Maltreatment in psychiatrically hospitalized dually diagnosed adolescent substance abusers

The medical charts of 150 consecutive admissions of dually diagnosed substance abusing adolescents admitted to a psychiatric hospital were examined to determine the extent and characteristics of maltreatment. Results indicated that 61% of the sample experienced or had a history that warranted suspicion of past and/or current maltreatment. Physical abuse was the most frequent form of maltreatment, followed by sexual abuse and neglect. Thirty-seven percent of patients experienced multiple forms of maltreatment. Maltreated patients had significantly more hospitalizations than their nonmaltreated counterparts on the same unit. Moreover, the age of maltreated patients was significantly lower than nonmaltreated patients, perhaps indicating an earlier age of onset of psychiatric illness and/or substance abuse. Analyses of parental substance abuse and psychiatric history among the maltreated and nonmaltreated groups revealed no significant findings. Results are discussed in terms of the following: (1) increased risk of subsequent substance abuse in maltreated children; (2) need for systematic assessment of child maltreatment in psychological or psychiatric evaluations; and (3) importance of treatment to deal with abuse or neglect as part of a comprehensive substance abuse intervention strategy.