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- Title
Prevalence, Comorbidity, and Continuity of Psychiatric Disorders in a 15-Year Longitudinal Study of Youths Involved in the Juvenile Justice System.
- Authors
Teplin, Linda A.; Potthoff, Lauren M.; Aaby, David A.; Welty, Leah J.; Dulcan, Mina K.; Abram, Karen M.
- Abstract
Key Points: Question: What is the prevalence, continuity, and comorbidity of psychiatric disorders among youths during the 15 years after detention in a juvenile justice facility, and do outcomes vary by sex and race/ethnicity? Findings: In this cohort study of 1829 youths who were detained in a juvenile justice facility, 64% of males and 35% of females with a psychiatric disorder during detention had a disorder 15 years later. Substance use and behavioral disorders were more common among non-Hispanic White youths than Hispanic and Black youths. Meaning: This study's findings suggest that persistent psychiatric disorders may complicate the transition from adolescence to adulthood among youths who have been detained in a juvenile justice facility; the pediatric health community should advocate for early identification and treatment of disorders among this population. Importance: Previous studies have found that one-half to three-quarters of youths detained in juvenile justice facilities have 1 or more psychiatric disorders. Little is known about the course of their disorders as they age. Objective: To examine the prevalence, comorbidity, and continuity of 13 psychiatric disorders among youths detained in a juvenile justice facility during the 15 years after detention up to a median age of 31 years, with a focus on sex and racial/ethnic differences. Design, Setting, and Participants: The Northwestern Juvenile Project is a longitudinal cohort study of health needs and outcomes of 1829 randomly selected youths in a temporary juvenile detention center in Cook County, Illinois. Youths aged 10 to 18 years were interviewed in detention from November 20, 1995, through June 14, 1998. Participants were reinterviewed up to 12 times during the 15-year study period through February 2015, for a total of 16 372 interviews. The sample was stratified by sex, race/ethnicity (Black, Hispanic, and non-Hispanic White), age (10-13 years or 14-18 years), and legal status (processed in juvenile or adult court). Data analysis was conducted from February 2014, when data preparation began, to March 2020. Exposures: Detention in a juvenile justice facility. Main Outcomes and Measures: Psychiatric disorders, assessed by the Diagnostic Interview Schedule for Children, version 2.3 at the baseline interviews. Follow-up interviews were conducted using the Diagnostic Interview Schedule for Children, version IV; the Diagnostic Interview Schedule, version IV; and the World Mental Health Composite International Diagnostic Interview (beginning at the 6-year follow-up interview). Results: The study included 1829 youths sampled at baseline (1172 males and 657 females; mean [SD] age, 14.9 [1.4] years). Although prevalence and comorbidity of psychiatric disorders decreased as the 1829 participants aged, 52.3% of males and 30.9% of females had at least 1 or more psychiatric disorders 15 years postdetention. Among participants with a disorder at baseline, 64.3% of males and 34.8% of females had a disorder 15 years later. Compared with females, males had 3.37 times the odds of persisting with a psychiatric disorder 15 years after baseline (95% CI, 1.79-6.35). Compared with Black participants and Hispanic participants, non-Hispanic White participants had 1.6 times the 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) and greater than 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) throughout the follow-up period. Behavioral disorders and substance use disorders were the most prevalent 15 years after detention. Conclusions and Relevance: This study's findings suggest that persistent psychiatric disorders may complicate the transition from adolescence to adulthood, which is already challenging for youths involved in the juvenile justice system, many of whom are from racial/ethnic minority groups and low-income backgrounds. The pediatric health community should advocate for early identification and treatment of disorders among youths in the justice system. This cohort study examines the prevalence, comorbidity, and continuity of psychiatric disorders among youths detained in a juvenile justice facility during the 15 years after detention, with a focus on sex and racial/ethnic differences.
- Subjects
ILLINOIS; PSYCHIATRIC epidemiology; CONFIDENCE intervals; SUBSTANCE abuse; RACE; SEX distribution; BEHAVIOR disorders; DISEASE prevalence; QUESTIONNAIRES; JUVENILE delinquency; JUVENILE offenders; ETHNIC groups; STATISTICAL sampling; DATA analysis software; ODDS ratio; WHITE people; COMORBIDITY; LONGITUDINAL method; ADOLESCENCE
- Publication
JAMA Pediatrics, 2021, Vol 175, Issue 7, pe205807
- ISSN
2168-6203
- Publication type
Article
- DOI
10.1001/jamapediatrics.2020.5807