Treatment issues in a personality disordered offender: a case of attention deficit hyperactivity disorder in secure psychiatric services

ADHD is a long-term risk factor for personality disorder and criminal behaviour. Yet the prevalence of ADHD adults in detained settings is unknown. Diagnosis and treatment in such settings have implications for immediate and long-term risk management. This paper presents a case-study of a young man detained for personality disorder in a high-security hospital. It describes his assessment, diagnosis and treatment for ADHD. A 2-year followup revealed significant improvement in cognitive functioning, mood and affect. Psychotherapy, education and rehabilitation became possible following treatment. Clinical and management issues are discussed.