Whitbeck Les B, Sittner Hartshorn Kelley J, Crawford Devan M, Walls Melissa L, Gentzler Kari C, Hoyt Dan R
Department of Sociology, 739 Oldfather Hall, University of Nebraska-Lincoln, Lincoln, NE, 68588-0324, USA,
Soc Psychiatry Psychiatr Epidemiol. 2014 Jun;49(6):961-73. doi: 10.1007/s00127-014-0825-0. Epub 2014 Feb 2.
Our objective was to investigate change in prevalence rates for mental and substance abuse disorders between early adolescence and young adulthood in a cohort of indigenous adolescents who participated in an 8-year panel study.
The data are from a lagged, sequential study of 671 indigenous adolescents (Wave 1) from a single culture in the Northern Midwest USA and Canada. At Wave 1 (mean age 11.3 years, Wave 4 (mean age 14.3 years), Wave 6 (mean age 16.2 years), and at Wave 8 (mean age 18.3 years) the tribally enrolled adolescents completed a computer-assisted personal interview that included DISC-R assessment for 11 diagnoses. Our yearly retention rates by diagnostic wave were: Wave 2, 94.7 %; Wave 4, 87.7 %; Wave 6, 88.0 %; Wave 8, 78.5 %.
The findings show a dramatic increase in lifetime prevalence rates for substance use disorders. By young adulthood, over half had met criteria of substance abuse or dependence disorder. Also at young adulthood, 58.2 % had met lifetime criteria of a single substance use or mental disorder and 37.2 % for two or more substance use or mental disorders. The results are compared to other indigenous diagnostic studies and to the general population.
A mental health crisis exists within the indigenous populations that participated in this study. Innovations within current mental health service systems are needed to address the unmet demand of adolescents and families.
我们的目的是调查参与一项为期8年的小组研究的一群本土青少年从青春期早期到青年期精神和药物滥用障碍患病率的变化。
数据来自对美国中西部北部和加拿大单一文化群体中671名本土青少年（第1波）的滞后序列研究。在第1波（平均年龄11.3岁）、第4波（平均年龄14.3岁）、第6波（平均年龄16.2岁）和第8波（平均年龄18.3岁）时，部落登记的青少年完成了一次计算机辅助个人访谈，其中包括对11种诊断的DISC-R评估。我们按诊断波次计算的年度保留率分别为：第2波，94.7%；第4波，87.7%；第6波，88.0%；第8波，78.5%。
研究结果显示物质使用障碍的终生患病率急剧上升。到青年期时，超过一半的人符合药物滥用或依赖障碍的标准。同样在青年期，58.2%的人符合单一物质使用或精神障碍的终生标准，37.2%的人符合两种或更多物质使用或精神障碍的终生标准。研究结果与其他本土诊断研究以及普通人群进行了比较。
参与本研究的本土人群中存在心理健康危机。需要对当前的心理健康服务系统进行创新，以满足青少年及其家庭未得到满足的需求。
