Información del artículo
El objetivo de este artículo es presentar una revisión actualizada que sirva para mejorar el conocimiento sobre los problemas de salud preexistentes al ingreso y asociados con la estancia en centros de reforma juvenil que presentan los adolescentes delincuentes. Sobre esta base, se ofrecen unas recomendaciones para el cuidado de la salud física y mental y para la educación en la salud de estos jóvenes que sean de utilidad para los profesionales sanitarios que los atienden mientras permanecen en custodia y, por extensión, para los que los atienden en el ámbito ambulatorio.
De la bibliografía consultada, el 63 % de los estudios se han elaborado en Estados Unidos, el 24% en Europa occidental (España, Reino Unido, Holanda, Bélgica, Suecia y Finlandia), el 8 % en Australia y el 5 % en Canadá. En estos estudios no se observan diferencias cualitativas apreciables en los problemas de salud que con mayor frecuencia presentan estos jóvenes, coincidiendo en que las necesidades sanitarias prioritarias son la provisión de servicios preventivos y/o terapéuticos odontológicos, psiquiátricos, de inmunización y de enfermedades infecciosas y de servicios para la educación en la salud.
El fracaso en la identificación e intervención precoz de las necesidades sanitarias de estos adolescentes no sólo puede afectar adversamente su calidad de vida en el futuro desarrollo físico, emocional e intelectual, sino que también puede conducir a incrementar las dificultades para su rehabilitación y reinserción social.
Palabras clave:
Adolescencia
Delincuencia juvenil Centro de reforma juvenil Estado de salud
Salud física
Salud mental Cuidado de la salud
Pruebas diagnósticas
Inmunizaciones
Guía
The aim of this article was to provide an update that would serve to increase knowledge of health problems among juvenile delinquents before and during incarceration in juvenile correctional centers. Recommendations are made for the care of mental and physical health and for the health education of these teenagers that could be useful for health professionals providing health care to these teenagers while in custody as well as for those seeing them in the ambulatory setting.
From the literature consulted, 63 % of studies have been performed in the United States, 24% in Western Europe (Spain, United Kingdom, Holland, Belgium, Sweden, Finland), 8% in Australia and 5% in Canada. These studies show no appreciable qualitative differences in the health problems most frequently presented by these teenagers and there is agreement that the areas that should be prioritized are the provision of preventive and/or therapeutic dental care, as well as programs for psychiatric care, immunization, infectious diseases and health education.
Failure to identify the health requirements of these teenagers and to provide early interventions can not only adversely effect their quality of life and their future physical, emotional and intellectual development but can also make their rehabilitation and reintegration into society more difficult.
Key words:
Adolescence
Juvenile delinquency
Juvenile reform center
Health status
Physical health
Mental health
Health care
Diagnostic tests
Immunizations
Guide
El Texto completo está disponible en PDF
Bibliografía
[1.]
La infancia en Europa. Apartado 6.E.: Niños y jóvenes entre rejas. Informe elaborado por Save the Children. Junio, 1998. Disponible en: http://www.savethechildren.es/organización/infeuropa.htm.
[2.]
I. Gómez de Terreros.
Pobreza, delincuencia, drogadicción y criminalidad en la infancia y adolescencia.
Tratado de Pediatría Social, pp. 661-677
[3.]
Informe especial sobre la violencia juvenil en Aragón. Zaragoza: Ed. El Justicia de Aragón, marzo de 2002
[4.]
W.S. Yancy.
Juvenile delinquency: Considerations for pediatricians.
Pediatr Rev, 16 (1995), pp. 12-16
[6.]
D.P. Farrington, R. Loeber.
Epidemiology of juvenile violence.
Child Adolesc Psychiatr Clin North Am, 9 (2000), pp. 733-748
[7.]
Ley Orgánica 5/2000, de 12 de enero, Reguladora de la Responsabilidad Penal de los Menores. B.O.E. núm.11, 13 de enero de 2000; p. 1422-41
[8.]
Woolfenden S.R., Williams K., Peat J. Family and parenting interventions in children and adolescents with conduct disorder and delinquency aged 10-17. Cochrane Database Syst Rev 2001; 2: CD003015. Disponible en: http://www.update-software.com/abstracts/ab003015.htm
[9.]
