Meta-analysis of the prevalence of attention-deficit hyperactivity disorder in prison: A comment on Fazel and Favril (2024) and reanalysis of the data.

ABSTRACT

BACKGROUND: Fazel and Favril presented a reanalysis of our previously published systematic review and meta-analysis on the prevalence of attention deficit hyperactivity disorder (ADHD) in prison. AIMS: The current paper addresses some of the criticisms of Fazel and Favril on our meta-analysis and presents a reanalysis of the data, focusing on adult detained persons. METHODS: We conducted a meta-regression on 28 studies (n = 7710) to estimae the pooled prevalence of ADHD. RESULTS: This reanalysis yielded a pooled estimate of 22.2% for the prevalence of ADHD (95% confidence interval [CI] 15.7; 28.6), which disagrees with the estimate given by Fazel and Favril (8.3%, 95% CI 3.8; 12.8). CONCLUSION: We argue that the ADHD prevalence provided by Fazel and Favril was an underestimate due to their use of too restrictive exclusion criteria and suboptimal analysis methods. Our reanalysis on detained adults suggests a higher ADHD prevalence, which highlights the need to diagnose and treat ADHD in prison.