Psychiatric symptoms and substance use disorders in a nationally representative sample of American adolescents involved with foster care.
OBJECTIVE
To ascertain the prevalence of psychiatric symptoms and substance use disorders among adolescents with a lifetime history of foster care placement, using data from a nationally representative sample of U.S. adolescents.


METHODS
We studied adolescents aged 12-17 years in the public use file of the 2000 National Household on Drug Abuse (n = 19,430, including 464 adolescents with history of foster care placement). Psychiatric symptoms and substance use disorders were ascertained through direct interviewing of adolescents. Logistic regression analyses were used to estimate the odds of past-year psychiatric symptoms and substance use disorders among adolescents involved with foster care, as compared to those without a lifetime history of foster care placement (comparison group).


RESULTS
Adolescents involved with foster care had more past-year psychiatric symptoms, and especially more conduct symptoms, and past-year substance use disorders than those never placed in foster care. Adolescents involved with foster care were about four times more likely to have attempted suicide in the preceding 12 months (adjusted odds ratio [AOR] 3.95; 95% confidence interval [CI] 2.78, 5.61), and about five times more likely to receive a drug dependence diagnosis in the same period (AOR 4.81; 95% CI 3.22, 7.18).


CONCLUSIONS
Adolescents involved with foster care have a higher prevalence of psychiatric symptoms and drug use disorders than those never placed in foster care. Additionally, the results of this study suggest that they may be at elevated risk for suicide attempts.
Pilowsky
Daniel J
DJ
Department of Psychiatry, Columbia College of Physicians and Surgeons, Columbia University, New York, New York, USA. dp14@columbia.edu
Wu
Li-Tzy
LT
D000293:Adolescent; D000294:Adolescent Behavior; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D005581:Foster Home Care; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008603:Mental Health; D015995:Prevalence; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology