Plattner Belinda, Aebi Marcel, Steinhausen Hans-Christoph, Bessler Cornelia
Fachstelle für Kinder- und Jugendforensik am Zentrum für Kinder- und Jugendpsychiatrie, Universität Zürich, Schweiz.
Z Kinder Jugendpsychiatr Psychother. 2011 Jul;39(4):231-40; quiz 241-2. doi: 10.1024/1422-4917/a000113.
Incarcerated adolescents show a high prevalence rate of psychopathology and comorbid psychiatric conditions. Child and adolescent psychiatrists working in the penal system are confronted with the need to provide care and to develop specific treatment plans.
The data gathered from incarcerated juveniles were analyzed with a special focus on gender-specific treatment aspects. The Mini-International Neuropsychiatric Interview for children and adolescents was used to assess psychopathology in detained juveniles in Austria. The final study sample consisted of 333 juveniles (58 girls and 275 boys).
90 % of the juveniles in our sample suffered from at least one psychiatric disorder, and more than 60 % were diagnosed with two or more simultaneous psychiatric disorders. Using factor analyses we found three clinically relevant disorder patterns according to psychopathological characteristics for males: ADHD/conduct disorder and drug abuse; anxiety and depression; separation anxiety disorder/PTSD and alcohol abuse. In females, we found four disorder patterns: separation anxiety disorder/social phobia/dysthymia; PTSD and drug abuse in combination with either ADHD or conduct disorder; depression and alcohol abuse.
Considering that juvenile detainees are burdened by high rates of psychopathology and comorbidity, it is essential to develop a substantiated diagnostic procedure in order when making treatment decisions; different disorder patterns must be considered in conjunction with detained juveniles. The patterns of psychopathology observed might be related to different characteristics in the development of delinquent behavior, in treatment needs, and legal prognosis.
被监禁的青少年精神病理学和共病精神疾病的患病率很高。在刑罚系统工作的儿童和青少年精神科医生面临着提供护理和制定具体治疗计划的需求。
对从被监禁青少年收集的数据进行分析,特别关注性别特异性治疗方面。使用儿童和青少年版的迷你国际神经精神病学访谈来评估奥地利被拘留青少年的精神病理学。最终研究样本包括333名青少年(58名女孩和275名男孩)。
我们样本中的90%的青少年患有至少一种精神障碍,超过60%被诊断患有两种或更多种同时存在的精神障碍。通过因素分析,我们根据男性的精神病理学特征发现了三种临床相关的障碍模式:注意力缺陷多动障碍/品行障碍和药物滥用;焦虑和抑郁;分离焦虑障碍/创伤后应激障碍和酒精滥用。在女性中,我们发现了四种障碍模式:分离焦虑障碍/社交恐惧症/心境恶劣;创伤后应激障碍和药物滥用与注意力缺陷多动障碍或品行障碍同时存在;抑郁和酒精滥用。
考虑到被拘留青少年负担着高比率的精神病理学和共病问题,在做出治疗决策时制定一个有充分依据的诊断程序至关重要;必须结合被拘留青少年考虑不同的障碍模式。观察到的精神病理学模式可能与犯罪行为发展、治疗需求和法律预后的不同特征有关。