The nature and characteristics of psychiatric comorbidity in incarcerated adolescents.
OBJECTIVE
To determine the prevalence of psychiatric disorders, the degree of psychiatric comorbidity, and the relationship between these and sociodemographic variables in a sample of incarcerated adolescents. A comparison with an age- and sex-matched community sample was conducted.


METHODS
Age- and sex-matched samples of 49 incarcerated adolescents and 49 nondelinquents were compared for psychiatric morbidity and psychosocial characteristics. Psychiatric diagnoses were determined using the Diagnostic Interview for Children and Adolescents-Revised (DICA-R). Additional information on psychosocial, family, and offence characteristics was obtained using a semistructured interview designed specifically for this study. The prevalence of single and comorbid psychiatric disorders was determined.


RESULTS
Approximately 63.3% of incarcerated adolescents had 2 or more psychiatric disorders. The degree of psychiatric morbidity was directly related to indicators of family adversity, physical abuse, other psychosocial variables, or polysubstance abuse. Psychiatric comorbidity was more frequent in females. Incarcerated adolescents were more likely to endorse symptoms of thought disorder.


CONCLUSIONS
Findings identify preventive intervention foci for policy makers and planners in the area of adolescent corrections. Implications for education and training of nonclinical custodial staff are discussed as is the need for a more therapeutic orientation in correctional facilities.
Ulzen
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George Hull Centre for Children and Families, Etobicoke, Ontario.
Hamilton
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D000293:Adolescent; D003131:Combined Modality Therapy; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007604:Juvenile Delinquency / Q000523:psychology / Q000534:rehabilitation / Q000706:statistics & numerical data*; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation; D009864:Ontario / Q000453:epidemiology; D010348:Patient Care Team; D011329:Prisoners / Q000523:psychology / Q000706:statistics & numerical data*; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D012959:Socioeconomic Factors