Lehti Venla, Niemelä Solja, Hoven Christina, Mandell Donald, Sourander Andre
Department of Child Psychiatry, University of Turku, Turku, Finland.
Soc Sci Med. 2009 Oct;69(8):1194-203. doi: 10.1016/j.socscimed.2009.07.045. Epub 2009 Aug 21.
The Arctic has been a subject to various socio-cultural changes; indigenous people living in the region have experienced injustice and oppression in different forms. Furthermore, there are currently various new social, political and environmental challenges. It has been assumed that the continuous socio-cultural transition has an influence on indigenous people's wellbeing. We conducted a systematic literature review with regard to epidemiological mental health research on Arctic indigenous children and adolescents. The aim was to describe the nature and scope of research conducted and to explore for possible regional and ethnic differences in mental health. It was found that current epidemiological knowledge is based mainly on cross-sectional studies from selected regions and limited to substance use and suicidal behaviour. Youth suicide rates are alarmingly high in many parts of the Arctic, particularly in Greenland and Alaska. Differences between indigenous and non-indigenous groups are also most evident and uniform across suicide studies, with rates being systematically higher among indigenous youth. Substance use is common throughout the Arctic, however, regional and ethnic differences in usage vary considerably. Other psychosocial problems remain largely unexplored. In addition, very little is known about the causes of mental health problems in general and the impact of rapid socio-cultural changes in particular. There are several methodological limitations in the studies included here, many related to the validity of research instruments in different cultural contexts. There is a need for longitudinal comparative studies from the entire Arctic with culturally relevant instruments addressing mental health in early childhood as well.
北极地区经历了各种社会文化变迁；生活在该地区的原住民遭受了不同形式的不公正和压迫。此外，目前还面临着各种新的社会、政治和环境挑战。人们认为，持续的社会文化转型会影响原住民的福祉。我们针对北极地区原住民儿童和青少年的心理健康流行病学研究进行了一项系统的文献综述。目的是描述已开展研究的性质和范围，并探索心理健康方面可能存在的地区和种族差异。研究发现，当前的流行病学知识主要基于选定地区的横断面研究，且仅限于物质使用和自杀行为。北极地区许多地方的青少年自杀率高得惊人，尤其是在格陵兰岛和阿拉斯加。在自杀研究中，原住民和非原住民群体之间的差异也最为明显且一致，原住民青少年的自杀率普遍更高。物质使用在整个北极地区都很常见，然而，其使用情况在地区和种族上存在很大差异。其他心理社会问题在很大程度上仍未得到充分探索。此外，对于心理健康问题的总体原因，尤其是快速社会文化变革的影响，人们知之甚少。本文纳入的研究存在若干方法学上的局限性，其中许多与研究工具在不同文化背景下的有效性有关。需要在整个北极地区开展纵向比较研究，并使用与文化相关的工具来研究幼儿期的心理健康问题。
