dc.contributor |
Reykjavík University (RU) |
dc.contributor |
Háskólinn í Reykjavík (HR) |
dc.contributor.author |
Young, Susan |
dc.contributor.author |
González, Rafael A. |
dc.contributor.author |
Fridman, Moshe |
dc.contributor.author |
Hodgkins, Paul |
dc.contributor.author |
Kim, Keira |
dc.contributor.author |
Gudjonsson, Gisli H. |
dc.date.accessioned |
2019-11-22T15:15:05Z |
dc.date.available |
2019-11-22T15:15:05Z |
dc.date.issued |
2018-06-25 |
dc.identifier.citation |
Young, S., González, R. A., Fridman, M., Hodgkins, P., Kim, K. og Gudjonsson, G. H. (2018). The economic consequences of attention-deficit hyperactivity disorder in the Scottish prison system. BMC Psychiatry, 18(1), 210. doi:10.1186/s12888-018-1792-x |
dc.identifier.issn |
1471-244X |
dc.identifier.uri |
https://hdl.handle.net/20.500.11815/1353 |
dc.description.abstract |
Background: Attention-deficit hyperactivity disorder (ADHD) is highly prevalent amongst prison inmates and the
criminal justice system (CJS) likely bears considerable costs for offenders with ADHD. We aimed to examine the
relationship between ADHD and health-related quality of life (HRQoL) and quality-adjusted life years (QALY)
amongst imprisoned adults; and to estimate the annual expenditure associated with ADHD status in prison.
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. Participants were interviewed using the Diagnostic Interview for ADHD in Adults 2.0.
The Health Utilities Index Mark 3 (HUI3) was used to measure health status, and to calculate attribute specific
HRQoL scores and QALY. Health service utilisation was obtained through inspection of medical prison records.
Inmates with ADHD were compared with inmates without ADHD.
Results: Inmates with ADHD had significantly lower QALYs, with a clinically significant adjusted difference of 0.13.
Psychiatric co-morbidity accounted for the variation of ADHD on the HUI3 emotion domain only. Medical costs for
inmates with ADHD were significantly higher; and behaviour-related prison costs were similar to prisoners without
ADHD, reflecting a low frequency of recorded critical incidents.
Conclusions: ADHD may directly contribute to adverse health and quality of life through cognitive and executive
function deficits, and co-morbid disorders. The extrapolation of conservative cost estimates suggests that the
financial burden of medical and behavior-related prison care for inmates with ADHD in the UK is approximately
£11.7 million annually. The reported cost estimates are conservative as there is great variability in recorded critical
incidents in prisons. In turn, for some prison establishments the prison care costs associated with prisoners with
ADHD may be considerably greater. |
dc.description.sponsorship |
The study was supported by Shire Pharmaceutical Development Limited
through a restricted grant. Shire had no role in the design and conduct of
the study (collection, management, analysis, and interpretation of the data)
or on the preparation, review, or approval of the manuscript, and the
decision to submit the manuscript for publication. The research was also
supported by the National Institute for Health Research (NIHR) Imperial
Biomedical Research Centre |
dc.format.extent |
210 |
dc.language.iso |
en |
dc.publisher |
Springer Science and Business Media LLC |
dc.relation.ispartofseries |
BMC Psychiatry;18(1) |
dc.rights |
info:eu-repo/semantics/openAccess |
dc.subject |
Psychiatry and Mental health |
dc.subject |
ADHD |
dc.subject |
Health-related quality of life |
dc.subject |
Economic evaluation |
dc.subject |
Quality-adjusted life years |
dc.subject |
Prison |
dc.subject |
Costs |
dc.subject |
Fangelsisvist |
dc.subject |
Fangelsi |
dc.subject |
Lífsgæði |
dc.subject |
Sálfræði |
dc.subject |
Psychology |
dc.title |
The economic consequences of attention-deficit hyperactivity disorder in the Scottish prison system |
dc.type |
info:eu-repo/semantics/article |
dcterms.license |
© 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/). |
dc.description.version |
Peer Reviewed (ritrýnd grein) |
dc.identifier.journal |
BMC Psychiatry |
dc.identifier.doi |
https://doi.org/10.1186/s12888-018-1792-x |
dc.contributor.school |
Viðskiptadeild (HR) |
dc.contributor.school |
School of Business (RU) |