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15 - Psychopharmacology and juvenile delinquency

Published online by Cambridge University Press:  11 August 2009

By
Niranjan S. Karnik ,
Marie V. Soller  and
Hans Steiner
Edited by
Carol L. Kessler  and
Louis James Kraus
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 disorderdelinquent behaviorsintermittent explosive disorderjuvenile offendersoppositional-defiant disorderpharmacotherapymaladaptive aggressionmedicationpsychopharmacology
Type
Chapter
Information
The Mental Health Needs of Young Offenders
Forging Paths toward Reintegration and Rehabilitation
 , pp. 308 - 339
Publisher: Cambridge University Press
Print publication year: 2007

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  • Psychopharmacology and juvenile delinquency
    • By Niranjan S. Karnik, Division of Child and Adolescent Psychiatry Stanford University 401 Quarry Road Stanford, CA 94305 USA, Marie V. Soller, Resident in Psychiatry San Mateo Medical Center San Mateo, CA USA, Hans Steiner, 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
  • Edited by Carol L. Kessler, Columbia University, New York, Louis James Kraus, Rush University, Chicago
  • Book: The Mental Health Needs of Young Offenders
  • Online publication: 11 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511543913.016
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  • Psychopharmacology and juvenile delinquency
    • By Niranjan S. Karnik, Division of Child and Adolescent Psychiatry Stanford University 401 Quarry Road Stanford, CA 94305 USA, Marie V. Soller, Resident in Psychiatry San Mateo Medical Center San Mateo, CA USA, Hans Steiner, 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
  • Edited by Carol L. Kessler, Columbia University, New York, Louis James Kraus, Rush University, Chicago
  • Book: The Mental Health Needs of Young Offenders
  • Online publication: 11 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511543913.016
Available formats
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Save book to Google Drive

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  • Psychopharmacology and juvenile delinquency
    • By Niranjan S. Karnik, Division of Child and Adolescent Psychiatry Stanford University 401 Quarry Road Stanford, CA 94305 USA, Marie V. Soller, Resident in Psychiatry San Mateo Medical Center San Mateo, CA USA, Hans Steiner, 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
  • Edited by Carol L. Kessler, Columbia University, New York, Louis James Kraus, Rush University, Chicago
  • Book: The Mental Health Needs of Young Offenders
  • Online publication: 11 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511543913.016
Available formats
×