD and very high levels of SUDs, plus moderate levels of other externalizing disorders and psychotic psychopathology and (3) ASD and moderate to high levels of personality disorders (other than ASPD) and SUDs. Conclusion Our results highlight the importance of all parts of the CJS to be prepared to handle offenders with ASD, often with high levels of additional psychiatric problems. Traditional approaches in treatment or other psychosocial interventions for ASD may need to be adapted to at least three general clinical profiles- one with mainly neurodevelopmental problems, one with a spectrum of externalizing problems and one with complex personality related difficulties.
Collapse
Affiliation(s)
- Björn Hofvander
- Lund Clinical Research on Externalizing and Developmental Psychopathology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Department of Forensic Psychiatry, Region Skåne, Trelleborg, Sweden
- Centre of Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden
| | - Thomas Nilsson
- Centre of Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden
| | - Ola Ståhlberg
- Centre of Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden
| | - Emma Claesdotter
- Lund Clinical Research on Externalizing and Developmental Psychopathology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Patricia Moberg
- Department of Forensic Psychiatry, Region Skåne, Trelleborg, Sweden
| | - Klara Ahlbäck
- Lund Clinical Research on Externalizing and Developmental Psychopathology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Malin Hildebrand Karlén
- Centre of Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
3
|
李 燕, 陆 斯, 莫 艳, 经 连, 姚 丽, 谭 伟, 韦 秋. [Alterations in the intestinal microbiota of preterm infants with neurodevelopmental impairments: a prospective cohort study]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2023; 25:689-696. [PMID: 37529950 PMCID: PMC10414177 DOI: 10.7499/j.issn.1008-8830.2302130] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/10/2023] [Indexed: 08/03/2023]
Abstract
OBJECTIVES To investigate the difference in intestinal microbiota between preterm infants with neurodevelopmental impairment (NDI) and those without NDI. METHODS In this prospective cohort study, the preterm infants who were admitted to the neonatal intensive care unit of Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region from September 1, 2019 to September 30, 2021 were enrolled as subjects. According to the assessment results of Gesell Developmental Scale at the corrected gestational age of 1.5-2 years, they were divided into two groups: normal (n=115) and NDI (n=100). Fecal samples were collected one day before discharge, one day before introducing solid food, and at the corrected gestational age of 1 year. High-throughput sequencing was used to compare the composition of intestinal microbiota between groups. RESULTS Compared with the normal group, the NDI group had a significantly higher Shannon diversity index at the corrected gestational age of 1 year (P<0.05). The principal coordinate analysis showed a significant difference in the composition of intestinal microbiota between the two groups one day before introducing solid food and at the corrected gestational age of 1 year (P<0.05). Compared with the normal group, the NDI group had a significantly higher abundance of Bifidobacterium in the intestine at all three time points, a significantly higher abundance of Enterococcus one day before introducing solid food and at the corrected gestational age of 1 year, and a significantly lower abundance of Akkermansia one day before introducing solid food (P<0.05). CONCLUSIONS There are significant differences in the composition of intestinal microbiota between preterm infants with NDI and those without NDI. This study enriches the data on the characteristics of intestinal microbiota in preterm infants with NDI and provides reference for the microbiota therapy and intervention for NDI in preterm infants.
Collapse
|
4
|
Byng R, Kirkpatrick T, Lennox C, Warren FC, Anderson R, Brand SL, Callaghan L, Carroll L, Durcan G, Gill L, Goodier S, Graham J, Greer R, Haddad M, Harris T, Henley W, Hunter R, Leonard S, Maguire M, Michie S, Owens C, Pearson M, Quinn C, Rybczynska-Bunt S, Stevenson C, Stewart A, Stirzaker A, Todd R, Walter F, Weston L, Wright N, Taylor RS, Shaw J. Evaluation of a complex intervention for prisoners with common mental health problems, near to and after release: the Engager randomised controlled trial. Br J Psychiatry 2023; 222:18-26. [PMID: 35978272 PMCID: PMC10895504 DOI: 10.1192/bjp.2022.93] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 05/13/2022] [Accepted: 05/14/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Many male prisoners have significant mental health problems, including anxiety and depression. High proportions struggle with homelessness and substance misuse. AIMS This study aims to evaluate whether the Engager intervention improves mental health outcomes following release. METHOD The design is a parallel randomised superiority trial that was conducted in the North West and South West of England (ISRCTN11707331). Men serving a prison sentence of 2 years or less were individually allocated 1:1 to either the intervention (Engager plus usual care) or usual care alone. Engager included psychological and practical support in prison, on release and for 3-5 months in the community. The primary outcome was the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM), 6 months after release. Primary analysis compared groups based on intention-to-treat (ITT). RESULTS In total, 280 men were randomised out of the 396 who were potentially eligible and agreed to participate; 105 did not meet the mental health inclusion criteria. There was no mean difference in the ITT complete case analysis between groups (92 in each arm) for change in the CORE-OM score (1.1, 95% CI -1.1 to 3.2, P = 0.325) or secondary analyses. There were no consistent clinically significant between-group differences for secondary outcomes. Full delivery was not achieved, with 77% (108/140) receiving community-based contact. CONCLUSIONS Engager is the first trial of a collaborative care intervention adapted for prison leavers. The intervention was not shown to be effective using standard outcome measures. Further testing of different support strategies for prison with mental health problems is needed.
