Prevalence of Mental Disorder and Service Use by Immigrant Generation and Race/Ethnicity Among US Adolescents
Prevalence of Mental Disorder and Service Use by Immigrant Generation and Race/Ethnicity Among US Adolescents
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DOI：
10.1016/j.jaac.2018.01.020
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发表时间：
2018-04-01
影响因子：
13.3
通讯作者：
Merikangas, Kathleen R.
中科院分区：
文献类型：
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作者：
Georgiades, Katholiki;Paksarian, Diana;Merikangas, Kathleen R.
目的：要检查的差异，在美国青少年的终身患病率的精神障碍和服务使用的移民一代和种族/ethnication.Method：共6,250名青少年年龄在13至18岁的国家科摩罗调查复制青少年补充进行了评估的终身患病率的情绪和/或焦虑症，行为障碍，精神卫生服务的使用。12组定义的自我认定的种族/民族（非西班牙裔白色，西班牙裔，非西班牙裔黑人，亚洲）和移民一代（第一，第二，第三，或更多）进行了compared.Results：移民一代和种族/民族共同考虑时，终生精神障碍的患病率的差异是最明显的。与第三代+非西班牙裔白色青少年相比，第二代亚裔青少年的情绪/焦虑障碍的几率增加（调整的比值比[AOR] = 2.51; 95% CI = 1.22-5.17）和第三代+西班牙裔（AOR = 1.28; 95% CI = 1.00-1.63），但在第一代亚洲人中降低（AOR = 0.27; 95% CI = 0.10-0.71）和第二代非西班牙裔白色青少年（AOR = 0.50; 95% CI = 0.30-0.81）。第一代亚裔（AOR = 0.26; 95%CI = 0.09-0.71）和所有代非西班牙裔黑人青少年（AOR范围0.43-0.55）中行为障碍的几率较低。调整终身障碍后，第一代西班牙裔和非西班牙裔白色青少年以及所有代非西班牙裔黑人青少年接受心理健康服务的可能性较小（AOR范围0.24-0.55）。移民世代和种族/民族的疾病风险差异强调了考虑社会，经济，青少年精神病理学病因学和治疗研究中的文化影响。较低的服务使用率，特别是在第一代移民青少年中，突出表明需要确定和解决移民和种族/少数民族背景的青少年中精神障碍的识别和治疗障碍。
Objective: To examine differences in lifetime prevalence of mental disorder and service use among U.S. adolescents by both immigrant generation and race/ethnicity.Method: A total of 6,250 adolescents aged 13 to 18 years in the National Comorbidity Survey Replication Adolescent Supplement were assessed for lifetime prevalence of mood and/or anxiety disorders, behavior disorders, and mental health service use. Twelve groups defined by self-identified race/ethnicity (non-Hispanic white, Hispanic, non-Hispanic black, Asian) and immigrant generation (first, second, third, or more) were compared.Results: Differences in prevalence of lifetime mental disorder were most apparent when immigrant generation and race/ethnicity were considered jointly. Compared to third+generation non-Hispanic white adolescents, the odds of mood/anxiety disorder were increased among second-generation Asian (adjusted odds ratio [AOR] = 2.51; 95% CI = 1.22-5.17) and third+generation Hispanic (AOR = 1.28; 95% CI = 1.00-1.63) but reduced among first-generation Asian (AOR = 0.27; 95% CI = 0.10-0.71) and second-generation non-Hispanic white adolescents (AOR = 0.50; 95% CI = 0.30-0.81). The odds of behavior disorder were lower among first-generation Asian (AOR = 0.26; 95% CI = 0.09-0.71) and all generations of non Hispanic black adolescents (AOR range 0.43-0.55). Adjusting for lifetime disorder, first-generation Hispanic and non-Hispanic white adolescents and all generations of non-Hispanic black adolescents were less likely to receive mental health services (AOR range 0.24-0.55).Conclusions: Variation in risk of disorder by immigrant generation and race/ethnicity underscores the importance of considering social, economic, and cultural influences in etiologic and treatment studies of adolescent psychopathology. Lower rates of service use, particularly among first-generation immigrant adolescents, highlight the need to identify and address barriers to recognition and treatment of mental disorders among adolescents from immigrant and racial/ethnic minority backgrounds.