How prevalent are psychiatric disorders in youth in detention?

Research has shown that a number of adolescents who are kept in a juvenile justice facility have at least 1 psychiatric disorder. An investigation in JAMA Pediatrics examined how those prevalent psychiatric disorders are as well as the continuity and comorbidity from them in the 15 years following detention in a juvenile facility.¹

The investigators used the Northwestern Juvenile Project, which is a longitudinal cohort study that looked at the health needs and outcomes of 1829 children and adolescents in a temporary juvenile detention center in Cook County, Illinois. The participants were interviewed when in detention between November 1995 to June 1998. They were then interviewed again up to 12 more times over the course of 15 years, which resulted in 16,372 interviews.

There were 1172 boys and 657 girls included in the sample and they had an average age of 14.9 years at baseline. As they aged, the prevalence and comorbidity associated with psychiatric disorders declined, but 52.3% of the males and 30.9% of the females had at least 1 psychiatric disorder after detention. Among the participants who had a psychiatric disorder at baseline, 64.3% of the males and 34.8% of the females had one 15 years later. When compared to their female counterparts, males had 3.37 times the odds of a psychiatric disorder persisting 15 years after baseline (95% CI, 1.79-6.35). Non-Hispanic White participants had 1.3 times the odds of substance use disorders (odds ratio, 1.90; 95% CI, 1.55-2.33 and odds ratio, 1.39; 95% CI, 1.11-1.73, respectively) and 1.6 times odds of behavioral disorders (odds ratio, 1.56; 95% CI, 1.27-1.91 and odds ratio, 1.59; 95% CI, 1.23-2.05, respectively) during the follow-up period when compared to Black and Hispanic participants. Fifteen years after detention, substance use disorders and behavioral disorders were the most ubiquitous.

For children and adolescence who have persistent psychiatric disorders, the transition to adulthood may become complicated. This can be further exacerbated by a period of detention in the juvenile justice system. As many of the children and teenagers in this system come from racial/ethnic minorities or low-income backgrounds, clinicians should urge for early diagnosis and treatment of these disorders in these particular 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 youths involved in the juvenile justice system. JAMA Pediatr. 2021;175(7):e205807. doi:10.1001/jamapediatrics.2020.5807