Youth Violence Prevention Resources. National Library of Medicine. Current Bibliographies in Medicine 2000-8. Disponible en: http://www.nml.nih.gov/pubs/cbm/youthviolence.html#5
[10.]
Canadian Paediatric Society, Adolescent Medicine Committee. Health care standards for youth in custodial facilities. Paediatr Child Health 1997;2:221-3. Reaffirmed January 2000. Disponible en: http://www.cps.ca/english/staments/AM/am96-02.htm
[11.]
Society for Adolescent Medicine. Health care for incarcerated youth. Position paper. J Adolesc Health 2000;27:73-5. Disponible en: http://www.adolescenthealth.org/html/incarerated_youth.html
[12.]
American Academy of Pediatrics, Committee on Adolescence. Health care for children and adolescents in the juvenile correctional care system. Pediatrics 2001;107:799-803. Disponible en: http://www.aap.org/policy/re0021.html
[13.]
J. Haapasalo, T. Hamalainen.
Childhood family problems and current psychiatric problems among young violent and property offenders.
J Am Acad Child Adolesc Psychiatry, 35 (1996), pp. 1394-1401
[14.]
D. Gorman-Smith, P.H. Tolan, R. Loeber, D.B. Henry.
Relation of family problems to patterns of delinquent involvement among urban youth.
J Abnorm Child Psychol, 26 (1998), pp. 319-333
[15.]
H. Steiner, E. Cauffman, E. Duxbury.
Personality traits in juvenile delinquents: Relation to criminal behavior and recidivism.
J Am Acad Child Adolesc Psychiatry, 38 (1999), pp. 256-262
[16.]
T.I. Herrenkohl, E. Maguin, K.G. Hill, J.D. Haukins, R.D. Abbott, R.F. Catalano.
Developmental risk factor for youth violence.
J Adolesc Health, 26 (2000), pp. 176-186
[17.]
E. Romero, J. Sobral, M.A. Luengo, J.A. Marzoa.
Values and antisocial behavior among Spanish adolescents.
J Genet Psychol, 162 (2001), pp. 20-40
[18.]
Oliván G. Maltreatment histories and mental health problems are common among runaway adolescents in Spain. Acta Paediatr. En prensa.
[19.]
P. Rohde, J.R. Seeley, D.E. Mace.
Correlates of suicidal behavior in a juvenile detention population.
Suicide Life Threat Behav, 27 (1997), pp. 164-175
[20.]
A. Conseur, F.P. Rivara, I. Emanuel.
Juvenile delinquency and adolescent trauma: How strong is the connection?.
Pediatrics, 99 (1997), pp. E5
[21.]
K. Hux, K. Hux, V. Bond, S. Skinner, D. Belan, D. Sanger.
Parental report of occurrences and consequences of traumatic brain injury among delinquent and non-delinquent youth.
Brain Inj, 12 (1998), pp. 667-681
[22.]
M. Stouthamer-Loeber, E.H. Wei.
The precursors of young fatherhood and its effect on delinquency of teenage males.
J Adolesc Health, 22 (1998), pp. 56-65
[23.]
D.K. Fast, J. Conry, C.A. Loock.
Identifying fetal alcohol syndrome among youth in the criminal justice system.
J Dev Behav Pediatr, 20 (1999), pp. 370-372
[24.]
C.R. McLaughlin, S.M. Reiner, P.N. Reams, T.F. Joost.
Factors associated with parenting among incarcerated juvenile offenders.
Adolescence, 34 (1999), pp. 665-670
[25.]
W. Halikias.
Forensic evaluations of adolescents: Psychosocial and clinical considerations.
Adolescence, 35 (2000), pp. 467-484
[26.]
J.H. Pincus.
Neurologic evaluation of violent juveniles.
Child Adolesc Psychiatr Clin North Am, 9 (2000), pp. 777-792
[27.]
R.E. Morris, E.A. Harrison, G.W. Knox, E. Tromanhauser, D.K. Marquis, L.L. Watts.
Health risk behavioral survey from 39 juvenile correctional facilities in the United States.
J Adolesc Health, 17 (1995), pp. 334-344
[28.]
