Prevalence of DSM-IV disorders and attendant help-seeking in 2 American Indian reservation populations
Prevalence of DSM-IV disorders and attendant help-seeking in 2 American Indian reservation populations
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DOI：
10.1001/archpsyc.62.1.99
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发表时间：
2005-01-01
影响因子：
--
通讯作者：
Mitchell, CM
中科院分区：
文献类型：
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作者：
Beals, J;Manson, SM;Mitchell, CM
背景资料：美国印第安人服务利用、精神病流行病学、危险和保护因素项目（AI-SUPERPFP）估计了选定的美国印第安人保留地社区的心理健康负担和相关的求助。目的：为了确定常见DSM-IV疾病的终生和12个月患病率，其人口统计学相关性，和寻求帮助的模式在2个不同文化的美国印第安人保留社区在西南和北方平原。设计：1997年至2000年完成的一项横断面概率抽样调查。地点：一般社区。参与者：三千八十四（西南部= 1 446人，北方平原= 1 638人），年龄15-54岁，从部落名册中随机抽取了2个居住在其家园保留地或附近的部落群体。西南平原和北方平原部落的应答率分别为73.7%和76.8%，respectively.Main Outcomes Measures：AI-SUPERPFP复合国际诊断访谈，密歇根大学版本的复合国际诊断访谈的文化适应版本，以评估DSM-IV诊断和寻求帮助。AI-SUPERPFP DSM-IV疾病的总体终生患病率范围从西南女性的35.7%到两组男性的近50%。酗酒和酒精依赖是男性最常见的疾病，创伤后应激障碍在女性中最为普遍。许多终生酗酒或创伤后应激障碍的人不再符合12个月诊断的标准。抑郁和/或焦虑与物质障碍之间存在显著的共病水平。除种族、性别和年龄外，其他人口统计学相关因素通常与疾病状态无关。大多数患有终生障碍的参与者都曾向心理健康专业人员、其他医务人员或文化传统来源寻求帮助。结论：酒精障碍和创伤后应激障碍在这些美洲印第安人群体中比使用类似方法的其他群体更常见。抑郁和/或焦虑与物质障碍之间的实质性共病表明需要更好地协调共病障碍的治疗。
Background: The American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project (AI-SUPERPFP) estimated the mental health burden and associated help-seeking in select American Indian reservation communities.Objective: To determine the lifetime and 12-month prevalence of common DSM-IV disorders, their demographic correlates, and patterns of help-seeking in 2 culturally distinct American Indian reservation communities in the Southwest and Northern Plains.Design: Completed between 1997 and 2000, a cross-sectional probability sample survey.Setting: General community.Participants: Three thousand eighty-four (South-west= 1446 and Northern Plains= 1638) members, aged 15-54 years, of 2 tribal groups living on or near their home reservations were randomly sampled from the tribal rolls. Response rates were 73.7% and 76.8% for the Southwest and Northern Plains tribes, respectively.Main Outcomes Measures: The AI-SUPERPFP Composite International Diagnostic Interview, a culturally adapted version of the University of Michigan version of the Composite International Diagnostic Interview, to assess DSM-IV diagnoses and help-seeking.Results: Overall lifetime prevalence of AI-SUPERPFP DSM-IV disorders ranged from 35.7% for Southwest women to near 50% for both groups of men. Alcohol abuse and dependence were the most common disorders for men, with posttraumatic stress disorder most prevalent for women. Many of those with lifetime alcohol problems or posttraumatic stress disorder no longer met criteria for 12-month diagnoses. Significant levels of comorbidity were found between those with depressive and/or anxiety and substance disorders. Demographic correlates other than tribe, sex, and age were generally unrelated to disorder status. A majority of participants with lifetime disorders had sought help from mental health professionals, other medical personnel, or culturally traditional sources.Conclusions: Alcohol disorders and posttraumatic stress disorder were more common in these American Indian populations than in other populations using comparable methods. Substantial comorbidity between depressive and/ or anxiety and substance disorders suggests the need for greater coordination of treatment for comorbid disorders.