Collapse
Affiliation(s)
- Richard Byng
- Community and Primary Care Research Group, University of Plymouth, UK
| | - Tim Kirkpatrick
- Division of Psychology and Mental Health, University of Manchester, UK
| | - Charlotte Lennox
- Division of Psychology and Mental Health, University of Manchester, UK
| | | | - Rob Anderson
- College of Medicine & Health, University of Exeter, UK
| | | | - Lynne Callaghan
- Community and Primary Care Research Group, University of Plymouth, UK
| | - Lauren Carroll
- Community and Primary Care Research Group, University of Plymouth, UK
| | - Graham Durcan
- Centre for Mental Health, South Bank Technopark, London, UK
| | - Laura Gill
- Community and Primary Care Research Group, University of Plymouth, UK
| | - Sara Goodier
- Community and Primary Care Research Group, University of Plymouth, UK
| | - Jonathan Graham
- Division of Psychology and Mental Health, University of Manchester, UK
| | - Rebecca Greer
- Community and Primary Care Research Group, University of Plymouth, UK
| | | | | | | | - Rachael Hunter
- Research Department of Primary Care and Population Health, University College London, Royal Free Medical School, UK
| | - Sarah Leonard
- Division of Psychology and Mental Health, University of Manchester, UK
| | - Mike Maguire
- Centre for Criminology, University of South Wales, UK
| | - Susan Michie
- Research Department of Primary Care and Population Health, University College London, Royal Free Medical School, UK
| | | | - Mark Pearson
- Wolfson Palliative Care Research Centre, Hull York Medical School, Faculty of Health Sciences, University of Hull, UK
| | - Cath Quinn
- Community and Primary Care Research Group, University of Plymouth, UK
| | | | | | - Amy Stewart
- Community and Primary Care Research Group, University of Plymouth, UK
| | - Alex Stirzaker
- South West Mental Health Clinical Network, NHS England, UK
| | - Roxanne Todd
- Division of Psychology and Mental Health, University of Manchester, UK
| | - Florian Walter
- Division of Psychology and Mental Health, University of Manchester, UK
| | - Lauren Weston
- Community and Primary Care Research Group, University of Plymouth, UK
| | | | - Rod S Taylor
- MRC/CSO Social and Public Health Sciences Unit & Robertson Centre for Biostatistics, Institute of Health and Well Being, University of Glasgow, UK
| | - Jenny Shaw
- Division of Psychology and Mental Health, University of Manchester, UK and Greater Manchester Manchester Health NHS Foundation Trust, UK
| |
Collapse
|
5
|
Fovet T, Wathelet M, Pignon B, Jardri R, D'Hondt F, Amad A. Refining the clinical approach of psychotic experiences in people who are incarcerated. Schizophr Res 2022; 250:87-88. [PMID: 36370536 DOI: 10.1016/j.schres.2022.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 09/12/2022] [Accepted: 10/30/2022] [Indexed: 11/10/2022]
Affiliation(s)
- Thomas Fovet
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNcog - Lille Neuroscience & Cognition, F-59000 Lille, France; Centre National de Ressources et de Résilience Lille-Paris (CN2R), F-59000 Lille, France.
| | - Marielle Wathelet
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNcog - Lille Neuroscience & Cognition, F-59000 Lille, France; Centre National de Ressources et de Résilience Lille-Paris (CN2R), F-59000 Lille, France; Fédération Régionale de Recherche en Psychiatrie et Santé Mentale, Hauts-de-France, France
| | - Baptiste Pignon
- Université Paris Est Créteil (UPEC), INSERM, IMRB, AP-HP, Hôpitaux Universitaires "Henri Mondor", DMU IMPACT, Fondation FondaMental, F-94010 Créteil, France
| | - Renaud Jardri
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNcog - Lille Neuroscience & Cognition, F-59000 Lille, France
| | - Fabien D'Hondt
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNcog - Lille Neuroscience & Cognition, F-59000 Lille, France; Centre National de Ressources et de Résilience Lille-Paris (CN2R), F-59000 Lille, France
| | - Ali Amad
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNcog - Lille Neuroscience & Cognition, F-59000 Lille, France; Fédération Régionale de Recherche en Psychiatrie et Santé Mentale, Hauts-de-France, France
| |
Collapse
|
6
|
Fovet T, Eck M, Bouchard JP. De quels troubles psychiatriques souffrent les personnes détenues en France ? ANNALES MÉDICO-PSYCHOLOGIQUES, REVUE PSYCHIATRIQUE 2022. [DOI: 10.1016/j.amp.2022.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
7
|
Collins J, Horton K, Gale-St Ives E, Murphy G, Barnoux M. A Systematic Review of Autistic People and the Criminal Justice System: An Update of King and Murphy (2014). J Autism Dev Disord 2022:10.1007/s10803-022-05590-3. [PMID: 35637365 DOI: 10.1007/s10803-022-05590-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2022] [Indexed: 10/18/2022]
Abstract
The purpose of this paper was to determine whether recommendations made by King & Murphy (Journal of Autism and Developmental Disorders 44:2717-2733, 2014) in their review of the evidence on autistic people in contact with the criminal justice system (CJS) have been addressed. Research published since 2013 was systematically examined and synthesised. The quality of 47 papers was assessed using the Mixed Methods Appraisal Tool. Findings suggest a limited amount of good quality research has been conducted that has focused on improving our understanding of autistic people in contact with the CJS since 2013. Methodological limitations make direct comparisons between autistic and non-autistic offenders difficult. Autistic people commit a range of crimes and appear to have unique characteristics that warrant further exploration (i.e., vulnerabilities, motivations for offending).
Collapse
Affiliation(s)
- J Collins
- Tizard Centre, University of Kent, Canterbury, CT2 7NF, UK.
