Prevalence of Psychiatric Disorders among Teenage Offenders

There has been a significant number of adolescents admitted to National Youth Service of Chile (SENAME) detention centers in recent years, specifically since the promulgation of a law reform on juveniles' penal responsibility for people aged 14 to 18 years (2006).

To determine the prevalence of psychiatric disorders in adolescent male offenders aged between 14 and 17 years.

The Mini International Neuropsychiatric Interview for Kids and Adolescents (MINI-KID) was applied to 489 adolescents admitted to detention centers, to determine the presence of psychiatric disorders. (Hypo) maniac episodes, eating disorders, pervasive developmental disorders, tic disorders, and psychotic disorders were excluded. Furthermore, for purposes of analysis, 23 cases that used a substance of abuse or had signs of consumption the day of the interview were excluded.

Eighty six percent of respondents had at least one psychiatric disorder. 

• The most common were substance use disorders (76%). 
• Among these, marijuana dependence disorder had the higher frequency (51%). 
• Disruptive behavior disorders had also a high prevalence (38%), 
• followed by anxiety disorders (27%), 
• attention deficit and hyperactivity disorder (26%), 
• and affective disorders (21%).

There is a high prevalence of psychiatric morbidity among teenage offenders which could undermine rehabilitation.

Via:  http://ht.ly/SsoRe 

See also: Prevalencia de trastornos psiquiátricos en adolescentes infractores de ley en Chile at:  http://ht.ly/SsoQ3 

By: Gaete J, Labbé N, Del Villar P, Allende C, Valenzuela E.

Workplace Drug Testing on Urine Samples: Evidence for Improving Efficacy of a First-Level Screening Program

Previous reports revealed poor performance in identifying drugs of abuse users through first-level workplace drug testing (WDT), based on urine samples. In a cross-sectional study, we evaluated: (i) the effect of creatinine normalization of drug values from diluted urine samples (creatinine levels ≤20 mg/dL) on the prevalence of drug users; (ii) the independent procedure-related predictors of positivity and dilution.

Workers' urine samples were collected at the workplace or at our certified laboratory between 2008 and 2012. All samples were analysed for drugs of abuse by immuno-enzymatic method in our laboratory, according to the Italian WDT law. Detectable drugs of abuse concentrations lower than the positive cutoff values were normalized based on mean levels of urinary creatinine. Detectable concentrations of drugs were confirmed by GC/MS. Multivariate logistic regression was used to detect independent procedure-related predictors of positive and diluted urine samples.

Of the 3080 urine samples screened, 51 (1.7%) were found positive for some drugs of abuse (26 cannabinoids and 16 cocaine) and 116 (3.8%) were diluted. Seventeen out of 23 diluted urine samples with detectable concentrations of cannabinoids or cocaine were found positive after urine creatinine normalization and GC/MS confirmed both negative and positive results. This increased the percentage of positivity for cannabinoids and cocaine from 1.35% to 2.09% (+55%, p=0.0005), which is closer to the expected prevalence of drug users based on Italian self-reported surveys. Collection of samples in the laboratory was an independent predictor of positivity (OR=2.33, 95%CI 1.27-4.28) and diluted urine sample (OR=1.65, 95%CI 1.04-2.61).

Efficacy of first-level  WDT could be improved by well-controlled pre-analytical procedures and urine creatinine normalization of detected concentrations of drugs of abuse.

Via:  http://ht.ly/Ss1yt 

By: Crespi V1, Maio RC, Veronesi G, Gianfagna F, Taborelli S, Ferrario MM.

1Toxicology Laboratory, Occupational and Preventive Medicine, Varese Hospital, Varese, Italy.

Adolescent Substance Misusers With & Without Delinquency: Death, Mental & Physical Disorders & Criminal Convictions from Age 21 to 45

Little is known about adult outcomes of males who as adolescents sought treatment for alcohol misuse or drug use, and who additionally were engaging or not engaging in other forms of delinquency. Since the rates of negative outcomes vary in the general population, the study determined whether the sub-groups of clinic attendees fared differently as compared to males of the same age who had not sought treatment for substance misuse from age 21 to 45. 

Adolescent males who consulted the only substance misuse clinic in a Swedish city between 1968 and 1971 were divided into four groups: ALCOHOL no drug use, no criminal offending (n=52); ALCOHOL+D no drug use, plus criminal offending (n=105); DRUG use, no criminal offending (n=92); and DRUG+D plus criminal offending (n=474). These four groups were compared to a general population sample (GP) of males matched on age and birthplace, who did not seek treatment for SM in adolescence. National Swedish registers provided data on death, hospitalizations for substance misuse (SM), mental and physical disorders, and criminal convictions. 

