Prevalence and Persistence of Psychiatric Disorders in Youth After Detention

Abstract

Context Psychiatric disorders are prevalent among incarcerated juveniles. Most juveniles eventually return to their communities, where they become the responsibility of the community mental health system. Yet, no large-scale study has examined psychiatric disorders after youth leave detention. Objective To examine changes in prevalence and persistence of disorders during the 5 years after detention, focusing on sex and racial/ethnic differences. Design Prospective longitudinal study with up to 5 interviews (N = 1829). To ensure representation of key demographic subgroups, the randomly selected sample was stratified by sex, race/ethnicity (African American, non-Hispanic white, and Hispanic), age, and legal status (juvenile or adult court). Setting The Northwestern Juvenile Project, sampling youth from the Cook County Juvenile Temporary Detention Center, Chicago, Illinois. Participants Detained youth, 10 to 18 years at baseline interview. Main Outcome Measures At baseline, the Diagnostic Interview Schedule for Children Version 2.3. At follow-ups, the Diagnostic Interview Schedule for Children, Version IV (Child and Young Adult versions) and the Diagnostic Interview Schedule, Version IV (substance use disorders and antisocial personality disorder). Results Five years after baseline, more than 45% of males and nearly 30% of females had one or more psychiatric disorders with associated impairment. Substance use disorders were the most common disorders; males, however, had higher rates over time (5 years after baseline, adjusted odds ratio [AOR], 2.61; 95% CI, 1.96–3.47). Non-Hispanic whites and Hispanics also had higher rates of substance use disorders compared with African Americans (respectively, AOR, 1.96, 95% CI, 1.54–2.49; AOR, 1.59, 95% CI, 1.24–2.03). Females had higher rates of major depression over time (AOR, 1.59, 95% CI, 1.22–2.08). Conclusions Although prevalence rates of most psychiatric disorders declined over time, a substantial proportion of delinquent youth continue to have disorders. There were notable sex and racial/ethnic differences in the prevalence and persistence of disorders.

Mental Health Screening Outcomes Among Justice-Involved Youths Under Community Supervision

“…The present results are consistent with others (Abram et al, 2003;Cauffman, 2004;Cauffman, Lexcen, Goldweber, Shulman, & Grisso, 2007;Maschi, Stimmel, Morgen, Gibson, & O'Mary, 2012;Teplin et al, 2012) in showing a higher prevalence of diagnostic flags among girls than boys. One exception is that the present analysis did not find a gender difference in substance use as did Cauffman (2004) and Teplin et al (2012).…”

“…One exception is that the present analysis did not find a gender difference in substance use as did Cauffman (2004) and Teplin et al (2012). HICLAS analysis revealed that girls were also more likely than boys to present heterotypic (as opposed to homotypic) comorbidity in that they tended to be symptomatic on more than one type of diagnostic flag.…”

“…Despite the fact that the DPS screening results should, if anything, overestimate the true prevalence of disorders in the sample, the present estimates Screening Outcomes Among Justice-Involved Youth 221 tended to be lower than those drawn from samples of detained youth and adolescents (overall estimates ranging from 56% to 98%, Cauffman, 2004;Colins et al, 2010;Fazel et al, 2008;Harzke et al, 2012;Stoddard-Dare, Mallett, & Boitel, 2011;Teplin, Welty, Abram, Dulcan, & Washburn, 2012;Vermeiren et al, 2006). The present study is more in line with the Wasserman et al (2005) study of youths at probation intake, which found that 45.7% screened positive for at least one disorder on the DISC.…”

Firearm Homicide and Other Causes of Death in Delinquents: A 16-Year Prospective Study

“…6,7 We addressed these limitations by using newly available data from the Northwestern Juvenile Project, a large-scale longitudinal study of health needs and outcomes of delinquent youth. 4,16,17 We used interview data and obtained official death records up to 16 years after participants' baseline interview, analyzing all-cause mortality and deaths from all external causes (homicides, unintentional injuries, and suicides), 18 homicide alone, and firearm homicide alone. In the present article, we: (1) calculated mortality rates according to gender, race/ethnicity, and age, comparing them with the general population in Cook County, Illinois (hereafter referred to as general population); (2) compared causes of death with the general population; and (3) determined the association between mortality and modifiable risk factors, such as substance use disorders, gang membership, and drug dealing.…”

“…27 Additional information on our methods is provided in the Supplemental Appendix and published elsewhere. 4,16,17 Statistical Analysis…”