| | - K Horton
- Tizard Centre, University of Kent, Canterbury, CT2 7NF, UK
| | - E Gale-St Ives
- Tizard Centre, University of Kent, Canterbury, CT2 7NF, UK
| | - G Murphy
- Tizard Centre, University of Kent, Canterbury, CT2 7NF, UK
| | - M Barnoux
- Tizard Centre, University of Kent, Canterbury, CT2 7NF, UK
| |
Collapse
|
8
|
Heady N, Watkins A, John A, Hutchings H. Prevalence of neurodevelopmental disorders and their impact on the health and social well-being among looked after children (LAC): a systematic review protocol. Syst Rev 2022; 11:49. [PMID: 35305681 PMCID: PMC8934470 DOI: 10.1186/s13643-022-01923-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 03/08/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Looked after children (LAC) that are placed in either a foster, kinship, residential care setting or transition to adoption continue to develop debilitating disorders that significantly impact their overall health and social well-being. The prevalence of these disorders is often depicted under broad categories such as mental, behavioural or neurodevelopmental disorders (NDDs). Limited in research is the prevalence of what specific disorders fall under these broad categories. NDDs such as autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) which fall under an umbrella group in the expert field of genetics and neuropsychiatry will be explored. Unsupported, these disorders can lead to suboptimal health and social outcomes for both the child and family. In the general population, the prevalence of these NDDs and impacts on health and social well-being are relatively well documented, but for minority groups such as LAC, research is extremely limited. This review aims to estimate the prevalence of NDDs among LAC and explore how they might impact the health and social well-being of these vulnerable children. If feasible, the review will compare the prevalence rates to those children who are not looked after, to illuminate any differences or similarities between populations. METHODS PubMed, ASSIA, IBSS, Web of Science, PsychINFO, Scopus, Psych articles, Social Care Online, secondary, grey literature and government publications will be searched to identify any eligible studies. No restrictions will be placed on country, design or year of publication. Studies must provide primary data on the prevalence or incidence of NDDs for individuals < 25 years of age, supported by either a diagnostic code, standardised diagnostic assessment tool or survey response. The Joanna Briggs Institute (JBI) critical appraisal tools will be utilised to assess the quality and bias and the random-effects model used to estimate a pooled prevalence of NDDs. DISCUSSION Attaining an estimated prevalence of these NDDs and identifying any impacts on health and social well-being might inform key stakeholders in health, educational and social sectors with important information that might aid in the early identification and intervention to safeguard and meet the unique needs of these children. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD4201913103 .
Collapse
Affiliation(s)
- Nicola Heady
- Swansea University Medical School, Institute of Life Science 2, Floor 2, Singleton Campus, Swansea, SA2 8PP Wales
| | - Alan Watkins
- Swansea University Medical School, Institute of Life Science 2, Floor 2, Singleton Campus, Swansea, SA2 8PP Wales
| | - Ann John
- Swansea University Medical School, Institute of Life Science 2, Floor 2, Singleton Campus, Swansea, SA2 8PP Wales
| | - Hayley Hutchings
- Swansea University Medical School, Institute of Life Science 2, Floor 2, Singleton Campus, Swansea, SA2 8PP Wales
| |
Collapse
|
9
|
Riglin L, Leppert B, Langley K, Thapar AK, O'Donovan MC, Davey Smith G, Stergiakouli E, Tilling K, Thapar A. Investigating attention-deficit hyperactivity disorder and autism spectrum disorder traits in the general population: What happens in adult life? J Child Psychol Psychiatry 2021; 62:449-457. [PMID: 32663329 PMCID: PMC8365432 DOI: 10.1111/jcpp.13297] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/15/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are generally considered early-onset disorders so most research has therefore tended to focus on children. Differences between ADHD/ASD in adult life and childhood have been noted, but few population-based studies have examined them in adulthood. Furthermore, the interpretation of findings is hampered by changes in measure and from parent report to self-report. METHOD We examined continuous/trait measures of parent- and self-rated ADHD and ASD in adulthood (age 25 years) in a UK prospective longitudinal sample ALPSAC (the Avon Longitudinal Study of Parents and Children), using many of the same measures that parents reported on in childhood (N = 6,064). Our aim was to investigate these traits in this population for mean-level sex differences, overlaps with other cognitive, learning and communication problems and their associations with polygenic risk scores (PRS) for neuropsychiatric disorders (ADHD, ASD, schizophrenia, depression and anxiety). RESULTS ADHD and ASD traits in adulthood, as in childhood, showed associations with childhood cognitive, learning and communication problems and adult communication/language measures, although less so for self-ratings than parent-ratings. Males had higher ADHD and ASD trait levels, but this was not as marked as in childhood. In adulthood, ADHD (both parent- and self-rated) and ASD (parent-rated) symptoms showed associations with ADHD PRS; self-reported ADHD also showed association with depression PRS, whereas self-reported ASD did not show strong PRS associations. CONCLUSIONS Our findings suggest that in young adults, ADHD and ASD symptoms have similar characteristics as they do in childhood. Associations with other cognitive, learning and communication problems, and ADHD PRS were somewhat less pronounced for self-reported adult ADHD and ASD symptoms, suggesting that even at age 25, parent reports, where available, could be clinically useful.
Collapse
Affiliation(s)
- Lucy Riglin
- Division of Psychological Medicine and Clinical NeurosciencesMRC Centre for Neuropsychiatric Genetics and GenomicsCardiff UniversityCardiffUK
| | - Beate Leppert
- MRC Integrative Epidemiology UnitUniversity of BristolBristolUK
| | - Kate Langley
- Division of Psychological Medicine and Clinical NeurosciencesMRC Centre for Neuropsychiatric Genetics and GenomicsCardiff UniversityCardiffUK
- School of PsychologyCardiff UniversityCardiffUK
| | - Ajay K. Thapar
- Division of Psychological Medicine and Clinical NeurosciencesMRC Centre for Neuropsychiatric Genetics and GenomicsCardiff UniversityCardiffUK
| | - Michael C. O'Donovan
- Division of Psychological Medicine and Clinical NeurosciencesMRC Centre for Neuropsychiatric Genetics and GenomicsCardiff UniversityCardiffUK
| | | | | | - Kate Tilling
- MRC Integrative Epidemiology UnitUniversity of BristolBristolUK
| | - Anita Thapar
- Division of Psychological Medicine and Clinical NeurosciencesMRC Centre for Neuropsychiatric Genetics and GenomicsCardiff UniversityCardiffUK
| |
Collapse
|
10
|
Young S, Cocallis K. ADHD and offending. J Neural Transm (Vienna) 2021; 128:1009-1019. [PMID: 33538909 DOI: 10.1007/s00702-021-02308-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 01/14/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVES International studies have reported disproportionately higher rates of Attention Deficit Hyperactivity Disorder (ADHD) among youth and adult offenders across police custody, prison, probation and forensic mental health settings, estimated to fall at around 25%. This review aimed to investigate the presentation and vulnerabilities of this subpopulation of people with ADHD compared to those with ADHD in the general population and consider how this may impact on the approach to assessment and treatment in this population. METHODOLOGY A selective review of the extant literature was conducted to investigate how offenders with ADHD may present differently from their non-ADHD peers in their clinical presentation, criminogenic behaviour and psychological vulnerabilities. RESULTS Nearly all (around 96%) offenders with ADHD have additional comorbid problems, including mood, anxiety, conduct, substance use and personality disorders. Compared with offenders without ADHD, they become involved in the criminal justice system (CJS) at a younger age, have higher rates of recidivism, are more likely to make a false confession, engage in behavioural disturbances in custody, have health risk behaviours and a lower quality of life. Assessing and treating ADHD in this subpopulation may be more complex due to their presentation. CONCLUSIONS Offenders with ADHD are disadvantaged within the system by their ADHD symptoms being unrecognised and/or misunderstood; their diagnosis of ADHD may be missed or misdiagnosed. This is at cost to the individual, from both a health and rehabilitative perspective, as well as more broadly to society.
