Prevalence of mental disorders and utilization of mental health services in two American Indian reservation populations: Mental health disparities in a national context
Prevalence of mental disorders and utilization of mental health services in two American Indian reservation populations: Mental health disparities in a national context
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DOI：
10.1176/appi.ajp.162.9.1723
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发表时间：
2005-09-01
影响因子：
17.7
通讯作者：
Manson, SM
中科院分区：
文献类型：
--
作者：
Beals, J;Novins, DK;Manson, SM
目的：美国印第安人服务利用、精神病学流行病学、风险和保护因素项目（AI-SUPERPFP）提供了美国印第安人人群中DSM-III-R疾病的患病率和帮助这些疾病的服务利用率的估计值。1997年至1999年期间完成的AI-SUPERPFP旨在将调查结果与1990年至1992年进行的反映美国一般人口的基线全国科摩罗调查的结果进行比较。共有3，084名部落成员（西南部落1,446人，638年在北方平原部落）15岁-54年的生活或附近的家庭保留采访了适应密歇根大学复合国际诊断访谈。9 DSM-III-R疾病的寿命和12个月的患病率进行了估计，寻求帮助的精神疾病症状的模式进行了examined.Results：最常见的终身诊断在美国印第安人的人口是酒精依赖，创伤后应激障碍（PTSD），和抑郁症发作。与NCS结果相比，所有美洲印第安人样本的终生PTSD发生率较高，除西南部女性外，所有人的终生酒精依赖发生率较高，北方平原男性和女性的终生重度抑郁发作发生率较低。12个月利率的差异较小。考虑到人口统计学变量的差异后，与NCS样本相比，两个美国印第安人样本的PTSD和酒精依赖风险较高，但重度抑郁发作的风险较低。美国印第安人男性比那些在NCS更有可能寻求专业提供者的物质使用问题的帮助;美国印第安人女性不太可能与非专业提供者谈论情感问题。寻求帮助，从传统的治疗师是常见的，在美国印第安人的人口，特别是在Southwest.Conclusions：结果表明，这些美国印第安人的人口有可比性，在某些情况下，更大的心理健康服务需求，与美国的一般人口相比。
Objective: The American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project (AI-SUPERPFP) provided estimates of the prevalence of DSM-III-R disorders and utilization of services for help with those disorders in American Indian populations. Completed between 1997 and 1999, the AI-SUPERPFP was designed to allow comparison of findings with the results of the baseline National Comorbidity Survey (NCS), conducted in 1990-1992, which reflected the general United States population.Method: A total of 3,084 tribal members ( 1,446 in a Southwest tribe and 1,638 in a Northern Plains tribe) age 15-54 years living on or near their home reservations were interviewed with an adaptation of the University of Michigan Composite International Diagnostic Interview. The lifetime and 12-month prevalences of nine DSM-III-R disorders were estimated, and patterns of help-seeking for symptoms of mental disorders were examined.Results: The most common lifetime diagnoses in the American Indian populations were alcohol dependence, posttraumatic stress disorder (PTSD), and major depressive episode. Compared with NCS results, lifetime PTSD rates were higher in all American Indian samples, lifetime alcohol dependence rates were higher for all but Southwest women, and lifetime major depressive episode rates were lower for Northern Plains men and women. Fewer disparities for 12-month rates emerged. After differences in demographic variables were accounted for, both American Indian samples were at heightened risk for PTSD and alcohol dependence but at lower risk for major depressive episode, compared with the NCS sample. American Indian men were more likely than those in NCS to seek help for substance use problems from specialty providers; American Indian women were less likely to talk to nonspecialty providers about emotional problems. Help-seeking from traditional healers was common in both American Indian populations and was especially common in the Southwest.Conclusions: The results suggest that these American Indian populations had comparable, and in some cases greater, mental health service needs, compared with the general population of the United States.