Psychopharmacology and juvenile delinquency

doi:10.1017/CBO9780511543913.016

15 - Psychopharmacology and juvenile delinquency

Published online by Cambridge University Press: 11 August 2009

Niranjan S. Karnik ,

Marie V. Soller and

Hans Steiner

Edited by

Carol L. Kessler and

Louis James Kraus

Show author details

Niranjan S. Karnik: Affiliation:
Division of Child and Adolescent Psychiatry Stanford University 401 Quarry Road Stanford, CA 94305 USA
Marie V. Soller: Affiliation:
Resident in Psychiatry San Mateo Medical Center San Mateo, CA USA
Hans Steiner: Affiliation:
Professor of Psychiatry and Behavioral Sciences, Director of Education, Division of Child and Adolescent Psychiatry Co-Director, Center for Psychiatry and the Law Stanford University School of Medicine 401 Quarry Road Stanford, CA 94305 USA
Carol L. Kessler: Affiliation:
Columbia University, New York
Louis James Kraus: Affiliation:
Rush University, Chicago

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Summary

The miserable have no other medicine, but only hope.

William Shakespeare, Measure for Measure, Act III, Scene I.

Introduction

Psychopathology among juvenile offenders is widely considered to be a significant problem and has been examined in recent, broad psycho-epidemiological studies (Teplin et al., 2002; Vermeiren, 2003; Wasserman et al., 2003; Vermeiren et al., 2006). These estimates of psychiatric illness may partially overestimate the prevalence of psychopathology among all offenders due to the fact that incarcerated juveniles are more likely to have illness and to have greater morbidity than first-time offenders or those in diversion programs. Nevertheless, the high prevalence rates for psychopathology among juvenile offenders should be a cause of concern. The best approach to this population entails taking a developmental perspective which takes into account that despite their crimes these children continue to mature, grow, and change in profound ways (Frick, 2006; Karnik et al., 2006).

Treatment of confined juveniles has certain ethical and moral problems due to the unique consent and assent issues at play for this potentially vulnerable group of patients. A recent consensus report recommends behavioral management and psychotherapy be used where clinical indications clearly allow these as first-line interventions (Pappadopulos et al., 2003). Only after these approaches have failed should psychopharmacological interventions be considered (Pappadopulos et al., 2003; Schur et al., 2003). For example, an acutely manic offender who presents with pressured speech, aggressive behavior, and delusional thoughts would merit anti-psychotic medications for stabilization followed by psychotherapy and medications if needed, whereas a youth offender presenting with mild anxiety symptoms might merit psychotherapy as initial treatment.

Keywords

conduct disorder delinquent behaviors intermittent explosive disorder juvenile offenders oppositional-defiant disorder pharmacotherapy maladaptive aggression medication psychopharmacology

Type: Chapter
Information: The Mental Health Needs of Young Offenders
Forging Paths toward Reintegration and Rehabilitation
, pp. 308 - 339

DOI: https://doi.org/10.1017/CBO9780511543913.016 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2007

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