Substance abuse, conduct disorder and crime: assessment in a juvenile detention house in Istanbul, Turkey

Family-based prevention in youth's substance misuse in low- and middle-income countries: A review from Turkey and cultural adaptation of family based interventions

Family-based interventions have been recognized and practised more in high-income countries than in low- and middle-income countries. However, the threats posed by substance misuse to the youth do not change for the latter. The development of appropriate preventive programs is an area of interest for addiction prevention in low- and middle-income countries by recognizing the risk factors for substance misuse among young individuals. This study aims to present the risk factors primarily in family-based conditions for substance use among young people in low- and middle-income countries and to provide information on family-based interventions that can be developed in line with these factors. It is aimed to discuss how family-based studies can be adapted to samples such as Turkey in the light of three programs originating in the USA. Fifty-six publications gathered from the literature between 1989-2021 by using keywords were included in the study. Adolescence and young adulthood are the riskiest developmental periods for substance misuse worldwide. Economic, cultural and family-based factors involving the youth are of considerable importance. Families' consciousness of youth's substance use is worthful to prevent youth's addictions in the future. Studies show that family-based preventions are promising interventions in this regard.

Correlates and predictors of re-incarceration among Turkish adolescent male offenders: A single-center, cross-sectional study

BACKGROUND

Adolescents involved in the legal system are known to be under elevated risk for repeat offending. There may be many reasons for recidivism. Specifically, we aim to investigate the clinical, socio-demographic, and familial factors and psychopathology among adolescents in a penal institution and to determine risk factors for re-incarceration.

METHODS

This single-center cross-sectional survey was conducted at Tarsus Closed Penal Institution for Children and Youth. This institution is for males only, and all male adolescents detained at the center within the study period were evaluated with semi-structured interviews (K-SADS-PL). The adolescents completed Meaning and Purpose of Life Scale, The EPOCH measure of Adolescent Well-being, Family Sense of Belonging Scale, Children's Alexithymia Scale, Beck Depression Inventory, and State-Trait Anxiety Inventory for themselves. Descriptive and inferential analyses were used. P was set at 0.05.

RESULTS

Ninety adolescent offenders with a mean age of 16.6 years (S·D = 0.7) were enrolled. Mean age at first offense was 14.6 years (S·D = 2.1). The most common reason for offenses was reported as as being with peers who were offenders, too (57.8%). Most common diagnoses were substance use (36.7%), attention deficit/hyperactivity disorder (33.3%), and conduct disorder (26.7%). Rates of offending and conviction in first-degree relatives were 62.2% and 60.0%, respectively, and most of the adolescents had at least one peer with a criminal record (n = 71, 78.9%). Re-incarcerated adolescents had lower education, committed more violent crimes, and reported elevated use of substances, suicide attempts, and psychopathology. However, in regression analysis, age of onset was the sole predictor of re-incarceration.

CONCLUSION

Turkish male adolescents in forensic settings may be screened for externalizing disorders and referred for treatment. Re-incarcerated Turkish youth may be more susceptible to peer influence, substance use and externalizing disorders. It may be prudent to systematically screen offending youth for psychiatric disorders regardless of the individual's request for treatment and refer identified cases to treatment. Integration of child and adolescent psychiatrists with penal institutions serving youth may help in this regard.

Inhalant Use and Mental Health Problems in Russian Juvenile Delinquents

BACKGROUND

Inhalant use by children and adolescents has been linked to an increased risk of multiple drug use, mental health problems and antisocial behavior.

OBJECTIVES

The purpose of this study was to examine the association between the frequency of inhalant use and psychiatric diagnoses among incarcerated delinquent youths in Russia.

METHODS

A total of 370 incarcerated delinquents from a juvenile correction center in Northern Russia were assessed by means of a semi-structured psychiatric interview and by self-reports.

RESULTS

Compared to non-users (N = 266), inhalant users (N = 104) reported higher rates of PTSD, early onset conduct disorder, ADHD, alcohol abuse and dependence, as well as higher levels of antisocial behavior, impulsiveness and more psychopathic traits. Frequent inhalant users also reported the highest rates of co-occurring psychopathology.

CONCLUSIONS

Our findings suggest that inhalant use in delinquents is frequent and may require additional clinical measures to address the issue of psychiatric comorbidity.

Comorbidities and correlates of conduct disorder among male juvenile detainees in South Korea

BACKGROUND

The purpose of this study was to examine the rate and distribution of comorbidities, severity of childhood maltreatment, and clinical characteristics of adolescents with conduct disorder detained in a juvenile detention center in South Korea.