Collapse
Affiliation(s)
- Susan Young
- Psychology Services Limited, London, PO 1735, Croydon, C9 7AE, UK. .,Department of Psychology, Reykjavik University, Reykjavík, Iceland.
| | - Kelly Cocallis
- Northumbria Healthcare NHS Foundation Trust, Newcastle upon Tyne, UK
| |
Collapse
|
11
|
McKenzie K, Murray A, Murray G, Martin R. The use of an impact framework to evaluate the impact of research on policy and practice: Screening questionnaires for intellectual disability. RESEARCH EVALUATION 2020. [DOI: 10.1093/reseval/rvaa019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
There is an increasing emphasis on the importance of research having an impact on policy and practice. This can be more difficult to evidence in intellectual disability services because of the wide range of stakeholders involved. We evaluated whether an impact questionnaire covering: knowledge production, capacity building, informing policy and practice, social and economic benefits could successfully be used to evaluate the impact of research into and use of two screening questionnaires: the Learning Disability Screening Questionnaire (LDSQ) and Child and Adolescent Intellectual Disability Screening Questionnaire (CAIDS-Q). We conducted an online search for published peer reviewed and grey literature, and Internet resources that referenced LDSQ and/or CAIDS-Q. The resultant literature and resources were assessed for relevance and organized according to the categories outlined in the impact questionnaire. Evidence was found for all the areas of impact, with the largest body of evidence being in relation to informing policy and practice and social benefits and the least for economic benefits. The impact questionnaire provided the basis for a comprehensive and useful evaluative framework to assess impact, although there was some overlap between the different categories. The process of using it highlighted some wider issues to consider when attempting to evaluate impact. The results indicated that the research underpinning the LDSQ and CAIDS-Q had resulted in significant, generally positive, and wide-reaching impact on policy and practice in intellectual disability and other services, resulting in a number of positive outcomes.
Collapse
Affiliation(s)
- Karen McKenzie
- Department of Psychology, Northumbria University, Northumberland Road, Newcastle upon Tyne NE1 8ST, UK
| | - Aja Murray
- Department of Psychology, University of Edinburgh,George Square, Edinburgh EH8 9JZ, UK
| | - George Murray
- Department of Psychology, Northumbria University, Northumberland Road, Newcastle upon Tyne NE1 8ST, UK
- Department of Paediatrics, NHS Lothian, Morningside, EH105HF, UK
| | - Rachel Martin
- Department of Psychology, Northumbria University, Northumberland Road, Newcastle upon Tyne NE1 8ST, UK
| |
Collapse
|
12
|
de Abreu MS, Genario R, Giacomini AC, Demin KA, Lakstygal AM, Amstislavskaya TG, Fontana BD, Parker MO, Kalueff AV. Zebrafish as a Model of Neurodevelopmental Disorders. Neuroscience 2020; 445:3-11. [DOI: 10.1016/j.neuroscience.2019.08.034] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 07/21/2019] [Accepted: 08/20/2019] [Indexed: 12/14/2022]
|
13
|
Hollingdale J, Woodhouse E, Young S, Fridman A, Mandy W. Autistic spectrum disorder symptoms in children and adolescents with attention-deficit/hyperactivity disorder: a meta-analytical review. Psychol Med 2020; 50:2240-2253. [PMID: 31530292 DOI: 10.1017/s0033291719002368] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Research identifies highly variable prevalence estimates for autism spectrum disorder (ASD) in children and adolescents with attention deficit hyperactivity disorder (ADHD), particularly between community and clinical samples, warranting quantitative meta-analyses to investigate the true prevalence of ASD in children and adolescents with ADHD. METHODS Studies were identified through a systematic literature search of PsycINFO, MEDLINE and Web of Science through January 2018. Twenty-two publications met inclusion criteria (total N = 61 985). Two random effects meta-analyses were conducted: (1) to identify the proportion of children and adolescents with ADHD that met criteria for ASD; and (2) to compare the severity of dimensionally-measured ASD symptomology in children and adolescents with and without ADHD. RESULTS The overall pooled effect for children and adolescents with ADHD who met threshold for ASD was 21%. There was no significant difference between community samples (19%) and clinical samples (24%) or between US studies v. those from other countries. Children and adolescents with ADHD had substantially more dimensionally-measured ASD traits compared with those who did not have ADHD (d = 1.23). CONCLUSION The findings provide further evidence that ADHD and ASD are associated in nature. Clinical and research implications are discussed.
