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Health-related quality of life in prisoners with attention-deficit hyperactivity disorder and head injury

Health-related quality of life in prisoners with attention-deficit hyperactivity disorder and head injury


Title: Health-related quality of life in prisoners with attention-deficit hyperactivity disorder and head injury
Author: Young, Susan   orcid.org/0000-0002-8494-6949
González, Rafael A.
Fridman, Moshe
Hodgkins, Paul
Kim, Keira
Gudjonsson, Gisli H.
Date: 2018-06-22
Language: English
Scope: 209
University/Institute: Reykjavík University (RU)
Háskólinn í Reykjavík (HR)
School: Viðskiptadeild (HR)
School of Business (RU)
Department: Psychology (RU)
Sálfræði (HR)
Series: BMC Psychiatry;18(1)
ISSN: 1471-244X
DOI: 10.1186/s12888-018-1785-9
Subject: ADD; ADHD; Head injury; Höfuðáverkar; Traumatic brain injury; Heilaskaði; Prison population; Fangar; Health related quality of life; Lífsgæði; Co morbidity
URI: https://hdl.handle.net/20.500.11815/1309

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Citation:

Young, S., Gonzalez, R. A., Fridman, M., Hodgkins, P., Kim, K., & Gudjonsson, G. H. (2018). Health-related quality of life in prisoners with attention-deficit hyperactivity disorder and head injury. BMC Psychiatry, 18, 209. https://doi.org/10.1186/s12888-018-1785-9

Abstract:

Background: Attention-deficit hyperactivity disorder (ADHD) and head injury (including traumatic brain injury (TBI)) manifest in high levels across prison samples and guidance from the National Institute for Health and Care Excellence notes that people with acquired brain injury may have increased prevalence of ADHD. We aimed to examine the association of ADHD with TBI and the impact of the association upon health-related quality of life (HRQoL) and service use among imprisoned adults. Methods: An observational study was performed in 2011–2013, at Porterfield Prison, Inverness, United Kingdom (UK). The all male sample included 390 adult prison inmates with capacity to consent and no history of moderate or severe intellectual disability. Head injury was measured with a series of self-reported questions, addressing history of hits to the head: frequency, severity, loss of consciousness (LOC), and sequelae. Participants were interviewed using the Diagnostic Interview for ADHD in Adults 2.0. The Health Utilities Index Mark 3 was used to measure health status, and to calculate attribute specific HRQoL and Quality-Adjusted Life Year (QALY) scores. Results: 72% of prisoners sampled reported at least one head injury in their lifetime. Among those, 70% of head injuries occurred before age 16 and 70% experienced LOC. Prisoners with ADHD were nearly twice more likely to have TBI. Prisoners with ADHD-only and ADHD with co-morbid TBI had significantly lower scores in several HRQoL attributes, compared with TBI only or the absence of either condition. Adjusted logistic regression models indicated an average reduction of 0.20 QALYs in inmates with ADHD-only and 0.30 QALY loss in those with ADHD with co-morbid TBI compared with inmates with neither condition. Conclusions: There is a robust association between ADHD and TBI, and ADHD with co-morbid TBI confers significantly greater impairment in terms of HRQoL. Managing the short and long-term consequences of TBI is essential to improving care for prisoners and to addressing the criminogenic factors related to them. Keywords: Attention deficit/hyperactivity disorder, Head injury, Traumatic brain injury, Prison population, Health-related quality of life, Co-morbidity

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© The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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