B.K. Puri, M.T. Lambert, C.C. Cordess.
Characteristics of young offenders detained under section 53(2) at a young offenders' institution.
Med Sci Law, 36 (1996), pp. 69-76
[29.]
A.M. Fasher, N. Dunbar, B.A. Rothenbury, D.K. Bebb, S.J. Young.
The health of a group of young Australians in a New South Wales juvenile justice centre: A pilot study.
J Paediatr Child Health, 33 (1997), pp. 426-429
[30.]
J.D. Nesmith, L.V. Klerman, M.K. Oh, R.A. Feinstein.
Procreative experiences and orientations toward paternity held by incarcerated adolescent males.
J Adolesc Health, 20 (1997), pp. 198-203
[31.]
R.A. Feinstein, A. Lampkin, C.D. Lorish, L.V. Klerman, R. Maisiak, M.K. Oh.
Medical status of adolescents at time of admission to a juvenile detention center.
J Adolesc Health, 22 (1998), pp. 190-196
[32.]
D. Shelton.
Health status of young offenders and their families.
J Nurs Scholarsh, 32 (2000), pp. 173-178
[33.]
G. Oliván.
The health profile of Spanish incarcerated delinquent youths.
J Adolesc Health, 29 (2001), pp. 384
[34.]
M. Dolan, J. Holloway, S. Bailey, C. Smith.
Health status of juvenile offenders. A survey of young offenders appearing before the juvenile courts.
J Adolesc, 22 (1999), pp. 137-144
[35.]
R. Vermeiren, A. De Clippele, D. Deboutte.
A descriptive survey of Flemish delinquent adolescents.
J Adolesc, 23 (2000), pp. 277-285
[36.]
S.A. Lenssen, T.A. Doreleijers, M.E. Van Dijk, C.A. Hartman.
Girls in detention: What are their characteristics? A project to explore and document the character of this target group and the significant ways in which it differs from one consisting of boys.
J Adolesc, 23 (2000), pp. 287-303
[37.]
G. Oliván Gonzalvo.
Estado de salud y nutrición de mujeres adolescentes delincuentes.
An Esp Pediatr, 56 (2002), pp. 116-120
[38.]
G. Oliván Gonzalvo.
Estado de salud de jóvenes varones delincuentes.
Aten Primaria, 29 (2002), pp. 421-424
[39.]
B. Anderson, J.A. Farrow.
Incarcerated adolescents in Washington State. Health services and utilization.
J Adolesc Health, 22 (1998), pp. 363-367
[40.]
Oliván G. The health status of delinquent gipsy youths in Spain. Eur J Public Health. En prensa.
[41.]
G. Oliván Gonzalvo.
Consumo de tabaco, alcohol y drogas ilegales, actividad sexual y enfermedades infecciosas en adolescentes delincuentes.
An Esp Pediatr, 55 (2001), pp. 586
[42.]
S.J. Schoenthaler, I.D. Bier.
The effect of vitamin-mineral supplementation on juvenile delinquency among American schoolchildren: A randomized, double-blind placebo-controlled trial.
J Alter Complement Med, 6 (2000), pp. 31-35
[43.]
G. Oliván Gonzalvo.
Crecimiento y estado de nutrición de jóvenes varones delincuentes.
Rev Esp Pediatr, 57 (2001), pp. 436-439
[44.]
G. Oliván Gonzalvo.
Jóvenes gitanos delincuentes: crecimiento y estado de nutrición a su ingreso en un centro de reforma juvenil.
Med Clin (Barc), 118 (2002), pp. 117-118
[45.]
S.C. Thompson, E. Ogilvie, F. Veit, N. Crofts.
Serostatus for vaccine-preventable diseases in residents at Melbourne Juvenile Justice Centre.
Aust N Z J Public Health, 22 (1998), pp. 573-577
[46.]
E.L. Ogilvie, F. Veit, N. Crofts, S.C. Thompson.
Hepatitis infection among adolescents resident in Melbourne Juvenile Justice Centre: Risk factors and challenges.
J Adolesc Health, 25 (1999), pp. 46-51
[47.]
S.C. Thompson, E.L. Ogilvie, F.C. Veit, N. Crofts.