Collapse
|
14
|
Young S, Hollingdale J, Absoud M, Bolton P, Branney P, Colley W, Craze E, Dave M, Deeley Q, Farrag E, Gudjonsson G, Hill P, Liang HL, Murphy C, Mackintosh P, Murin M, O'Regan F, Ougrin D, Rios P, Stover N, Taylor E, Woodhouse E. Guidance for identification and treatment of individuals with attention deficit/hyperactivity disorder and autism spectrum disorder based upon expert consensus. BMC Med 2020; 18:146. [PMID: 32448170 PMCID: PMC7247165 DOI: 10.1186/s12916-020-01585-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 04/03/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Individuals with co-occurring hyperactivity disorder/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) can have complex presentations that may complicate diagnosis and treatment. There are established guidelines with regard to the identification and treatment of ADHD and ASD as independent conditions. However, ADHD and ASD were not formally recognised diagnostically as co-occurring conditions until the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) was published in 2013. Hence, awareness and understanding of both conditions when they co-occur is less established and there is little guidance in the clinical literature. This has led to uncertainty among healthcare practitioners when working with children, young people and adults who present with co-existing ADHD and ASD. The United Kingdom ADHD Partnership (UKAP) therefore convened a meeting of professional experts that aimed to address this gap and reach expert consensus on the topic that will aid healthcare practitioners and allied professionals when working with this complex and vulnerable population. METHOD UK experts from multiple disciplines in the fields of ADHD and ASD convened in London in December 2017. The meeting provided the opportunity to address the complexities of ADHD and ASD as a co-occurring presentation from different perspectives and included presentations, discussion and group work. The authors considered the clinical challenges of working with this complex group of individuals, producing a consensus for a unified approach when working with male and female, children, adolescents and adults with co-occurring ADHD and ASD. This was written up, circulated and endorsed by all authors. RESULTS The authors reached a consensus of practical recommendations for working across the lifespan with males and females with ADHD and ASD. Consensus was reached on topics of (1) identification and assessment using rating scales, clinical diagnostic interviews and objective supporting assessments; outcomes of assessment, including standards of clinical reporting; (2) non-pharmacological interventions and care management, including psychoeducation, carer interventions/carer training, behavioural/environmental and Cognitive Behavioural Therapy (CBT) approaches; and multi-agency liaison, including educational interventions, career advice, occupational skills and training, and (3) pharmacological treatments. CONCLUSIONS The guidance and practice recommendations (Tables 1, 4, 5, 7, 8 and 10) will support healthcare practitioners and allied professionals to meet the needs of this complex group from a multidisciplinary perspective. Further research is needed to enhance our understanding of the diagnosis, treatment and management of individuals presenting with comorbid ADHD and ASD.
Collapse
Affiliation(s)
| | - Jack Hollingdale
- South London & Maudsley NHS Foundation Trust, Service for Complex Autism and Associated Neurodevelopmental Disorders, London, UK
| | - Michael Absoud
- Department of Children's Neurosciences, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Department of Women & Children's Health, King's College, London, UK
| | - Patrick Bolton
- South London & Maudsley NHS Foundation Trust, Service for Complex Autism and Associated Neurodevelopmental Disorders, London, UK
| | | | | | - Emily Craze
- South London & Maudsley NHS Foundation Trust, National Autism Unit, Kent, UK
| | - Mayuri Dave
- Positive Behaviour, Learning Disability, Autism and Mental Health Service (PALMS) Hertfordshire Communication Disorders Clinics, Hertfordshire Community NHS Trust, St Albans, UK
| | - Quinton Deeley
- South London & Maudsley NHS Foundation Trust, National Autism Unit, Kent, UK
| | - Emad Farrag
- South London & Maudsley NHS Foundation Trust, Maudsley Health, Abu Dhabi, UAE
| | - Gisli Gudjonsson
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | | | - Clodagh Murphy
- Behavioural and Developmental Psychiatry Clinical Academic Group, Behavioural Genetics Clinic, National Adult Autism and ADHD Service, South London and Maudsley Foundation NHS Trust, London, UK.,Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Peri Mackintosh
- South London & Maudsley NHS Foundation Trust, National Autism Unit, Kent, UK
| | | | | | - Dennis Ougrin
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Patricia Rios
- Diagnostic Assessments and Treatment Services (DATS), Hertfordshire, UK
| | | | - Eric Taylor
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Emma Woodhouse
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| |
Collapse
|
15
|
Tzeng NS, Yeh HW, Chung CH, Chang HA, Kao YC, Chiang WS, Chien WC. Risk of Psychiatric Morbidity in Psychosexual Disorders in Male Patients: A Nationwide, Cohort Study in Taiwan. Am J Mens Health 2020; 13:1557988319842985. [PMID: 30971176 PMCID: PMC6460890 DOI: 10.1177/1557988319842985] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
This study aimed to investigate the association between males with psychosexual disorders (PSDs) and the risk of developing psychiatric disorders. A total of 34,972 enrolled patients, with 8,743 subjects who had suffered from PSD and 26,229 controls (1:3) matched for age and index year, from Taiwan’s Longitudinal Health Insurance Database (LHID) from 2000 to 2015, selected from the National Health Insurance Research Database (NHIRD). After adjusting all the confounding factors, the multivariate Cox regression model was used to compare the risk of developing psychiatric disorders, between the PSD and non-PSD groups, during the 15 years of follow-up. Of the all enrollees, 1,113 in the PSD cohort and 2,611 in the non-PSD cohort (1,180.96 vs. 954.68 per 100,000 person-year) developed psychiatric disorders. Multivariate Cox regression model survival analysis revealed that, after adjusting for gender, age, monthly income, urbanization level, geographic region, and comorbidities, the adjusted hazard ratio (HR) was 2.448 (95% CI [2.227, 2.633], p < .001). PSD has been associated with the increased risk in anxiety disorders, depressive disorders, bipolar disorders, sleep disorders, and psychotic disorders, respectively. Sexual dysfunctions, paraphilia, and gender identity disorders were associated with the overall psychiatric disorders with adjusted HRs as 1.990 (p < .001), 11.622 (p < .001), and 5.472 (p < .001), respectively. Male patients who suffered from PSD have a higher risk of developing psychiatric disorders, and this finding should be considered as a timely reminder for the clinicians to provide much more attention for these patients because of their mental health issues.
