Rollins School of Public Health, Department of Health Policy and Management, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
J Am Acad Child Adolesc Psychiatry. 2011 Feb;50(2):160-70. doi: 10.1016/j.jaac.2010.11.004. Epub 2010 Dec 31.
Little is known about racial/ethnic differences in the receipt of treatment for major depression in adolescents. This study examined differences in mental health service use in non-Hispanic white, black, Hispanic, and Asian adolescents who experienced an episode of major depression.
Five years of data (2004-2008) were pooled from the National Survey on Drug Use and Health to derive a nationally representative sample of 7,704 adolescents (12-17 years old) diagnosed with major depression in the past year. Racial/ethnic differences were estimated with weighted probit regressions across several measurements of mental health service use controlling for demographics and health status. Additional models assessed whether family income and health insurance status accounted for these differences.
The adjusted percentages of blacks (32%), Hispanics (31%), and Asians (19%) who received any treatment for major depression were significantly lower than those of non-Hispanic whites (40%; p < .001). Black, Hispanic, and Asian adolescents were also significantly less likely than non-Hispanic whites to receive prescription medication for major depression, to receive treatment for major depression from a mental health specialist or medical provider, and to receive any mental health treatment in an outpatient setting (p < .01). These differences persisted after adjusting for family income and insurance status.
Results indicated low rates of mental health treatment for major depression in all adolescents. Improving access to mental health care for adolescents will also require attention to racial/ethnic subgroups at highest risk for non-receipt of services.
对于青少年重度抑郁症的治疗,我们知之甚少种族/民族差异。本研究调查了经历重度抑郁症发作的非西班牙裔白种人、黑种人、西班牙裔和亚裔青少年在心理健康服务使用方面的差异。
从国家药物使用和健康调查中汇集了五年的数据(2004-2008 年),得出了一个具有全国代表性的样本,其中有 7704 名青少年(12-17 岁)在过去一年中被诊断患有重度抑郁症。通过加权概率回归,对几种心理健康服务使用的衡量指标进行了估计,控制了人口统计学和健康状况,以估计种族/民族差异。此外,模型还评估了家庭收入和健康保险状况是否解释了这些差异。
接受重度抑郁症任何治疗的黑人(32%)、西班牙裔(31%)和亚裔(19%)的调整后百分比明显低于非西班牙裔白人(40%;p<0.001)。与非西班牙裔白人相比,黑人、西班牙裔和亚裔青少年也明显不太可能接受抗抑郁处方药、接受心理健康专家或医疗提供者的治疗,以及在门诊环境中接受任何心理健康治疗(p<0.01)。在调整了家庭收入和保险状况后,这些差异仍然存在。
结果表明,所有青少年的重度抑郁症治疗率都很低。改善青少年心理健康服务的获取,还需要关注服务接受率最高的种族/民族亚群。