Compared to the GP, and after controlling for co-occurring adult outcomes:

• ALCOHOL showed elevated risks for SM hospitalization and convictions for violent crimes, and DRUG showed elevated risks for SM hospitalization, convictions for non-violent crimes, and hospitalization for psychosis. 
• ALCOHOL+D and DRUG+D showed increased risk for SM hospitalization, violent and non-violent convictions, and DRUG+D additionally, for death, and hospitalizations for psychosis and physical illness. 
• Misuse of alcohol without drug use or other delinquency in adolescence was associated with increased risk for convictions for violent crimes during the subsequent 25 years, in addition to SM, while adolescent drug use without other forms of delinquency was associated with increased risks for convictions for non-violent crimes, hospitalizations for SM, and non-affective psychosis. 
• Cannabis use, with and without delinquency, was associated with subsequent hospitalization for non-affective psychosis. 

Consistent with contemporary studies, most adolescents treated for SM from 1968-1971 presented delinquency that was associated with an increase in risk of all adverse outcomes to age 45.

Via: http://ht.ly/S0wpi

By: Larm P1, Silva TC2, Hodgins S3.

• 1Maria Ungdom Research Centre, Karolinska Institutet, Stockholm County Council, Stockholm, Sweden; Centre for Clinical Research Västerås, Uppsala University, Västmanland County Hospital Västerås, Västerås, Sweden. Electronic address: peter.larm@ltv.se.
• 2Center for Developmental Research, Örebro University, Örebro, Sweden.
• 3Maria Ungdom Research Centre, Karolinska Institutet, Stockholm County Council, Stockholm, Sweden; Département de Psychiatrie, Université de Montréal, Montréal, Canada.

Cannabinoids in Exhaled Breath Following Controlled Administration of Smoked Marijuana

Below:  Median (interquartile range) THC breath concentrations from chronic and occasional cannabinoid smokers after smoking a single 6.8% THC cigarette for 10 min

Dashed line indicates limit of quantitation. *P = 0.0156, group comparison.

THC was the major cannabinoid in breath; no sample contained THCCOOH and only 1 contained CBN. Among chronic smokers (n = 13), all breath samples were positive for THC at 0.89 h, 76.9% at 1.38 h, and 53.8% at 2.38 h, and only 1 sample was positive at 4.2 h after smoking. Among occasional smokers (n = 11), 90.9% of breath samples were THC-positive at 0.95 h and 63.6% at 1.49 h. One occasional smoker had no detectable THC. Analyte recovery from breath pads by methanolic extraction was 84.2%–97.4%. Limits of quantification were 50 pg/pad for THC and CBN and 100 pg/pad for THCCOOH. Solid-phase extraction efficiency was 46.6%–52.1% (THC) and 76.3%–83.8% (THCCOOH, CBN). Matrix effects were −34.6% to 12.3%. Cannabinoids fortified onto breath pads were stable (≤18.2% concentration change) for 8 h at room temperature and −20°C storage for 6 months.

Breath may offer an alternative matrix for testing for recent driving under the influence of cannabis, but is limited to a short detection window (0.5–2 h).

Read more at: http://ht.ly/Rmqa0 HT https://twitter.com/NIDAnews

Adolescent Substance Use: The Role of Demographic Marginalization and Socioemotional Distress

Below:  Conceptual model of relationships among race/ethnic marginalization, socioemotional distress, and substance use with student gender, race/ethnicity, and schoolwide race/ethnic diversity as moderators.

We investigated the links between race/ethnic marginalization (i.e., having few same-race/ethnic peers at school) and adolescents’ socioemotional distress and subsequent substance use (alcohol and marijuana) initiation and use. Data from 7,731 adolescents (52% females; 55% White, 21% African American, 16% Latino, 8% Asian American) were drawn from the National Longitudinal Study of Adolescent to Adult Health (Add Health). In our path analysis model, we found that adolescents who were racial/ethnically marginalized at school (i.e., who had less than 15% same-ethnic peers) reported poorer school attachment, which was linked to greater depressive symptoms. More depressive symptoms were associated with higher levels of subsequent marijuana and alcohol use. These relationships showed some variation by students’ gender, race/ethnicity, and age. Findings suggest that the influence of school demographics extends beyond the academic domain into the health and well-being of young people.

Via:   http://ht.ly/QrTez   HT @UTAustin