Collapse
Affiliation(s)
- Nian-Sheng Tzeng
- 1 Department of Psychiatry, School of Medicine, Tri-Service General hospital, National Defense Medical Center, Taipei, Republic of China.,2 Student Counseling Center, National Defense Medical Center, Taipei, Republic of China
| | - Hui-Wen Yeh
- 1 Department of Psychiatry, School of Medicine, Tri-Service General hospital, National Defense Medical Center, Taipei, Republic of China.,3 Institute of Bioinformatics and System Biology, National Chiao Tung University, Hsin-Chu, Republic of China.,4 Department of Nursing, Tri-Service General hospital, and School of Nursing, National Defense Medical Center, Taipei, Republic of China.,5 Department of Nursing, Kang-Ning University (Taipei Campus), Taipei, Republic of China
| | - Chi-Hsiang Chung
- 6 Department of Medical Research, Tri-Service General hospital, National Defense Medical Center, Taipei, Republic of China.,7 School of Public Health, National Defense Medical Center, Taipei, Republic of China.,8 Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Republic of China
| | - Hsin-An Chang
- 1 Department of Psychiatry, School of Medicine, Tri-Service General hospital, National Defense Medical Center, Taipei, Republic of China.,2 Student Counseling Center, National Defense Medical Center, Taipei, Republic of China
| | - Yu-Chen Kao
- 1 Department of Psychiatry, School of Medicine, Tri-Service General hospital, National Defense Medical Center, Taipei, Republic of China.,9 Department of Psychiatry, Song-Shan Branch, Tri-Service General hospital, National Defense Medical Center, Taipei, Republic of China
| | - Wei-Shan Chiang
- 1 Department of Psychiatry, School of Medicine, Tri-Service General hospital, National Defense Medical Center, Taipei, Republic of China
| | - Wu-Chien Chien
- 6 Department of Medical Research, Tri-Service General hospital, National Defense Medical Center, Taipei, Republic of China.,7 School of Public Health, National Defense Medical Center, Taipei, Republic of China.,10 Graduate of Life Sciences, National Defense Medical Center, Taipei, Republic of China
| |
Collapse
|
16
|
Muñoz García-Largo L, Martí-Agustí G, Martin-Fumadó C, Gómez-Durán EL. Intellectual disability rates among male prison inmates. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2020; 70:101566. [PMID: 32482301 DOI: 10.1016/j.ijlp.2020.101566] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 04/22/2020] [Accepted: 04/23/2020] [Indexed: 06/11/2023]
Abstract
While only a small percentage of people with intellectual disabilities are responsible for criminal behaviors, the literature points to their overrepresentation in prisons, although not enough attention has been paid to intellectual disability data for inmates. We retrieved studies - in English, Spanish, Italian or French and indexed in Medline between 2000 and 2018 - that provided intellectual disability data for prisons collected by the administration of validated tests to male inmates. Identified were 13 studies involving more than 15,000 inmates referring to intellectual disability and borderline intellectual disability. The general findings of our review corroborate the overrepresentation of people with ID in prisons, although prevalence rates range widely, from as low as 1% to as high as 69.9% (p<0.000001), reflecting to differences in methodology, in local, social and cultural factors and in judicial procedures. Published studies clearly underline the overrepresentation of people with intellectual disabilities in prisons, differences between countries, the vulnerabilities of persons with intellectual disabilities and the need for proper assessment and management policies in prisons worldwide.
Collapse
Affiliation(s)
- Leticia Muñoz García-Largo
- Sant Joan de Déu, Barcelona, Spain; School of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
| | | | | | | |
Collapse
|
17
|
Christensen L, Baker BL. Risk-Taking and Delinquent Behaviors Among Youth with and without Intellectual Disabilities. JOURNAL OF MENTAL HEALTH RESEARCH IN INTELLECTUAL DISABILITIES 2020; 13:1-24. [PMID: 32351658 PMCID: PMC7189909 DOI: 10.1080/19315864.2019.1710786] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
INTRODUCTION Youth with intellectual disabilities (ID) demonstrate higher rates of disruptive behavior disorders (DBDs) than youth with typical development (TD). DBDs such as oppositional defiant disorder (ODD) predict higher rates of delinquency during adolescence. Yet, few studies have examined risk-taking and delinquency among youth with ID. METHODS We used a self-report measure to determine whether 13-year-old youth with ID (n= 23) reported higher rates of risk-taking and delinquent behavior than their TD peers (n=77). We also examined whether or not youth had a previous diagnosis of ODD. RESULTS Our results suggest that youth with ID reported fewer rule-breaking and risk-taking behaviors than their TD peers. In contrast, youth with a previous diagnosis of ODD reported more of these behaviors. CONCLUSION Our results appear discrepant from previous studies, which find higher rates of risk-taking and delinquency among youth with ID. As such, we discuss the factors that may explain our discrepant results, including our definition and assessment of ID, and the age of our participants.
