Abstract
BackgroundInhalant use is among the most pernicious and poorly understood forms of adolescent substance use. Many youth in the juvenile justice system have used inhalants, but little is known about inhalant use disorders (IUDs) in antisocial youth populations. The purpose of this study was to examine the prevalence, clinical features, and latent structure of DSM-IV IUDs in a state population of antisocial youth.MethodsCross-sectional survey conducted in 2003. Of 740 youth residing in Missouri State Division of Youth Services' (MDYS) residential treatment facilities at the time the study was conducted, 723 (97.7%) completed interviews. Eighty-seven percent were male, with a mean age of 15.5 (SD = 1.2). Nearly 4 in 10 youth (38.5%; n = 279) reported lifetime inhalant use. Youth ranged from very mildly to severely antisocial.ResultsOf 279 inhalant users, 52 (18.6%) met DSM-IV inhalant abuse criteria and 79 (28.3%) met inhalant dependence criteria. Five of 10 IUD criteria were met by > 10% of the total sample. Latent class analyses demonstrated a substantial concordance between DSM-IV-defined IUDs and an empirically-derived classification based on responses to DSM-IV IUD diagnostic criteria.ConclusionIUDs and constituent criteria were prevalent among youth in the juvenile justice system. Two groups of problem inhalant users were identified, symptomatic users-DSM-IV inhalant abuse and highly symptomatic users-DSM-IV inhalant dependence, which differed primarily in severity of inhalant-related problems. Inhalant screening, prevention and treatment efforts in juvenile justice settings are rarely delivered, but critically needed.
Highlights
Inhalant use is among the most pernicious and poorly understood forms of adolescent substance use
inhalant use disorders (IUDs) and several individual IUD criteria were prevalent in this sample of antisocial youth
A number of youth met one or two inhalant dependence criteria but did not meet DSM-IV criteria for inhalant abuse or dependence. These diagnostic orphans evidenced worrisome inhalant-related problems that are not captured by the current set of IUD diagnostic criteria in DSM-IV
Summary
Inhalant use is among the most pernicious and poorly understood forms of adolescent substance use. Many youth in the juvenile justice system have used inhalants, but little is known about inhalant use disorders (IUDs) in antisocial youth populations. The purpose of this study was to examine the prevalence, clinical features, and latent structure of DSM-IV IUDs in a state population of antisocial youth. Inhalant use and formal DSM-IV inhalant use disorders (IUDs) remain a curious case study in the annals of psychiatric epidemiology. For more than thirty years, nationally representative surveys have identified inhalant use as among the most prevalent forms of adolescent substance use [1,2]. A small corpus of animal studies, case reports, and clinical investigations further suggests that malignant health and social outcomes may attend adolescent inhalant use. Inhalant use has been implicated in documented cases of cardiac, renal, and liver toxicity and hepatorenal failure [5,6,7], bowel and bladder dysfunction [8], bone marrow suppression and reduced T-cell responsivity [9,10], irreversible congestive heart failure [11], severe neurological damage and cognitive dysfunction [12,13], effects in offspring similar to those of fetal alcohol syndrome [14], and a host of psychiatric, social, academic, and interpersonal functional impairments [15,16,17,18,19]
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