Juvenile offenders and hepatitis B: Risk, vaccine uptake and vaccination status.
Med J Aust, 169 (1998), pp. 306-309
[48.]
Teens in detention may be at risk for hepatitis C. National Library of Medicine. Medline Plus. Health Information. Disponible en: http://www.nlm.nih.gov/medlineplus/news/fullstory_6558.html - skip.
[49.]
R.E. Morris, C.J. Baker, M. Valentine, A.J. Pennisi.
Variations in HIV risk behaviors of incarcerated juveniles during a four-year period: 1989-1992.
J Adolesc Health, 23 (1998), pp. 39-48
[50.]
M.K. Oh, G.A. Cloud, L.S. Wallace, J. Reynolds, M. Sturdevant, R.A. Feinstein.
Sexual behavior and sexually transmitted diseases among male adolescents in detention.
Sex Trans Dis, 21 (1994), pp. 127-132
[51.]
C. Poulin, M. Alary, J. Ringuet, J.Y. Frappier, E. Roy, J. Lefebvre.
Prevalence of chlamydial infection and frequency of risk behaviours for STDs and HIV infection among adolescents in public juvenile facilities in the province of Quebec.
Can J Public Health, 88 (1997), pp. 266-270
[52.]
M.K. Oh, K.R. Smith, M. O' Cain, D. Kilmer, J. Johnson, E.W. Hook III.
Urine-based screening of adolescents in detention to guide treatment for gonococcal and chlamydial infections.
Arch Pediatr Adolesc Med, 152 (1998), pp. 52-56
[53.]
Centers for Disease Control and Prevention.
High prevalence of chlamydial and gonococcal infection in women entering jails and juvenile detention centers: Chicago, Birmingham and San Francisco, 1998.
MMWR Morb Mortal Wkly Rep, 48 (1999), pp. 793-796
[54.]
P.J. Kelly, R.M. Bair, J. Baillargeon, V. German.
Risk behaviors and the prevalence of Chlamydia in a juvenile detention facility.
Clin Pediatr (Phila), 39 (2000), pp. 521-527
[55.]
C.C. Breuner, J.A. Farrow.
Pregnant teens in prison: Prevalence, management, and consequences.
West J Med, 162 (1995), pp. 328-330
[56.]
M. Dolan, J. Holloway, S. Bailey, L. Kroll.
The psychosocial characteristics of juvenile sexual offenders referred to an adolescent forensic service in the UK.
Med Sci Law, 36 (1996), pp. 343-352
[57.]
J.A. Rosenblatt, A. Rosenblatt, E.E. Biggs.
Criminal behavior and emotional disorder: Comparing youth served by the mental health and juvenile justice systems.
J Behav Health Serv Res, 27 (2000), pp. 227-237
[58.]
R. Dembo.
On the poignant need for substance misuse services among youths entering the juvenile justice system.
Int J Addict, 30 (1995), pp. 747-751
[59.]
R. Loeber, M. Stouthamer-Loeber, H.R. White.
Developmental aspects of delinquency and internalizing problems and their association with persistent juvenile substance use between ages 7 and 18.
J Clin Child Psychol, 28 (1999), pp. 322-332
[60.]
C.B. Forrest, E. Tambor, A.W. Riley, M.E. Ensminger, B. Starfield.
The health profile of incarcerated male youths.
Pediatrics, 105 (2000), pp. 286-291
[61.]
R.J. Kosky, M.G. Sawyer, M. Fotheringham.
The mental health status of adolescents released from custody: A preliminary study.
Aust N Z Psychiatry, 30 (1996), pp. 326-331
[62.]
S.R. Pliszka, J.O. Sherman, M.V. Barrow, S. Irick.
Affective disorder in juvenile offenders: A preliminary study.
Am J Psychiatry, 157 (2000), pp. 130-132
[63.]
H. Steiner, I.G. Garcia, Z. Matthews.
Posttraumatic stress disorder in incarcerated juvenile delinquents.
J Am Acad Child Adolesc Psychiatry, 36 (1997), pp. 357-365
[64.]
E. Cauffman, S.S. Feldman, J. Waterman, H. Steiner.
Posttraumatic stress disorder among female juvenile offenders.
