Comorbidity is Common Among Youths in Juvenile Detention
On a typical day in the United States, roughly 109,000 youths under age 18 are in jail. These teens have problems beyond their involvement with the law: Research suggests that, much more often than the general population, they are challenged by mental disorders and co-occurring abuse of alcohol and other substances. To better understand the extent of this problem, to explore treatment interventions for juvenile detainees, and to tailor prevention programs for high-risk youth, NIDA has focused on this special population.
A recent NIDA-funded study highlights data from the Northwestern Juvenile Project, a large-scale study of psychiatric disorders in detained adolescents. Dr. Karen Abram, Dr. Linda A. Teplin, and their colleagues at Northwestern University Feinberg School of Medicine and Children's Memorial Hospital in Chicago conducted diagnostic interviews of 1,829 youths ages 10 to 18 at the Cook County Juvenile Temporary Detention Center. More than 10 percent of male participants and almost 14 percent of female participants had a substance abuse disorder plus a major mental disorder, such as psychosis, manic episode, or major depressive episode. About 600 of these 1,829 adolescents had substance abuse disorders plus behavioral disorders.
In examining a subset of 305 youths with major mental disorders at the Center, the researchers found that more than half of the females and three-quarters of the males also reported a substance abuse disorder. When the scientists examined data from a different subset of 874 youths with substance abuse disorders, they found that 30 percent of the females and 21.4 percent of the males had a major mental disorder as well. About 25 percent of these juvenile justice system detainees with major mental disorders reported that their psychiatric problem preceded their substance abuse disorder by more than 1 year. Almost 67 percent of females and more than 54 percent of males developed their mental and drug abuse disorders within the same year.
"As members of the medical community, we need to be aware of the high prevalence of comorbid disorders in this population and adjust our focus to include treating all of a person's health problems," says NIDA Director Dr. Nora Volkow. "We need to recognize that these problems can be severe and can include physical injuries and serious mental disorders. Effectively addressing these concerns will be key to breaking the cycle of comorbid disorders.
"The findings indicate a need for additional research that delves further into comorbid substance abuse," concludes Dr. Volkow. "Improving our awareness of substance abuse as a condition that does not exist in isolation will contribute to more effective prevention and treatment interventions."
- Abram, K.M.; Teplin, L.A.; et al. Comorbid psychiatric disorders in youth in juvenile detention. Archives of General Psychiatry 60(11):1097-1108, 2003. [Abstract]