METHODS

In total, 173 juvenile detainees were recruited. We analyzed the distribution of psychiatric disorders among the sample and compared the rate of comorbidities between groups with and without conduct disorder. We compared the two groups in terms of demographic and clinical characteristics, as well as severity of childhood maltreatment and psychiatric problems, using the Young Self Report (YSR) scale.

RESULTS

A total of 95 (55%) of the detainees were diagnosed with conduct disorder, and 93 (96.9%) of them had at least one comorbid axis I psychiatric disorder. Detainees with conduct disorder had a higher number of comorbid psychiatric disorders; a higher rate of violent crime perpetration; had suffered more physical, emotional, and sexual abuse; and showed higher total YSR scores and externalizing behavior, somatic complaints, rule-breaking behavior, and aggressive behavior YSR subscale scores.

CONCLUSIONS

Conduct disorder is a common psychiatric disorder among juvenile detainees in South Korea, who tend to commit more violent crimes and show more psychopathology than detainees who do not have conduct disorder. These findings highlight the importance of diagnosing and intervening in conduct disorder within the juvenile detention system.

Prevalence of psychiatric disorders, comorbidity patterns, and repeat offending among male juvenile detainees in South Korea: a cross-sectional study

BACKGROUND

High rates of psychiatric disorders and comorbidities have been reported in juvenile detainees, and both phenomena are thought to contribute to repeat offending. However, research on this topic has been limited in Asian countries, like South Korea. The purpose of this study was to examine the prevalence of psychiatric disorders, comorbidity patterns, and the relationship between psychiatric disorders and repeat offending among a cross-section of youths detained in a male juvenile detention center in South Korea.

METHODS

One hundred seventy-three juvenile detainees were recruited. The distribution of psychiatric disorders within the sample was estimated by applying criteria from the Diagnostic and Statistical Manual of Mental Disorders IV. Logistic regression was used to assess significant comorbidity patterns and relationships between psychiatric disorders and repeat offending.

RESULTS

In all, 90.8% of the detainees had at least one psychiatric diagnosis, and 75.1% had psychiatric comorbidities. The most common psychiatric disorder was alcohol use disorder, followed by conduct disorder and attention-deficit hyperactivity disorder. Among the comorbidities present, alcohol use disorder with disruptive behavior disorder was the most common combination. The presence of two psychiatric disorders was associated with a higher rate of recidivism, and alcohol use disorder was also associated with repeat offending when combined with disruptive behavior disorders, but not with anxiety disorders, major depression, or psychotic disorders.

CONCLUSIONS

Juvenile detainees evidence high rates of psychiatric disorders and comorbidities. Assessment of and intervention in psychiatric disorders, especially alcohol use disorder and comorbid alcohol use disorder with disruptive behavior disorders, may help prevent further offenses.

Prevalence of antisocial personality disorder among Chinese individuals receiving treatment for heroin dependence: a meta-analysis

Background

Studies from Western countries consistently report very high rates of comorbid Antisocial Personality Disorder (ASPD) among individuals with heroin addiction, but the reported proportion of Chinese individuals with heroin addiction who have co-morbid ASPD varies widely, possibly because Chinese clinicians do not consider personality issues when treating substance abuse problems.

Aim

Conduct a meta-analysis of studies that assessed the proportion of Chinese individuals with heroin dependence who have comorbid ASPD.

Methods

We searched for relevant studies in both Chinese databases (China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, Taiwan Electronic Periodical Services) and western databases (PubMed, EMBASE, and PsycInfo). Two authors independently retrieved the literature, identified studies that met pre-defined inclusion and exclusion criteria, assessed the quality of included studies, and extracted the data used in the analysis. Statistical analysis was performed using StatsDirect 3.0 and R software.

Results

The search yielded 15 eligible studies with a total of 3692 individuals with heroin dependence. Only 2 of the studies were rated as high-quality studies. All studies were conducted in rehabilitation centers or hospitals. The pooled lifetime prevalence of ASPD in these subjects was 30% (95%CI: 23%-38%), but the heterogeneity of results across studies was great (I² =95%, p<0.001). Men had a higher prevalence than women (44% vs. 21%), and injection heroin users had higher prevalence than those who smoked heroin (44% vs. 27%). Studies that were methodologically stronger had higher reported prevalence of ASPD among heroin dependent individuals.

