How prevalent are psychiatric disorders in youth in detention?

Research shows that a number of young people who are detained in a juvenile detention center have at least 1 psychiatric disorder. A study in JAMA Pediatrics examined what those common psychiatric disorders are like, as well as their continuity and comorbidity in the 15 years after detention in a juvenile detention center.1

The researchers used the Northwestern Juvenile Project, a longitudinal cohort study that looked at the health needs and outcomes of 1,829 children and adolescents at a temporary juvenile detention center in Cook County, Illinois. The participants were interviewed during their detention between November 1995 and June 1998. They were then re-interviewed up to 12 times over a period of 15 years, resulting in 16,372 interviews.

There were 1172 boys and 657 girls in the sample and they had a mean age of 14.9 years at baseline. With age, the prevalence and comorbidity associated with psychiatric disorders decreased, but 52.3% of men and 30.9% of women had at least 1 psychiatric disorder after incarceration. Of the participants who had a psychiatric disorder at baseline, 64.3% of the men and 34.8% of the women had it 15 years later. Compared to their female counterparts, men were 3.37 times more likely to have a psychiatric disorder persisting 15 years after baseline (95% CI 1.79-6.35). Non-Hispanic white participants were 1.3 times likely to have substance use disorders (odds ratio, 1.90; 95% CI, 1.55-2.33 and odds ratio, 1.39; 95% CI, respectively , 1.11-1.73) and 1.6 times the odds ratio, 1.56; 95% CI, 1.27-1.91 and odds ratio, 1.59; 95% CI, respectively. 1.23-2.05) during the follow-up period compared to black and Hispanic participants. Fifteen years after incarceration, substance use and behavioral disorders were most ubiquitous.

For children and adolescents with persistent psychiatric disorders, the transition into adulthood can be complicated. This can be exacerbated by a period of detention in the juvenile justice system. Since many of the children and teens in this system are from racial/ethnic minorities or low-income backgrounds, clinicians should push for early diagnosis and treatment of these conditions in these specific groups.

Reference

1. Teplin L, Potthoff L, Aaby D, Welty L, Dulcan M, Abram K. Prevalence, comorbidity, and continuity of psychiatric disorders in a 15-year longitudinal study of juveniles involved in juvenile justice. JAMA Pediatrician. 2021;175(7):e205807. doi:10.1001/jamapediatrics.2020.5807

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