Whitbeck Les B, Hoyt Dan, Johnson Kurt, Chen Xiaojin
Department of Sociology, University of Nebraska-Lincoln, 739 Oldfather Hall, Lincoln, NE 68588-0324, USA.
Soc Psychiatry Psychiatr Epidemiol. 2006 Aug;41(8):632-40. doi: 10.1007/s00127-006-0070-2. Epub 2006 Jun 15.
This study reports prevalence and comorbidity of five DSM-III-R diagnoses (alcohol abuse, alcohol dependence, drug abuse, major depressive episode, and generalized anxiety disorder) among American Indian and Canadian First Nations parents/caretakers of children aged 10-12 years from the Northern Midwest United States and Canada. Lifetime prevalence rates were compared to adults in the National Comorbidity Survey (NCS) and Southwest and Northern Plains cultures from the AI-SUPERPFP study.
Native interviewers used computer-assisted personal interviews to administer the University of Michigan Composite International Diagnostic Interview (UM-CIDI) to 861 tribally enrolled parents and caretakers (625 females; 236 males) of 741 tribally enrolled children aged 10-12 years. Fathers/male caretakers ranged in age from 21 years to 68 years with an average age of 41 years; mothers/female caretakers ranged in age from 17 years to 77 years with an average of 39 years.
About three-fourths (74.6%) of the adults met lifetime criteria for one of the five disorders; approximately one-third (31.6%) met lifetime criteria for two or more of the five disorders. Prevalence of the substance use disorders was higher than those in the general population (NCS); prevalence of internalizing disorders (major depressive disorder and generalized anxiety disorder) was very similar to those in the general population. Prevalence rates for alcohol abuse among the Northern Midwest adults were higher than those reported for Southwest and Northern Plains Tribes, but rates of alcohol dependency were very similar across cultures.
The higher prevalence rates for some mental disorders found for the Northern Midwest are discussed in terms of potential method variance. The Northern Midwest results reflect unique patterns of psychiatric disorders in the ubiquity of substance abuse disorders and the co-occurrence of substance abuse disorders with internalizing disorders. Reducing lifetime occurrences of substance abuse disorders would have an enormous positive impact on the mental health of this population.
本研究报告了美国印第安人和加拿大第一民族中，来自美国中西部北部和加拿大的10至12岁儿童的父母/照料者中，五种《精神疾病诊断与统计手册第三版修订版》（DSM-III-R）诊断（酒精滥用、酒精依赖、药物滥用、重度抑郁发作和广泛性焦虑障碍）的患病率及共病情况。将终生患病率与全国共病调查（NCS）中的成年人以及AI-SUPERPFP研究中的西南和北部平原文化中的成年人进行了比较。
由本土访谈员使用计算机辅助个人访谈，对741名部落登记在册的10至12岁儿童的861名部落登记在册的父母和照料者（625名女性；236名男性）进行密歇根大学综合国际诊断访谈（UM-CIDI）。父亲/男性照料者年龄在21岁至68岁之间，平均年龄为41岁；母亲/女性照料者年龄在17岁至77岁之间，平均年龄为39岁。
约四分之三（74.6%）的成年人符合五种疾病之一的终生标准；约三分之一（31.6%）符合五种疾病中两种或更多种的终生标准。物质使用障碍的患病率高于一般人群（NCS）；内化障碍（重度抑郁症和广泛性焦虑障碍）的患病率与一般人群非常相似。中西部北部成年人中酒精滥用的患病率高于西南和北部平原部落报告的患病率，但不同文化中酒精依赖的患病率非常相似。
就潜在的方法差异而言，讨论了中西部北部发现的一些精神障碍的较高患病率。中西部北部的结果反映了精神疾病的独特模式，即物质滥用障碍普遍存在，且物质滥用障碍与内化障碍同时出现。减少物质滥用障碍的终生发生率将对该人群的心理健康产生巨大的积极影响。