Conclusions

There are substantial methodological problems in the available literature about ASPD in Chinese individuals receiving treatment for heroin dependence, but we estimate that about one-third of them meet criteria for ASPD. Further work is needed to increase clinicians’ awareness of this issue; to compare the pathogenesis, treatment responsiveness and recidivism of those with and without ASPD; and to develop and test targeted interventions for this difficult-to-treat subgroup of individuals with heroin dependence.

Histopathological changes of rat kidney with exposure to chronic thinner inhalation

INTRODUCTION

Organic solvents are liquid substances commonly used in everyday life at home and in industrial workplaces. These solvents are found primarily in paint as thinner. Because other narcotics are hard to find, thinner is used as a narcotic especially among youngsters of low socioeconomic level. The aim of this study is to determine the histopathological changes of rat kidney with exposure to chronic thinner inhalation.

METHODS

Randomized trial--the study was conducted at the animal care facility of Haydarpasa Numune Education and Research Hospital. Forty albino Wistar male rats were used throughout the experiment. Three groups of rats inhaled thinner in a glass cage for 1, 3, and 5 weeks, respectively. Ten rats inhaled only the air in the room as the control group.

RESULTS

We observed the development of inflammation in the kidneys that became more remarkable as exposure time extended. Development of inflammation because of thinner apparently differed between the groups of week 1 and week 5. There was no difference in granuloma development. If the experiment lasted longer, there might have been granuloma development.

CONCLUSIONS

Based on histopathological evaluations, it was shown that exposure to chronic thinner inhalation causes detectable damage on the kidney, which becomes more prominent as exposure period extends. As we established disorders in movement and consciousness in the rats during thinner inhalation, we can conclude that thinner also has a damaging effect upon the central nervous system.

Psychiatric disorders in detained male adolescents: a systematic literature review

OBJECTIVE

To provide a best estimate of the prevalence of psychiatric disorders among detained male adolescents, with particular emphasis on impairment, multi-informant assessment, and race or ethnicity.

METHOD

Computer-assisted searches were executed to identify relevant studies.

RESULTS

Fifteen studies using adolescents as informants met inclusion criteria (n = 3401), of which only 2 reported within a subsample on parent-derived diagnoses. The mean prevalence of any disorder was 69.9% (95% CI 69.5% to 70.3%); with conduct disorder occurring most frequently (46.4%, 95% CI 45.6% to 47.3%), followed by substance use disorder (45.1%, 95% CI 44.6% to 45.5%), oppositional defiant disorder (19.8%, 95% CI 19.2% to 20.3%), and attention-deficit hyperactivity disorder (13.5%, 95% CI 13.2% to 13.9%). Although lower, rates for internalizing disorders were still substantial, with any anxiety disorder found in 15.9% (95% CI 15.6% to 16.1%), major depression in 12.0% (95% CI 11.7% to 12.2%), and posttraumatic stress disorder in 9.6% (95% CI 9.2% to 10.0%). Three studies reported on psychotic disorders, finding low rates (1.35%, 95% CI 1.32% to 1.39%). Estimates of prevalence were only marginally different when impairment was not required, while consistency between adolescents and parents was poor. Findings on the relations between race or ethnicity were too scarce and inconsistent to interpret.

CONCLUSION

Detained male adolescents bear substantial mental health needs, emphasizing the need to organize effective mental health services for this troubled group. However, our knowledge on mental disorders in detained youth should be enhanced, in particular regarding the reliability of adolescents, compared with parent report, and whether clinically relevant differences exist by race or ethnicity.

[Prevalence and factors associated with behavioral disorders in adolescents: a population-based study]

This study proposed to estimate the prevalence of behavioral disorders and associated factors in adolescents (11-15 years), using a cross-sectional design (n = 1,145). Subjects answered a self-administered questionnaire. Behavioral disorder was assessed with the Mini International Neuropsychiatric Interview (MINI). The study analyzed disorders in relation to gender, age, socioeconomic status, schooling, failure in school, religion, smoking, sedentary lifestyle, alcohol consumption, drug use, depression, and bullying (as victim). Ordinal regression was used for the statistical analysis, with a hierarchical model for the outcome. An estimated 29.2% of the sample presented behavioral disorders. In the multivariate analysis, the odds ratio for a male adolescent to present one additional point on the behavioral disorder scale was 2.04 (95%CI: 1.53-2.71). Alcohol consumption, drug use, and suffering bullying were associated with higher scores on the behavioral disorder scale. The findings also showed that the factors associated with behavioral disorder showed a strong interrelationship between health behaviors in adolescence.