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Comorbidity and Continuity of Psychiatric Disorders in Youth After Detention A Prospective Longitudinal Study

NCJ Number
Jama Psychiatry Volume: 72 Issue: 1 Dated: January 2015 Pages: 84-93
Karen M. Abram; Naomi A. Zwecker; Leah J. Welty; Jennifer A. Hershfield; Mina K. Dulcan; Linda A. Teplin
Date Published
January 2015
10 pages
This study determined the comorbidity and continuity of psychiatric disorders among youth 5 years after detention.
The study found that 5 years after detention, when participants were 14 to 24 years old, almost 27 percent of males and 14 percent of females had comorbid psychiatric disorders. Although females had significantly higher rates of comorbidity when in detention (odds ratio, 1.3; 95 percent CI, 1.0-1.7), males had significantly higher rates than females at follow-up (odds ratio, 2.3; 95 percent CI, 1.6-3.3). Substance use plus behavioral disorders was the most common comorbid profile among males, affecting one in six. Participants with more disorders at baseline were more likely to have a disorder approximately 5 years after detention, even after adjusting for demographic characteristics. There was substantial continuity of disorder; however, some baseline disorders predicted alcohol and drug use disorders at follow-up. Although prevalence rates of comorbidity decreased in youth after detention, rates remained substantial and were higher than rates in the most comparable studies of the general population. Youth with multiple disorders at baseline were at highest risk for disorder 5 years later. Because many psychiatric disorders first appear in childhood and adolescence, primary and secondary prevention of psychiatric disorders offers the greatest opportunity to reduce costs to individuals, families, and society. Only a concerted effort to address the many needs of delinquent youth will help them thrive in adulthood. This was a prospective longitudinal study of a stratified random sample of 1,829 youth (1,172 male and 657 female; 1,005 African American, 296 non-Hispanic White, 524 Hispanic, and 4 other race/ethnicity) recruited from the Cook County Juvenile Temporary Detention Center, Chicago, Illinois, between November 20, 1995, and June 14, 1998, and who received their time 2 follow-up interview between May 22, 2000, and April 3, 2004. At baseline, the Diagnostic Interview Schedule for Children Version 2.3 was used to measure psychiatric disorders; and 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) were used. (Publisher abstract modified) javascript:SearchID('SearchTerm.asp?strWhich=IndexTerm')