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Citation
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Widding-Havneraas T, Zachrisson HD, Markussen S, Elwert F, Lyhmann I, Chaulagain A, Bjelland I, Halmoy A, Rypdal K, Mykletun A. J. Am. Acad. Child Adolesc. Psychiatry 2023; ePub(ePub): ePub. |
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Abstract
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OBJECTIVE: Criminality rates are higher among persons with ADHD and evidence that medication reduces crime is limited. Medication rates between clinics vary widely even within universal healthcare systems, partly due to providers' treatment preferences. We used this variation to estimate causal effects of pharmacological treatment of ADHD on four-years criminal outcomes.
METHOD: We used Norwegian population-level registry data to identify all unique patients aged 10 to 18 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, i.e., patients who receive treatment due to 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- 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 in crimes requiring criminal intent, conspiracy, and planning.
Language: en |