J Am Acad Child Psychiatry, 37 (1998), pp. 1209-1216
[65.]
J. Timmons-Mitchell, C. Brown, S.C. Schulz, S.E. Webster, L.A. Underwood, W.E. Semple.
Comparing the mental health needs of female incarcerated juvenile delinquents.
Behav Sci Law, 15 (1997), pp. 195-202
[66.]
H.A. Foley, C.O. Carlton, R.J. Howell.
The relationship of attention deficit hyperactivity disorder and conduct disorder to juvenile delinquency: Legal implications.
Bull Am Acad Psychiatry Law, 24 (1996), pp. 333-345
[67.]
D. Shelton.
Emotional disorders in young offenders.
J Nurs Scholarsh, 33 (2001), pp. 259-263
[68.]
S.H. Kataoka, B.T. Zima, D.A. Dupre, K.A. Moreno, X. Yang, J.T. McCracken.
Mental health problems and service use among female juvenile offenders: Their relationship to criminal history.
J Am Acad Child Adolesc Psychiatry, 40 (2001), pp. 549-555
[69.]
T.P. Ulzen, H. Hamilton.
The nature and characteristics of psychiatric comorbidity in incarcerated adolescents.
Can J Psychiatry, 43 (1998), pp. 57-63
[70.]
I. Svensson, I. Lundberg, C. Jacobson.
The prevalence of reading and spelling difficulties among inmates of institutions for compulsory care of juvenile delinquents.
Dyslexia, 7 (2001), pp. 62-76
[71.]
I. Richards.
Psychiatric disorder among adolescents in custody.
Aust N Z J Psychiatry, 30 (1996), pp. 788-793
[72.]
R. Dembo.
Problems among youths entering the juvenile justice system, their service needs and innovative approaches to address them.
Subst Use Misuse, 31 (1996), pp. 81-94
[73.]
T. Swaffe, C.R. Hollin.
Adolescents' experiences for anger in a residential setting.
J Adolesc, 20 (1997), pp. 567-575
[74.]
National Guideline Clearinghouse. Practice parameters for the assessment and treatment of children and adolescents with conduct disorder. Disponible en: http://www.guideline.gov/VIEWS/summary.asp?guideline = 000322∑mary_type = b rief_summary&view = brief_summary&sSearch_string = delin quency.
[75.]
National Guideline Clearinghouse. Screening and assessing adolescents for substance use disorders. Disponible en: http://www.guideline.gov/VIEWS/summary.asp?guideline http://www.guideline.gov/VIEWS/summary.asp?guideline = 001042∑mary_type = brief_summary&view = brief_summary&sSearch_string = delinquency.
[76.]
T. Mieczkowski, R. Newel, B. Wraight.
Using hair analysis, urinalysis, and self-report to estimate drug use in a sample of detained juveniles.
Subs Use Misuse, 33 (1998), pp. 1547-1567
[77.]
Screening Tests for Adolescents & Young Adults (Ages 13-29)(American Association for Clinical Chemistry). Disponible en: http://www.nlm.nih.gov/cgi/medlineplus/leavemedplus.pl?t heURL = http%3A%2F%2Fwww%2Elabtestsonline%2Eorg% 2Funderstanding%2Fwellness %2Fc %5Fyoungadult%2Ehtml.
[78.]
Comité Asesor de Vacunas (1998-2001), Asociación Española de Pediatría. Vacunas en adolescentes. En: Manual de Vacunas en Pediatría. Edición 2001; p. 407-16.
[79.]
J. Batalla, L. Urbiztondo, R. Guerrero.
Programas vacunales en las instituciones penitenciarias.
Vacunas 2001, pp. 131-137
[80.]
D.O. Lewis, C.A. Yeager, R. Lovely, A. Stein, C.S. Cobham-Portorreal.
A clinical follow-up of delinquents males: Ignored vulnerabilities, unmet needs, and the perpetuation of violence.
J Am Acad Child Adolesc Psychiatry, 33 (1994), pp. 518-528
[81.]
H. Steiner, E. Cauffman.
Juvenile justice, delinquency, and psychiatry.
Child Adolesc Psychiatr Clin North Am, 7 (1998), pp. 653-672
[82.]
