Association of Family Income Supplements in Adolescence With Development of Psychiatric and Substance Use Disorders in Adulthood Among an American Indian Population
Association of Family Income Supplements in Adolescence With Development of Psychiatric and Substance Use Disorders in Adulthood Among an American Indian Population
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DOI：
10.1001/jama.2010.621
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发表时间：
2010-05-19
影响因子：
120.7
通讯作者：
Angold, Adrian
中科院分区：
文献类型：
--
作者：
Costello, E. Jane;Erkanli, Alaattin;Angold, Adrian
在一项自然实验中，一些家庭获得收入补贴，青少年行为症状的患病率显着下降。这些青少年现在是年轻的成年人。目的研究收入补贴在青春期和成年期对成人精神疾病患病率的影响。设计准实验，纵向。人口和设置一个有代表性的样本的儿童年龄为9，11，或13岁（其中349人[25%]是美国印第安人）进行了精神和物质使用障碍的评估，直到21岁（1993-2006年）。在1993年参加调查的1420人中，有1185人作为成年人接受了采访。从1996年开始，当印第安人保留地开设赌场时，每个美国印第安人（但没有非印第安人）都获得了从500美元增加到9000美元左右的年收入补贴。主要结果测量基于3个年龄组的精神疾病诊断和统计手册的成人精神疾病和物质使用障碍的患病率，调整了年龄，性别，在家庭中的时间长度，结果作为成年人，印度人比非印度人明显更少有精神疾病（106名印度人[加权30.2%] vs 337名非印度人[加权36.0%];比值比[OR]，0.46; 95%置信区间[CI]，0.30-0.72; P= 0.001），特别是酒精和大麻滥用，依赖，或两者兼而有之。印度青年中最年轻的年龄组接触家庭收入的时间最长。种族/民族和年龄队列之间的相互作用是显着的。计划中的比较显示，在最年轻的印度年龄组中，（31.4%）高于印度中部队列（41.7%; OR，0.43; 95% CI，0.24-0.78; P= 0.005）或年龄最大的队列（41.3%; OR，0.69; 95% CI，0.51-0.94; P=.01）或最年轻的非印度队列（37.1%; OR，0.66; 95% CI，0.48-0.90; P=.008）。研究假设没有支持尼古丁或其他药物，或情绪或行为障碍。在成年后收到的收入补充没有影响成人psychopathology.Conclusion较低的患病率在美国印第安青年以下的家庭收入补充，与nonexposed，非印度人口，持续到成年。JAMA. 2010; 303（19）：1954-1960年
Context In a natural experiment in which some families received income supplements, prevalence of adolescent behavioral symptoms decreased significantly. These adolescents are now young adults.Objective To examine the effects of income supplements in adolescence and adulthood on the prevalence of adult psychiatric disorders.Design Quasi-experimental, longitudinal.Population and Setting A representative sample of children aged 9, 11, or 13 years in 1993 (349 [25%] of whom are American Indian) were assessed for psychiatric and substance use disorders through age 21 years (1993-2006). Of the 1420 who participated in 1993, 1185 were interviewed as adults. From 1996, when a casino opened on the Indian reservation, every American Indian but no non-Indians received an annual income supplement that increased from $500 to around $9000.Main Outcome Measures Prevalence of adult psychiatric disorders and substance use disorders based on the Diagnostic and Statistical Manual of Mental Disorders in 3 age cohorts, adjusted for age, sex, length of time in the family home, and number of Indian parents.Results As adults, significantly fewer Indians than non-Indians had a psychiatric disorder (106 Indians [weighted 30.2%] vs 337 non-Indians [weighted 36.0%]; odds ratio [OR], 0.46; 95% confidence interval [CI], 0.30-0.72; P=.001), particularly alcohol and cannabis abuse, dependence, or both. The youngest age-cohort of Indian youth had the longest exposure to the family income. Interactions between race/ethnicity and age cohort were significant. Planned comparisons showed that fewer of the youngest Indian age-cohort had any psychiatric disorder (31.4%) than the Indian middle cohort (41.7%; OR, 0.43; 95% CI, 0.24-0.78; P=.005) or oldest cohort (41.3%; OR, 0.69; 95% CI, 0.51-0.94; P=.01) or the youngest non-Indian cohort (37.1%; OR, 0.66; 95% CI, 0.48-0.90; P=.008). Study hypotheses were not upheld for nicotine or other drugs, or emotional or behavioral disorders. The income supplement received in adulthood had no impact on adult psychopathology.Conclusion Lower prevalence of psychopathology in American Indian youth following a family income supplement, compared with the nonexposed, non-Indian population, persisted into adulthood. JAMA. 2010; 303(19): 1954-1960