Context
Psychiatric disorders are prevalent among incarcerated juveniles. Most juveniles eventually return to their communities, where they become the responsibility of the community mental health system. Yet, no large-scale study has examined psychiatric disorders after youth leave detention.
Objective
To examine changes in prevalence and persistence of disorders during the 5 years after detention, focusing on sex and racial/ethnic differences.
Design
Prospective longitudinal study with up to 5 interviews (N = 1829). To ensure representation of key demographic subgroups, the randomly selected sample was stratified by sex, race/ethnicity (African American, non-Hispanic white, and Hispanic), age, and legal status (juvenile or adult court).
Setting
The Northwestern Juvenile Project, sampling youth from the Cook County Juvenile Temporary Detention Center, Chicago, Illinois.
Participants
Detained youth, 10 to 18 years at baseline interview.
Main Outcome Measures
At baseline, the Diagnostic Interview Schedule for Children Version 2.3. 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).
Results
Five years after baseline, more than 45% of males and nearly 30% of females had one or more psychiatric disorders with associated impairment. Substance use disorders were the most common disorders; males, however, had higher rates over time (5 years after baseline, adjusted odds ratio [AOR], 2.61; 95% CI, 1.96–3.47). Non-Hispanic whites and Hispanics also had higher rates of substance use disorders compared with African Americans (respectively, AOR, 1.96, 95% CI, 1.54–2.49; AOR, 1.59, 95% CI, 1.24–2.03). Females had higher rates of major depression over time (AOR, 1.59, 95% CI, 1.22–2.08).
Conclusions
Although prevalence rates of most psychiatric disorders declined over time, a substantial proportion of delinquent youth continue to have disorders. There were notable sex and racial/ethnic differences in the prevalence and persistence of disorders.