Lê Cook Benjamin, Carson Nicholas, Alegria Margarita
Harvard Medical School (Psychiatry) and Cambridge Health Alliance, USA.
J Health Care Poor Underserved. 2010 May;21(2 Suppl):49-66. doi: 10.1353/hpu.0.0289.
Individuals with early onset of psychiatric disorder have worse social outcomes than individuals with adult onset. It is unknown whether this association varies by racial/ ethnic group. Identifying groups at risk for poor social outcomes is important for improving clinical and policy interventions. We compared unemployment, high school dropout, arrest, and welfare participation by race/ethnicity and time of onset using a nationally representative sample of Whites, Blacks, Asians, and Latinos with lifetime psychiatric disorder. Early onset was associated with worse social outcomes than adult onset. Significant Black-White and Latino-White differences in social outcomes were identified. The association between early onset and negative social outcomes was similar across Whites, Latinos, and Blacks. For Asians, the association between unemployment and early onset was opposite that of Whites. Increasing early detection and treatment of psychiatric illness should be prioritized. Further study will clarify the association between onset and social outcomes among sub-ethnic populations.
患有早发性精神疾病的个体比成年后发病的个体具有更差的社会结局。尚不清楚这种关联是否因种族/族裔群体而异。识别出具有不良社会结局风险的群体对于改善临床和政策干预措施很重要。我们使用具有终生精神疾病的白人、黑人、亚洲人和拉丁裔的全国代表性样本,比较了种族/族裔和发病时间与失业、高中辍学、被捕和福利参与情况之间的关系。早发性比成年后发病与更差的社会结局相关。在社会结局方面发现了显著的黑人和白人以及拉丁裔和白人之间的差异。早发性与负面社会结局之间的关联在白人、拉丁裔和黑人中相似。对于亚洲人,失业与早发性之间的关联与白人相反。应优先加强对精神疾病的早期检测和治疗。进一步的研究将阐明亚族裔人群中发病与社会结局之间的关联。