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Originalarbeit

Psychopathologische und komorbide Störungen inhaftierter Jugendlicher in Österreich

Implikationen für einen jugendpsychiatrischen Versorgungsauftrag im Strafvollzug

Published Online:June 10, 2011https://doi.org/10.1024/1422-4917/a000113

Abstract

Fragestellung: Inhaftierte Jugendliche zeigen hohe Prävalenzraten an psychiatrischen Störungen und gehäuft psychiatrische Komorbidität. Im Strafvollzug tätige Kinder- und JugendpsychiaterInnen stehen vor der Versorgungsaufgabe und der Notwendigkeit, störungsspezifische Behandlungsansätze auszuarbeiten. Die in dieser Studie erhobenen psychiatrischen Störungen bei inhaftierten Jugendlichen wurden im Hinblick auf störungsspezifische Behandlungsaspekte geschlechtsspezifisch ausgewertet. Methodik: Das Mini International Neuropsychiatric Interview für Kinder und Jugendliche wurde angewandt, um die Psychopathologie bei in Österreich inhaftierten Jugendlichen zu erheben. Die endgültige Stichprobe umfasste 333 Jugendliche (58 Mädchen und 275 Jungen). Ergebnisse: 90 % der inhaftierten Jugendlichen litten an mindestens einer psychiatrischen Störung, über 60 % zeigten zwei oder mehr koexistierende Störungsbilder. Mittels Faktorenanalyse wurden für männliche Jugendliche drei klinisch relevante Störungsmuster anhand von psychopathologischen Merkmalen ausgearbeitet: ADHS/Störung des Sozialverhaltens und Drogenmissbrauch; Angst und Depression; Trennungsangst/PTBS und Alkoholmissbrauch. Für weibliche Jugendliche ergaben sich vier Störungsmuster: Trennungsangst/Sozialphobie/Dysthymie; PTBS und Drogenmissbrauch in Kombination mit entweder ADHS oder Störung des Sozialverhaltens; Depression und Alkoholmissbrauch. Schlussfolgerungen: Aufgrund der hohen Raten an Psychopathologien bei inhaftierten Jugendlichen ist eine umfassende und strukturierte Diagnostik unerlässlich für die weitere Behandlungsentscheidung, da bei inhaftierten Jugendlichen verschiedene Störungsmuster berücksichtigt werden müssen. Die gefundenen Störungsmuster könnten im Zusammenhang mit der Entstehung delinquenten Verhaltens, mit unterschiedlichen Behandlungsbedürfnissen und mit dem Risiko für erneute Delikte wichtig sein.


Psychopathological and comorbid disorders of incarcerated adolescents in Austria

Objective: Incarcerated adolescents show a high prevalence rate of psychopathology and comorbid psychiatric conditions. Child and adolescent psychiatrists working in the penal system are confronted with the need to provide care and to develop specific treatment plans. Method: The data gathered from incarcerated juveniles were analyzed with a special focus on gender-specific treatment aspects. The Mini-International Neuropsychiatric Interview for children and adolescents was used to assess psychopathology in detained juveniles in Austria. The final study sample consisted of 333 juveniles (58 girls and 275 boys). Results: 90 % of the juveniles in our sample suffered from at least one psychiatric disorder, and more than 60 % were diagnosed with two or more simultaneous psychiatric disorders. Using factor analyses we found three clinically relevant disorder patterns according to psychopathological characteristics for males: ADHD/conduct disorder and drug abuse; anxiety and depression; separation anxiety disorder/PTSD and alcohol abuse. In females, we found four disorder patterns: separation anxiety disorder/social phobia/dysthymia; PTSD and drug abuse in combination with either ADHD or conduct disorder; depression and alcohol abuse. Conclusions: Considering that juvenile detainees are burdened by high rates of psychopathology and comorbidity, it is essential to develop a substantiated diagnostic procedure in order when making treatment decisions; different disorder patterns must be considered in conjunction with detained juveniles. The patterns of psychopathology observed might be related to different characteristics in the development of delinquent behavior, in treatment needs, and legal prognosis.

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