Psychiatric disorders in youth in juvenile detention.

Abstract

Background

Given the growth of juvenile detainee populations, epidemiologic data on their psychiatric disorders are increasingly important. Yet, there are few empirical studies. Until we have better epidemiologic data, we cannot know how best to use the system’s scarce mental health resources.

Methods

Using the Diagnostic Interview Schedule for Children (DISC 2.3), interviewers assessed a randomly selected, stratified sample of 1829 African American, non-Hispanic white, and Hispanic youth (1172 males, 657 females, ages 10–18) arrested and detained in Cook County, Illinois (which includes Chicago and surrounding suburbs). We present six-month prevalence estimates by demographic subgroups (gender, race/ethnicity, and age) for the following disorders: affective disorders (major depressive episode, dysthymia, manic episode), anxiety (panic, separation anxiety, overanxious, generalized anxiety, and obsessive-compulsive disorders), psychosis, attention deficit hyperactivity disorder (ADHD), disruptive behavior disorders (oppositional defiant disorder, conduct disorder) and substance use disorders (alcohol and drug).

Results

Nearly two thirds of males and nearly three quarters of females met diagnostic criteria for one or more psychiatric disorders. Excluding conduct disorder (common among detained youth), nearly 60% of males and over two thirds of females met diagnostic criteria and had diagnosis-specific impairment for one or more psychiatric disorders. One half of males and almost one half of females had a substance use disorder, and over 40% of males and females met criteria for disruptive behavior disorders. Affective disorders were also prevalent, especially among females; 20% of females met criteria for a major depressive episode. Rates of many disorders were higher among females, non-Hispanic whites, and older adolescents.

Conclusion

These results suggest substantial psychiatric morbidity among juvenile detainees. Youth with psychiatric disorders pose a challenge for the juvenile justice system and, after their release, for the larger mental health system.