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Prevalence, Comorbidity, and Continuity of Psychiatric Disorders in a 15-Year Longitudinal Study of Youths Involved in the Juvenile Justice System

NCJ Number
JAMA Pediatrics Volume: 175 Issue: 7 Dated: April 2021 Pages: 1-12
Date Published
April 2021
12 pages

This study examined the prevalence, continuity, and comorbidity of psychiatric disorders among youths during the 15 years after detention in a juvenile justice facility, as well as whether outcomes varied by sex and race/ethnicity.


This Northwestern Juvenile Project was a longitudinal cohort study of health needs and outcomes of 1,829 randomly selected youths in a temporary juvenile detention center in Cook County, Illinois. Youths ages 10 to 18 years old were interviewed in detention from November 20, 1995, through June 14, 1998. Participants were re-interviewed up to 12 times during the 15-year study period through February 2015, for a total of 16,372 interviews. The sample was stratified by sex, race/ethnicity (Black, Hispanic, and non-Hispanic White), age (10-13 years or 14-18 years), and legal status (processed in juvenile or adult court). Data analysis was conducted from February 2014, when data preparation began, to March 2020. The study found that although prevalence and comorbidity of psychiatric disorders decreased as the 1,829 participants aged, 52.3 percent of males and 30.9 percent of females had at least one or more psychiatric disorders 15 years after detention. Among participants with a disorder at baseline, 64.3 percent of males and 34.8 percent of females had a disorder 15 years later. Compared with females, males had 3.37 times the odds of persisting with a psychiatric disorder 15 years after baseline (95 percent CI, 1.79-6.35). Compared with Black participants and Hispanic participants, non-Hispanic White participants had 1.6 times the odds of behavioral disorders (odds ratio, 1.56; 95 percent CI, 1.27-1.91 and odds ratio, 1.59; 95 percent CI, 1.23-2.05, respectively) and greater than 1.3 times the odds of substance-use disorders (odds ratio, 1.90; 95 percent CI, 1.55-2.33 and odds ratio, 1.39; 95 percent CI, 1.11-1.73, respectively) throughout the follow-up period. Behavioral disorders and substance-use disorders were the most prevalent 15 years after detention. This study’s findings suggest that persistent psychiatric disorders may complicate the transition from adolescence to adulthood, which is already challenging for youths involved in the juvenile justice system, many of whom are from racial/ethnic minority groups and low-income backgrounds. The pediatric health community should advocate for early identification and treatment of disorders among youths in the justice system. (publisher abstract modified)

Date Published: April 1, 2021