Psychiatric disorders may persist in some young people after detention

A study of juveniles detained in Chicago suggests that more than 45 percent of males and nearly 30 percent of females had one or more psychiatric disorders with associated impairment five years after detention, according to a report published in the October issue of Archives of General Psychiatry.

Psychiatric disorders are prevalent among incarcerated juveniles. The disorders are likely to persist as the juveniles grow to be young adults because risk factors for psychiatric disorders are common among delinquent youth, including maltreatment, dysfunctional families, family substance abuse and brain injuries, according to the study background.

Linda A. Teplin, Ph.D., of Northwestern University Feinberg School of Medicine, Chicago, and colleagues present data from the Northwestern Juvenile Project, a longitudinal study of 1,829 youth (1,172 males and 657 females, ages 10 to 18 years at baseline) who were detained at the Cook County Juvenile Temporary Detention Center in Chicago. The authors examined changes in prevalence and persistence of disorders during the first five years after detention, focusing on sex and racial/ethnic differences.

"Although prevalence rates of most psychiatric disorders declined over time, a substantial proportion of delinquent youth continued to have disorders as they aged. For some youth, detention may coincide with a period of crisis that subsequently abates. Many youth, however, continue to struggle: five years after detention, when participants were ages 14 to 24 years, nearly half of males and nearly 30 percent of females had one or more psychiatric disorders with associated impairment," the authors comment.

Substance use disorders were the most common. At baseline, compared with females, males had about one-third greater odds of any substance use disorder. Five years after baseline, males had more than 2.5 times the odds of these disorders compared with females. Non-Hispanic whites and Hispanics also had higher rates of substance use disorders vs. African-Americans, according to the study results.

The study also found that females had higher rates of major depression over time. For any disruptive behavior disorder, males and females did not have significantly different rates at baseline but prevalence decreased faster among females than among males. Three years after baseline, males had 1.82 times the odds of any disruptive behavior disorder compared with females; at five years after baseline, males had 2.95 times the odds, the study results indicate.

"Substance use and disruptive behavior disorders continued to be the most common disorders. For many delinquent youth – especially males – externalizing disorders were not limited to adolescence," the authors comment.