men ta l d is ord ers in t eena gers
method Data were drawn from 6,483 adolescent–parent pairs who
Clinical Guidance
participated in the National Comorbidity Survey Replication Adolescent Supplement, a national survey of adolescents
Food insecurity is associated with mood, anxiety, behavior,
13 to 17 years old. Frequency and severity of food insecurity
and substance disorders above and beyond the effects of
were assessed with questions based on the U.S. Department
other measures of SES in adolescents, suggesting that it
of Agriculture’s Food Security Scale (standardized to a mean
may be clinically useful to routinely inquire about hunger
of 0, variance of 1). DSM-IV mental disorders were assessed
in child and adolescent patients.
with the World Health Organization Composite International Diagnostic Interview. Associations of food insecurity with
Identifying children and adolescents in clinical care who
DSM-IV/Composite International Diagnostic Interview
experience recurrent hunger can be accomplished with
diagnoses were estimated with logistic regression models
a brief verbal assessment at each session.
controlling for family SES (parental education, household income, relative deprivation, community-level inequality,
Routinely assessing whether children and adolescents
and subjective social status).
in care are experiencing food insecurity provides the
results
at alleviating hunger and facilitating consistent access
opportunity to link families to social services aimed
Food insecurity was highest in adolescents with the
to food.
lowest SES. Controlling simultaneously for other aspects of SES, standardized food insecurity was associated with an increased odds of past-year mood, anxiety, behavior, and substance disorders. A 1-standard deviation increase in food insecurity was associated with a 14% increase in the odds of past-year mental disorder, even after controlling for extreme poverty. The association between food insecurity and mood disorders was strongest in adolescents living in families with a low household income and high relative deprivation.
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