T. Grisso, R. Barnum, K.E. Fletcher, E. Cauffman, D. Peuschold.
Massachusetts Youth Screening Instrument for mental health needs of juvenile justice youths.
J Am Acad Child Adolesc Psychiatry, 40 (2001), pp. 541-548
[83.]
T.K. Taylor, J.M. Eddy, A. Biglan.
Interpersonal skills training to reduce aggressive and delinquent behavior: Limited evidence and the need for an evidence-based system of care.
Clin Child Fam Psychol Rev, 2 (1999), pp. 169-182
[84.]
Y.M. Terry, C.J. Vander Wall, D.C. McBride, H. Van Duren.
Provision of drug treatment services in the juvenile justice system: A system reform.
J Behav Health Serv Res, 27 (2000), pp. 194-214
[85.]
D.D. Sanger, J.W. Creswell, J. Dworak, L. Schultz.
Cultural analysis of communication behaviors among juveniles in a correctional facility.
J Commun Disord, 33 (2000), pp. 31-57
[86.]
C.M. Borduin.
Multisystemic treatment of criminality and violence in adolescents.
J Am Acad Child Adolesc Psychiatry, 38 (1999), pp. 242-249
[87.]
C.A. Winters.
Learning disabilities, crime, delinquency, and special education placement.
Adolescence, 32 (1997), pp. 451-462
[88.]
C. Negy, D. Lachar, C.P. Gruber, N.D. Garza.
The Personality Inventory for Youth: Validity and comparability of English and Spanish versions for regular education and juvenile justice samples.
J Pers Assess, 76 (2001), pp. 250-263
[89.]
R. Vermeiren, A. De Clippele, D. Deboutte.
Eight month follow-up of delinquent adolescents: Predictors of short-term outcome.
Eur Arch Psychiatry Clin Neurosci, 250 (2000), pp. 133-138
[90.]
W.C. Myers, P.R. Burton, P.D. Sanders, K.M. Donat, J. Cheney, T.M. Fitzpatrick.
Project back-on-track at 1 year: A delinquency treatment program for early-career juvenile offenders.
J Am Acad Child Adolesc Psychiatry, 39 (2000), pp. 1127-1134
[91.]
N. Schlapman, P.S. Cass.
Project: HIV prevention for incarcerated youth in Indiana.
J Community Health Nurs, 17 (2000), pp. 151-158
[92.]
W.B. De Bruin, B. Fischhoff.
The effect of question format on measured HIV/AIDS knowledge: Detention center teens, high school students, and adults.
AIDS Educ Prev, 12 (2000), pp. 187-198
[93.]
N.L. Anderson, A. Nyamathi, J.A. Mc Avoy, F. Conde, C. Casey.
Perceptions about risk for HIV/AIDS among adolescents in B juvenile detention.
West J Nurs Res, 23 (2001), pp. 336-359
[94.]
A. Robertson, M.L. Levin.
AIDS knowledge, condom attitudes, and risk-taking sexual behavior of substance-abusing juvenile offenders on probation or parole.
AIDS Educ Prev, 11 (1999), pp. 450-461
[95.]
R. Loeber, D.P. Farrington.
Young children who commit crime: Epidemiology, developmental origins, risk factors, early interventions, and policy implications.
Dev Psychopathol, 12 (2000), pp. 737-762
[96.]
P. Kelly.
The dangerousness of youth-at-risk: The possibilities of surveillance and intervention in uncertain times.
J Adolesc, 23 (2000), pp. 463-476
[97.]
J.H. Laub, G.E. Vaillant.
Delinquency and mortality: A 50-year follow-up study of 1,000 delinquent and nondelinquent boys.
Am J Psychiatry, 157 (2000), pp. 96-102
[98.]
G. Bazemore, W.C. Terry.
Developing delinquent youths: A reintegrative model for rehabilitation and a new role for the juvenile justice system.
Child Welfare, 76 (1997), pp. 665-716
[99.]
E. Currie.
Sociologic perspectives on juvenile violence.
Child Adolesc Psychiatr Clin North Am, 9 (2000), pp. 749-763
Copyright © 2002. Asociación Española de Pediatría
