Abstract
Abstract Objective The main aim was to analyze the prevalence and patterns of comorbidity in 11 identified broad categories of psychiatric conditions and 48 specific psychiatric conditions among 613 youth from the Missouri Division of Youth Services (DYS) residential sites using advanced data mining techniques on clinical assessment data. Methods This study was based on youth detainee population at DYS residential placements receiving psychiatric care through the telemedicine network established between DYS and University of Missouri Department of Psychiatry. Association Rule Mining (ARM) algorithm was used to determine the associations and the co-occurrence pattern among the comorbid psychiatric conditions. Results About 88% of the DYS youth are diagnosed with two or more psychiatric disorders. From the ARM analysis, the most commonly co-occurred disorders are obtained as substance-related or -addicted disorders (SUD) and disruptive, impulse-control, and conduct disorders (CD) (n [%] = 258 [42.1%], followed by SUD, CD, and depressive disorder (DD) (145 [23.7%]), SUD, CD, and neurodevelopmental disorder (NDD) (133 [21.7%]), and DD, CD and NDD (120 [19.6%]). Discussion The study found high prevalence of comorbidity among the youth patients of the Missouri DYS facilities receiving care through the University of Missouri telemedicine network. The ideal scenario for assessment of any of these disorders in a patient should include substantial consideration in delineating the symptoms and history before eliminating any of them. Conclusion The comorbid patterns obtained can help in determining treatment regimens for DYS youth that can be effective in reducing recidivism and delinquency.
Highlights
Background and SignificanceMany youths under 18 years of age in the United States are incarcerated in the juvenile justice system (JJS) residential facilities
Numerous comprehensive studies have indicated that mental health disorders like, depressive disorders (DDs), schizophrenia spectrum disorders (SSD), anxiety disorders (AD), obsessive-compulsive related disorder, trauma and stressor related disorders, disruptive behavior disorders, and neurodevelopment disorders (NDD), and substance use disorders are commonly found among these incarcerated youth.[6,7,8]
This led to the presence of 11 distinct psychiatric disorder classes such as, AD, bipolar and related disorders (BD), DD, disruptive, impulse-control and conduct disorders (CD), neurocognitive disorders, NDD, obsessivecompulsive and related disorders, schizophrenia spectrum disorders (SSD), sleep-wake disorders, substance-related or -addicted disorders (SUD) and trauma- and stressor-related disorders (TSD). ►Table 1 shows the frequency distribution of the specific disorders under the broad diagnostic and statistical manual-5 (DSM-5) classes for psychiatric disorders
Summary
Background and SignificanceMany youths under 18 years of age in the United States are incarcerated in the juvenile justice system (JJS) residential facilities. In previous studies on juveniles, estimates reveal that approximately 50 to 75% of youth encountering JJS are diagnosed with at least one diagnosable mental health disorder.[3,4,5] Numerous comprehensive studies have indicated that mental health disorders like, depressive disorders (DDs) (major depression, persistent depression, and manic episodes), schizophrenia spectrum disorders (SSD) (psychotic disorders), anxiety disorders (AD) (panic, separation anxiety, and generalized anxiety), obsessive-compulsive related disorder, trauma and stressor related disorders (posttraumatic stress disorder), disruptive behavior disorders (conduct and oppositional defiant disorder), and neurodevelopment disorders (NDD) (attention-deficit hyperactivity disorder [ADHD]), and substance use disorders are commonly found among these incarcerated youth.[6,7,8] There is growing evidence that commonly found mental disorders are associated with increase in risks for youth engaging in aggressive behaviors.[8,9] addressing the mental health conditions of the incarcerated youth is important in considering treatment response, and lack of such treatment in the residential facilities can lead in worsening effect on offending behavior and delinquency
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