OBJECTIVE: This study aimed to explore retrospective childhood ADHD 
symptomatology, psychiatric comorbidity, rates of substance-use disorders (SUD), 
as well as their association with high-risk health behaviors in prison and 
adverse health outcomes.
METHOD: A randomly selected representative sample of inmates in the Puerto Rico 
correctional system (N = 1,179) was assessed with the Spanish-language Wender 
Utah Rating Scale (WURS); the Composite International Diagnostic Interview 
(CIDI) modules for lifetime/current major depression disorder (MDD), generalized 
anxiety disorder (GAD), and SUD; the Davidson Trauma Scale (DTS; posttraumatic 
stress disorder [PTSD]); and self-reports of in-site high-risk behaviors.
RESULTS: Wald χ(2) tests revealed significant associations of ADHD with MDD and 
PTSD, as well as increased risk for overdosing and intravenous drug use in 
prison. A logistic regression model adjusted for mood and anxiety comorbidity 
predicted lifetime SUD diagnosis (odds ratio = 2.38; 95% confidence interval = 
[1.15, 4.94]).
CONCLUSION: Our results provide further evidence on the association of drug 
dependence and ADHD symptoms, and their overrepresentation among prison inmates.