Co-Occurring DisordersCo-Occurring DisordersBest Practices and AdolescentBest Practices and Adolescent

Mary Jane Alumbaugh, Ph.DMary Jane Alumbaugh, Ph.D

Co-Occurring Disorders at Co-Occurring Disorders at Intake: CSATIntake: CSAT

74%

59%

48%

36%

22%

28%

67%

48%

36%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Any Co-Occuring Disorder

Conduct Disorder

ADHD

Depressive Disorder

Anxiety Disorder

Traumatic Stress Disorder

Lifetime victimization

Acute victimization

Victimization in past 90 days

Co-Occurring Disorders at Co-Occurring Disorders at Intake: SOCIntake: SOC

Comorbidity By Referral Comorbidity By Referral SourceSource

Subset of CSAT sample (data from 1285 youth assessed between 1998 and 2001 with complete referral source and diagnosis

Comorbidity by Referral Source

7.5%

1.6%

1.0%

13.4%

2.0%

49.2%

16.1%

3.3%

5.9%

6.4%

3.0%

1.7%

6.0%

3.8%

57.3%

13.2%

3.5%

5.1%

0.0% 20.0% 40.0% 60.0% 80.0% 100.0%

School

Mental Health

Physical Health

Soc Serv./Child Welfare

Drug Abuse Program

Criminal Justice

Caregiver

Self

Other

Not Comorbid with SA(n=305)

Comorbid with SA (n=980)

* Referral Source is self-reported, 6 sites did not ask this item.

Patterns of Referral Source for Patterns of Referral Source for YouthYouth

With/Without ComorbiditySubset of CMHS SOC data of 10,194 youth with complete data on diagnosis and

referral source

Average Scores of Child Behavioral and Emotional Problems* for children with Co-occurring substance use problems at Intake, 6

Months, and 12 Months

Internalizing and Externalizing Scores:

Internalizing: n=101; F(3,98)=1396, P<.001.Externalizing: n=101; F(3,98)=1706, P<.001.* Child behavioral and emotional problems were measured by the CBCL (Child Behavior Checklist). Clinical range for internalizing and externalizing scores is between 60 and 63, while clinical range for the eight syndrome scales is between 67 and 70.

110.9

96.590

128.1

112100

0

40

80

120

160

200

240

Intake 6 Months 12 Months

Avera

ge T

ota

l C

AF

AS

Scale

Sco

re

Children without Cooccuring substance use problems

Children with Cooccuring substance useproblems

Data Collection Points

Average Score of Child Functional Impairment* for children with and without Co-occurring substance use problems at Intake, 6

Months and 12 Months

Children with Co-occurring substance use problems: n = 98; F(3,95)=243.1, p<.001.Children without Co-occurring substance use problems: n = 2099; F(3,2096)=4677, p<.001.* Child functional impairment was measured by the CAFAS (Child and Adolescent Functional Assessment Scale).