Objective-To examine suicidal ideation, suicide attempts, lethality of suicide attempts, and the relationship between psychiatric disorder and recent attempts in newly detained juveniles.Methods-The sample included 1829 juveniles, aged 10 to 18 years, sampled after intake to a detention center in Chicago, IL. Interviewers administered the Diagnostic Interview Schedule for Children (DISC) to assess for thoughts of death, suicidal ideation, suicide plans, lifetime suicide attempts, number of attempts, age at first attempt, attempts within the last 6 months, method of suicide attempts, and psychiatric disorder.Results-More than one-third of juvenile detainees and nearly half of females had felt hopeless or thought about death in the 6 months prior to detention. Approximately 1 of 10 (10.3%, CI: 7.7% -12.8%) juvenile detainees had thought about committing suicide in the past 6 months, and 1 of 10 (11.0%, CI: 8.3% -13.7%) had ever attempted suicide. Recent suicide attempts were most prevalent in females and youth with major depression and generalized anxiety disorder.Conclusions-Fewer than half of detainees with recent thoughts of suicide had told anyone about their ideation. Identifying youth at risk for suicide --especially those suffering from depressive and anxiety disorders --is a crucial step to preventing suicide.

Objective This manuscript examines the prevalence of childhood maltreatment and the relationship between childhood maltreatment and current psychiatric disorder in detained youths. Methods Clinical research interviewers assessed history of childhood maltreatment with the Child Maltreatment Assessment Profile and psychiatric diagnosis with the Diagnostic Interview Schedule for Children version 2.3 in a stratified, random sample of 1829 detained youths at the Cook Country Juvenile Temporary Detention Center; final n=1735. History of maltreatment was also ascertained from records from the Cook County Court Child Protection Division. Results Over three-quarters of females and over two-thirds of males had a history of physical abuse (moderate or severe). More than 40% of females and 10% of males had a history of sexual abuse. Females and non-Hispanic whites had the highest prevalence rates of childhood maltreatment. Among females, sexual abuse was associated with every type of psychiatric disorder. For example, females who experienced abuse were 2.6 to 10.7 times more likely to have any disorder compared with females who had no maltreatment. Among males, maltreatment was associated with every disorder except anxiety disorders (odds ratios ranged from 1.9–7.9). Among those who were sexually abused, abuse with force was associated with anxiety and affective disorders for females and attention-deficit/hyperactivity (ADHD)/disruptive behavior and substance use disorders for males. Conclusions Psychiatrists and other mental health specialists must screen delinquent youth, not only for psychiatric disorders but also for past and ongoing maltreatment. Discharge planning should include protective and therapeutic services. Trauma-related mental health services should be available during incarceration.

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