Collapse
Affiliation(s)
- Lisa Christensen
- USC University Center of Excellence in Developmental Disabilities - Children's Hospital Los Angeles
| | | |
Collapse
|
18
|
Buadze A, Friedl N, Schleifer R, Young S, Schneeberger A, Liebrenz M. Perceptions and Attitudes of Correctional Staff Toward ADHD-A Challenging Disorder in Everyday Prison Life. Front Psychiatry 2020; 11:600005. [PMID: 33633596 PMCID: PMC7901975 DOI: 10.3389/fpsyt.2020.600005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 11/30/2020] [Indexed: 01/13/2023] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that is associated with risk-taking behaviors, poor self-control, and interpersonal difficulties. Affected individuals have an increased probability of involvement with the criminal justice system, contributing to a higher rate of arrest, and imprisonment compared with the general population; they are also inadequately treated once sentenced. Because prison staff play a central role in the identification of inmates with mental disorders, they could well be key to improving provision of care. There is however little knowledge of the conceptions, perceptions, and attitudes of prison staff toward ADHD. Such information could help to identify starting points for awareness training and further implementation of specific ADHD treatment. To bridge this gap, we undertook a study based on a qualitatively-driven mixed methods design, combining qualitative data collection in the form of narrative interviews with 19 prison staff from a Swiss correctional facility with quantitative data collection in the form of a survey that included the Attitudes toward Prisoners scale. The interviews were analyzed with QSR NVIVO 11 and a qualitative content analysis approach was used to evaluate findings. Prison staff were generally aware of ADHD and its symptomology, believing it to a be "real," but "fashionable" disorder and favoring hereditary-genetic or biological explanatory models for its development. They viewed inmates with ADHD rather negatively, as complicating correctional efforts, and perceived them as sticking out, as tying up more resources and as frequently being involved in confrontations. Our findings suggest that difficulties in pragmatic aspects of communication and language comprehension may be perceived "as not listening or following instructions," creating additional tensions. Consequently, inmates with ADHD are more often exposed to disciplinary sanctions, such as solitary confinement-an intervention deemed "necessary" by staff. Therefore, staff training on ADHD might need to cover evidence on adverse effects. Non-pharmacological interventions for treatment were preferred and considered to be highly efficacious. Skepticism toward pharmacological treatment prevailed, even when benefits from stimulant medication were described. Interestingly, this skepticism was not the result of negative experiences with the misuse and diversion of stimulants. Acceptance of multimodal treatment among prison staff may require customized strategies.
Collapse
Affiliation(s)
- Anna Buadze
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Nadine Friedl
- Hospital of Psychiatry Münsingen, Münsingen, Switzerland
| | - Roman Schleifer
- Department of Forensic Psychiatry, Institute of Forensic Medicine, University of Bern, Bern, Switzerland
| | - Susan Young
- Psychology Services Limited, London, United Kingdom.,Department of Psychology, Reykjavik University, Reykjavík, Iceland
| | - Andres Schneeberger
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.,Psychiatrische Dienste Graubuenden, Chur, Switzerland
| | - Michael Liebrenz
- Department of Forensic Psychiatry, Institute of Forensic Medicine, University of Bern, Bern, Switzerland
| |
Collapse
|
19
|
Mundt AP, Baranyi G. The Unhappy Mental Health Triad: Comorbid Severe Mental Illnesses, Personality Disorders, and Substance Use Disorders in Prison Populations. Front Psychiatry 2020; 11:804. [PMID: 32922316 PMCID: PMC7456858 DOI: 10.3389/fpsyt.2020.00804] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 07/27/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Information on the comorbidity of mental health problems in prison populations is scarce. The aim of the present study was to assess the prevalence of comorbidities at intake to prison between three diagnostic groups: severe mental illnesses (SMIs), personality disorders (PDs), and substance use disorders (SUDs). The co-occurrence of those disorders in prison populations may require the integration of differential treatment approaches and novel treatment trials. METHODS A consecutive sample of N = 427 (229 male and 198 female) individuals committed to imprisonment in Santiago de Chile was assessed with the Mini Neuropsychiatric Interview and the Structured Clinical Interview for DSM-IV (module for borderline personality disorders) on arrival at prison. Diagnoses were a priori grouped as SMI including psychosis, bipolar disorder and major depression, PD including borderline and antisocial PD and SUD including alcohol and drug abuse or dependence. Sex stratified multivariate binary logistic regression analyses were conducted to assess sociodemographic, criminal and treatment characteristics of individuals with at least one diagnosis from each of the three diagnostic groups. RESULTS The triad of SMI, PD, and SUD was present in n = 138 (32.3%; 95% IC: 28.0-36.9) study participants, n = 105 (45.9%; 95% CI: 39.4-52.4) of the men and n = 33 (16.7%; 95% CI: 12.1-22.6) of the women. Among those with the disorder triad, n = 129 (30.2%; 95% CI: 26.0-34.8) had major depression, PD and SUD; n = 54 (12.6%; 95% CI: 9.8-16.2) had psychosis, PD and SUD. The disorder triad was more common in men (OR = 4.86; 95% IC: 2.63-8.95), younger age (OR = 0.94; 95% CI: 0.91-0.97), and participants with lower educational levels (OR = 1.69; 95% CI: 1.01-2.82). The disorder triad was significantly associated with previous incarcerations (OR 2.60; 95% CI: 1.55-4.34) and histories of psychiatric hospitalizations (OR 2.82; 95% CI: 1.27-6.28). DISCUSSION The complex triad of disorders from different diagnostic groups is common in prison populations, especially among young men. Successful treatment interventions may have the potential to break a cycle of repeat institutionalization in prisons and psychiatric institutions.
Collapse
Affiliation(s)
- Adrian P Mundt
- Faculty of Medicine, Universidad Diego Portales, Santiago, Chile.,Department of Psychiatry, Faculty of Medicine, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Gergő Baranyi
- Centre for Research on Environment, Society and Health, School of GeoSciences, The University of Edinburgh, Edinburgh, United Kingdom
| |
Collapse
|
20
|
McCarthy J, Chaplin E, Forrester A, Underwood L, Hayward H, Sabet J, Young S, Mills R, Asherson P, Murphy D. Prisoners with neurodevelopmental difficulties: Vulnerabilities for mental illness and self-harm. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2019; 29:308-320. [PMID: 31912971 DOI: 10.1002/cbm.2132] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 12/28/2018] [Accepted: 10/03/2019] [Indexed: 05/26/2023]
Abstract
BACKGROUND Research into neurodevelopmental disorders in adult offenders has tended to be disorder specific, so hindering service planning for a group of offenders with similar vulnerabilities. AIM To examine vulnerabilities for mental illness and self-harming behaviours among male prisoners screening positive for a range of neurodevelopmental difficulties-including but not confined to disorders of intellectual ability, attention deficit hyperactivity, and in the autistic spectrum. METHOD In a cross-sectional study, prisoners who screened positive for neurodevelopmental difficulties were compared to prisoners who screened negative for the same on indicators of suicide-related and self-harm behaviours, mental illness, and substance misuse using the Mini International Neuropsychiatric Interview (MINI). RESULTS Of 87 prisoners who screened positive for neurodevelopmental difficulties, 69 had full MINI mental health data. In comparison with 69 neurotypical men in the same prison, the neurodevelopmental difficulties group was significantly more likely to have thought about self-harm and suicide in the last month and to have significantly higher rates of concurrent mental disorders including psychosis, anxiety, depression, personality disorder, and substance dependency disorders. CONCLUSIONS This is one of the first studies to examine the mental health of adults with neurodevelopmental difficulties in a prison setting. This group, unlike those who meet diagnostic threshold, is not routinely considered by mental health or correctional services. The study found prisoners with neurodevelopmental difficulties showed greater vulnerability to mental disorder and thoughts of suicide and suicide-related behaviours than other prisoners. Accordingly, we recommend routine early screening across the criminal justice system for any neurodevelopmental difficulties to inform decision-making on the most appropriate disposal and support.
