Researchers hope that more accurate diagnosis and assessment can lead to improved inmate behavior and reduce offences
A new ADHD tool is being investigated in the UK prison population for the first time. Researchers from the Institute of Psychiatry, Kings College London are using the computer-based QbTest; an objective test to assist in the accurate diagnosis of ADHD in young adult inmates. QbTest is the first system that has been cleared by both the FDA and European authorities to be used in children and adults.
Lead investigator of the study Professor Philip Asherson, Professor of Molecular Psychiatry at the Institute of Psychiatry, King’s College London and consultant psychiatrist at the Maudsley Hospital commented “The burden of ADHD in the prison population is significant and we know that appropriate medical intervention can potentially improve inmate behaviour and improve educational and occupational achievements, positively impacting on reoffending rates. However, this relies on effective diagnosis and assessment which are a major focus for both the Criminal Justice System and National Health Service.”
The QbTest provides clear and unbiased measurement of the three core symptoms of ADHD – hyperactivity, inattention and impulsivity. QbTest combines the measurement of attention ability with movement tracking through an infrared measurement system. The test results are assembled into a report and compared with the results of people of the same sex and age who do not have ADHD. A clinician can then use the results to support decisions and facilitate discussion patients.
Data from studies already conducted in Sweden have shown that actively diagnosing and treating ADHD in prisons can improve inmate behaviour and bring about cost savings.[i] The Swedish Prison and Probation Service include QbTest in their clinical management of ADHD. The UKAAN study group expects data from the UK study to be available by late-2014.
The rate of ADHD in the UK prison setting far exceeds that in the general population.[ii],[iii] Studies have indicated that 24% of prisoners have had childhood ADHD, 14% of whom had persisting symptoms.iii Those with persisting symptoms accounted for eight times more aggressive incidents than other prisoners and had a significantly higher rate of reoffending.iii ADHD was the most important predictor of violent offending, even above substance misuse.iii
QbTest is developed by the Swedish company Qbtech AB and was cleared by the U.S. FDA for assessment of ADHD in children and in adults in 2012.
QbTest is a computer-based objective assessment system that measures all three core symptoms of ADHD – hyperactivity, inattention and impulsivity in patients between 6 and 60 years of age. When the test is finished the test results are compared against a normative database and a test report is automatically generated.
The QbTest is well documented and cleared by all concerned authorities, including FDA and the Swedish Medical Products Agency. QbTest has high clinical validity and gives the clinician a new perspective to make informed decisions. It is designed as a non-verbal test and can handle most forms of color blindness. The normative data has been gathered in Germany and Sweden.
The QbTest is also very well received by the patients – QbTest provides easy to understand reports that facilitate discussions with patients regarding their symptoms.
[ii] National Collaborating Centre for Mental Health. Attention deficit hyperactivity disorder. The NICE guideline on diagnosis and management of ADHD in children, young people and adults. Available at http://www.nice.org.uk/nicemedia/pdf/ADHDFullGuideline.pdf. Last accessed May 2013
[iii] The identification and management of ADHD offenders within the criminal justice system: a consensus statement from the UK Adult ADHD Network and criminal justice agencies. Young et al. BMC Psychiatry 2011, 11:32. Available at: http://www.biomedcentral.com/1471-244X/11/32. Last accessed May 2013