Turner R Jay, Gil Andres G
Life Course and Health Research Center, Florida International University, University Park Campus, Deuxieme Maison (DM 243), Miami, FL 33199, USA.
Arch Gen Psychiatry. 2002 Jan;59(1):43-50. doi: 10.1001/archpsyc.59.1.43.
Prevalence rates of psychiatric and substance use disorders among young adults in South Florida are presented. Unique aspects of the study include the large sample size, its ethnic diversity, and the fact that a substantial proportion of Hispanic participants were foreign born.
This study builds on a previous cohort study of students who entered middle school in 1990. A random subsample of this representative cohort (N = 1803) was interviewed between 1998 and 2000 when most were between 19 and 21 years of age. Disorders were assessed through computer-assisted personal interviews utilizing the DSM-IV version of the Michigan Composite International Diagnostic Interview.
More than 60% of the sample met lifetime criteria for 1 or more study disorders, and 38% did so within the preceding year. Childhood conduct and major depressive and alcohol abuse disorders were the most prevalent. Although rates of affective and anxiety disorders in females were double that in males, this gender difference disappeared when attention-deficit/hyperactivity disorder, conduct disorders, and antisocial personality disorders were also considered (46.6% vs 45.7% for females vs males, respectively). Substantially lower rates were observed among African Americans for depressive disorders and substance abuse and dependence. Among Hispanics, rates tend to be lower among the foreign-born in comparison with their US-born counterparts, particularly for the substance disorders.
The documented presence of psychiatric and substance disorders in middle and high school populations emphasizes the importance of prevention efforts in school settings. Research on the origins of ethnic and nativity differences is called for.
本文呈现了南佛罗里达州年轻成年人中精神疾病和物质使用障碍的患病率。该研究的独特之处包括样本量大、种族多样性以及相当比例的西班牙裔参与者是外国出生这一事实。
本研究基于一项先前针对1990年进入中学的学生的队列研究。在1998年至2000年期间,对这个具有代表性队列的随机子样本(N = 1803)进行了访谈,当时大多数人年龄在19至21岁之间。通过使用密歇根综合国际诊断访谈的DSM-IV版本的计算机辅助个人访谈来评估疾病。
超过60%的样本符合一种或多种研究疾病的终生标准,38%的样本在过去一年符合标准。儿童期品行障碍、重度抑郁症和酒精滥用障碍最为普遍。尽管女性情感和焦虑障碍的患病率是男性的两倍,但当同时考虑注意力缺陷/多动障碍、品行障碍和反社会人格障碍时,这种性别差异消失了(女性为46.6%,男性为45.7%)。非裔美国人中抑郁症、物质滥用和依赖的患病率显著较低。在西班牙裔中,外国出生者的患病率往往低于在美国出生的同龄人,尤其是物质障碍方面。
在初中和高中人群中记录到的精神疾病和物质障碍的存在强调了在学校环境中开展预防工作的重要性。需要对种族和出生地差异的起源进行研究。