Collapse
Affiliation(s)
- Jane McCarthy
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Eddie Chaplin
- London South Bank University School of Health and Social Care, Ringgold Standard Institution, 103 Borough Road, London, SE1 0AA, United Kingdom of Great Britain and Northern Ireland
| | - Andrew Forrester
- Greater Manchester Mental Health NHS Foundation Trust and South London and Maudsley NHS Foundation Trust, London, United Kingdom of Great Britain and Northern Ireland
- King's College London, London, United Kingdom of Great Britain and Northern Ireland
| | | | - Hannah Hayward
- King's College London, London, United Kingdom of Great Britain and Northern Ireland
| | - Jess Sabet
- King's College London, London, United Kingdom of Great Britain and Northern Ireland
| | - Susan Young
- Institute of Psychiatry, De Crespigny Park, London, SE5 8AF, United Kingdom of Great Britain and Northern Ireland
- Broadmoor Hospital West London Mental Health Trust, London, RG45 7EG, United Kingdom of Great Britain and Northern Ireland
| | - Richard Mills
- Research Autism, London, United Kingdom of Great Britain and Northern Ireland
| | - Philip Asherson
- King's College London, London, United Kingdom of Great Britain and Northern Ireland
| | - Declan Murphy
- King's College London, London, United Kingdom of Great Britain and Northern Ireland
| |
Collapse
|
21
|
Abstract
PURPOSE OF REVIEW To examine recent advances in the understanding of attention deficit hyperactivity disorder (ADHD) among the prison population. RECENT FINDINGS Efforts have been made to develop useful tools for assessing ADHD among prisoners. Prisoners with ADHD demonstrate incremental vulnerability due to comorbid psychiatric disorders, neurodevelopmental disorders and traumatic brain injury. Compared with prisoners without ADHD, prisoners with ADHD become involved in the criminal justice system at a younger age and have higher rates of recidivism in adulthood. Recent studies demonstrate the effectiveness of extended release stimulant medication and psychological interventions. Early identification and treatment of prisoners with ADHD have the potential to demonstrate health economic benefits. Our understanding of ADHD among prisoners continues to develop. However, further research is needed, particularly among neglected groups such as females. Much more attention is needed by the prison service to engender better outcomes for this at-risk population.
Collapse
|
22
|
Hofvander B, Bering S, Tärnhäll A, Wallinius M, Billstedt E. Few Differences in the Externalizing and Criminal History of Young Violent Offenders With and Without Autism Spectrum Disorders. Front Psychiatry 2019; 10:911. [PMID: 31920758 PMCID: PMC6927936 DOI: 10.3389/fpsyt.2019.00911] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 11/18/2019] [Indexed: 11/13/2022] Open
Abstract
Autism spectrum disorders (ASDs) are known to be associated with an increased risk of aggression and challenging behavior. In this study, we have mapped the externalizing history of a nationally representative cohort of young violent offenders with ASD, compared with offenders without ASD. Two hundred and sixty-nine violent offenders were assessed for prevalence of ASD, and participated in a thorough assessment of previous externalizing problems and criminal history. Twenty-six offenders met consensus clinical DSM-IV criteria for ASD and they were compared to offenders without ASD from the same cohort. Overall, we found a very high prevalence of externalizing and antisocial behaviors in the history of these offenders and there were few differences between the groups. Placements in foster homes were overrepresented in the ASD group and the ASD-offenders had significantly more often been diagnosed with a neurodevelopmental disorder (i.e. ASD or ADHD) by a clinician before the study. At index conviction, ASD offenders were overrepresented in sex crimes with a child victim. Though offenders without ASD had more previous convictions, in particular drug crimes, we found no difference in terms of total number of prosecuted crimes. Substance use disorders were more common among offenders without ASD. The ASD offenders scored higher compared to the non-ASD offenders on the Affective facet of the Psychopathy Checklist-Revised (PCL-R) but there were no differences in terms of total PCL-R scores. Our results provide important knowledge of the developmental history of offenders with ASD. Though this is a small and atypical phenotype it poses significant challenges to the criminal justice system and we need to understand more of it to be able to prevent these individuals from committing crimes but also to provide a fair judicial treatment, to assess exculpatory factors and improve our forensic treatment models.
Collapse
Affiliation(s)
- Björn Hofvander
- Child and Adolescent Psychiatry, Department of Clinical Sciences, Lund, Faculty of Medicine, Lund University, Lund, Sweden.,Centre of Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Sophie Bering
- Child and Adolescent Psychiatry, Department of Clinical Sciences, Lund, Faculty of Medicine, Lund University, Lund, Sweden
| | - André Tärnhäll
- Child and Adolescent Psychiatry, Department of Clinical Sciences, Lund, Faculty of Medicine, Lund University, Lund, Sweden
| | - Märta Wallinius
- Child and Adolescent Psychiatry, Department of Clinical Sciences, Lund, Faculty of Medicine, Lund University, Lund, Sweden.,Centre of Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Eva Billstedt
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|