AD/HD and criminality: Differential diagnostic and therapetic/prophylactic aspects (A general literature study and a description of Norwegian challeges in the field)

The impact of AD/HD (Attention Deficit/Hyperactivity Disorder) as a background factor for criminal activity is under discussion, both in the society and among professionals within psychiatry/psychology and other medical disciplines. A central topic in the discussion is whether a useful reduction of such activity can be reached by pharmacological treatment of the disorder. Studies of relevant international literature, mainly through the last 15 years have been made in the Medline/PubMed databases by combination of the terms AD/HD, and ASPD (Antisocial Personality Disorder). Additional literature has also been gathered. The main focus has been on young adult persons and upwards in age, much less on childhood and early adolescence. The literature shows that adult AD/HD and ASPD show distinctly common features, but also definite differences, both in clinical and neuro-physiological/-chemical respects. A priori, a pharmacological treatment of well diagnosed adult AD/HD, even in co-morbidity with ASPD, might be beneficial. Mostly used are the central stimulants methylphenidate and dexamphetamine, but atomoxetine, related to modern antidepressants, has also been introduced and validated. In Norway there has been an initial optimism leading to many, and at times weakly grounded, attempts to treat imprisoned or paroled persons with central stimulants. The results have been varying and often disappointing. This process and a current opinion on state of the art of such treatment will be described in the last part of the article.

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