Mental Disorders Among Adolescents in Juvenile Detention and Correctional Facilities: A Systematic Review and Metaregression Analysis of 25 Surveys

Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK.
Journal of the American Academy of Child and Adolescent Psychiatry (Impact Factor: 7.26). 10/2008; 47(9):1010-9. DOI: 10.1097/CHI.ObO13e31817eecf3
Source: PubMed


To systematically review and perform a meta-analysis of the research literature on the prevalence of mental disorders in adolescents in juvenile detention and correctional facilities.
Surveys of psychiatric morbidity based on interviews of unselected populations of detained children and adolescents were identified by computer-assisted searches, scanning of reference lists, hand-searching of journals, and correspondence with authors of relevant reports. The sex-specific prevalence of mental disorders (psychotic illness, major depression, attention-deficit/hyperactivity disorder [ADHD], and conduct disorder) together with potentially moderating study characteristics were abstracted from publications. Statistical analysis involved metaregression to identify possible causes of differences in disorder prevalence across surveys.
Twenty-five surveys involving 13,778 boys and 2,972 girls (mean age 15.6 years, range 10-19 years) met inclusion criteria. Among boys, 3.3% (95% confidence interval [CI] 3.0%-3.6%) were diagnosed with psychotic illness, 10.6% (7.3%-13.9%) with major depression, 11.7% (4.1%-19.2%) with ADHD, and 52.8% (40.9%-64.7%) with conduct disorder. Among girls, 2.7% (2.0%-3.4%) were diagnosed with psychotic illness, 29.2% (21.9%-36.5%) with major depression, 18.5% (9.3%-27.7%) with ADHD, and 52.8% (32.4%-73.2%) with conduct disorder. Metaregression suggested that surveys using the Diagnostic Interview Schedule for Children yielded lower prevalence estimates for depression, ADHD, and conduct disorder, whereas studies with psychiatrists acting as interviewers had lower prevalence estimates only of depression.
Adolescents in detention and correctional facilities were about 10 times more likely to suffer from psychosis than the general adolescent population. Girls were more often diagnosed with major depression than were boys, contrary to findings from adult prisoners and general population surveys. The findings have implications for the provision of psychiatric services for adolescents in detention.

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Available from: Niklas Långström
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    • "In 2010, males (83 %) and minority youth (68 %) accounted for a disproportionate amount of those in custody (Hockenberry 2013). More than two-thirds of incarcerated youth have been found to suffer from psychiatric disorders (Teplin et al. 2002), including posttraumatic stress disorder (PTSD; Abram et al. 2004), mood disorders, conduct disorder, psychosis, and attention deficit hyperactivity disorder (ADHD; Fazel et al. 2008), as well as suicidal ideation and attempted suicide (Abram et al. 2008). Approximately half of incarcerated youth suffer from substance use disorders (Abram et al. 2003; Teplin et al. 2002). "
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    • "Subsequently, we examined the combination offen*, and several instruments reported in the papers of Fazel et al. (2008) (i.e., Adolescent Psychopathology Scale [APS], Diagnostic Interview for Children and Adolescents [DICA], Diagnostic Interview Schedule for Children [DISC], Juvenile Detention Interview [JDI], Practical Adolescent Dual Diagnostic Interview [PADDI], Kiddie-Schedule for Affective Disorders and Schizophrenia [K-SADS], Schedules for Clinical Assessment in Neuropsychiatry [SCAN], Structured Clinical Interview for DSM Diagnoses [SCID] and Salford Needs Assessment Schedule for Adolescents [SNASA]), Esmeijer, Veerman, and van Leeuwen (1999) (i.e., Anxiety Disorder Interview Schedule for Children [ADIS], Child and Adolescent Psychiatric Assessment [CAPA], Child Assessment Schedule [CAS], DICA, DISC, Interview Schedule for Children [ISC], K-SADS and Structured Interview for Diagnostic Assessment of Children [SIDAC]), and one additional instrument (i.e., Composite International Diagnostic Interview [CIDI]). Second, reference lists from relevant studies on mental disorders in JSOs (e.g., Seto & Lalumière, 2010; Van Wijk et al., 2006) or juveniles who offended non-sexually (non-JSOs) (e.g., Fazel et al., 2008) were examined for studies that might be included in the current meta-analysis. Third, we contacted researchers who published on the prevalence of mental disorders in juvenile offenders in general, including JSOs, but who did not (yet) report separately on the prevalence of mental disorders in JSOs. "
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