title: The impact of psychiatric diagnosis on treatment adherence and duration among victimized children and adolescents in São Paulo, Brazil.
abstract: OBJECTIVE
  Despite the high prevalence of substance abuse and mood disorders among victimized children and adolescents, few studies have investigated the association of these disorders with treatment adherence, represented by numbers of visits per month and treatment duration. We aimed to investigate the effects of substance abuse and mood disorders on treatment adherence and duration in a special program for victimized children in São Paulo, Brazil.
  
  
  METHODS
  A total of 351 participants were evaluated for psychiatric disorders and classified into one of five groups: mood disorders alone; substance abuse disorders alone; mood and substance abuse disorders; other psychiatric disorders; no psychiatric disorders. The associations between diagnostic classification and adherence to treatment and the duration of program participation were tested with logistic regression and survival analysis, respectively.
  
  
  RESULTS
  Children with mood disorders alone had the highest rate of adherence (79.5%); those with substance abuse disorders alone had the lowest (40%); and those with both disorders had an intermediate rate of adherence (50%). Those with other psychiatric disorders and no psychiatric disorders also had high rates of adherence (75.6% and 72.9%, respectively). Living with family significantly increased adherence for children with substance abuse disorders but decreased adherence for those with no psychiatric disorders. The diagnostic correlates of duration of participation were similar to those for adherence.
  
  
  CONCLUSIONS
  Mood and substance abuse disorders were strong predictive factors for treatment adherence and duration, albeit in opposite directions. Living with family seems to have a positive effect on treatment adherence for patients with substance abuse disorders. More effective treatment is needed for victimized substance-abusing youth.
authors.affiliation: Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Departamento de Psiquiatria, Serviço de Psiquiatria da Infância e Adolescência do Instituto de Psiquiatria, The Equilibrium Project, Brazil. sscivoletto@uol.com.br
authors.forename: Sandra
authors.initials: S
authors.lastname: Scivoletto
authors.forename: Thiago F
authors.initials: TF
authors.lastname: Silva
authors.forename: Paulo Jannuzzi
authors.initials: PJ
authors.lastname: Cunha
authors.forename: Robert A
authors.initials: RA
authors.lastname: Rosenheck
mesh_terms: D000293:Adolescent; D001938:Brazil; D002648:Child; D002649:Child Abuse / Q000523:psychology*; D019548:Crime Victims / Q000523:psychology; D004812:Epidemiologic Methods; D005190:Family; D005260:Female; D018453:Homeless Youth / Q000523:psychology*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000628:therapy; D019964:Mood Disorders / Q000523:psychology* / Q000628:therapy; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000523:psychology* / Q000628:therapy; D013997:Time Factors; D055815:Young Adult