Columbia University, New York; New York State Psychiatric Institute, Columbia University Medical Center.
Behavioral Sciences Research Institute, University of Puerto Rico School of Medicine, San Juan.
J Am Acad Child Adolesc Psychiatry. 2021 May;60(5):579-592. doi: 10.1016/j.jaac.2020.02.014. Epub 2020 Apr 11.
To estimate the prevalence of psychiatric disorders and their continuity since childhood among young adults from the same ethnic group living in 2 low-income contexts.
Young adults (N = 2,004; ages 15-29) were followed (82.8% retention) as part of the Boricua Youth Study, a study of Puerto Rican youths recruited at ages 5-13 in the South Bronx (SBx), New York, and Puerto Rico (PR). We estimated prevalence (lifetime; past year) of major depressive (MDD), mania, hypomania, generalized anxiety (GAD), tobacco dependence, and any other substance use disorders (SUD).
The prevalence of every disorder was higher among young women from the SBx compared with those from PR (eg, 9.2% versus 4.1% past-year SUD; 14% versus 6.8% for MDD/GAD). Among SBx young men, tobacco dependence and illicit SUD were elevated. Across both contexts, men had higher adjusted odds of illicit SUD than women, while women had higher GAD than men. MDD did not differ by gender. Young adulthood disorders (except for alcohol use disorder and GAD) followed childhood disorders. For example, childhood externalizing disorders preceded both MDD (young men and women) and illicit SUD (young women only).
Young women raised in a context where adversities like ethnic discrimination concentrate are at high risk for psychiatric disorders. In certain high-poverty contexts, young men may present with MDD as often as women. Interventions to prevent psychiatric disorders may need to address gender-specific processes and childhood disorders. However, SUD prevention among young men may need to address other factors.
评估生活在两个低收入环境中的同一族裔的年轻成年人的精神障碍患病率及其从儿童期延续至今的情况。
作为波多黎各青年研究的一部分，我们对 2004 名（82.8%的保留率）年龄在 15-29 岁的年轻人进行了随访。该研究招募了在纽约南布朗克斯（SBx）和波多黎各（PR）的 5-13 岁的波多黎各青少年。我们估计了主要抑郁障碍（MDD）、躁狂症、轻躁狂症、广泛性焦虑症（GAD）、烟草依赖和任何其他物质使用障碍（SUD）的终身（过去一年）患病率。
与来自 PR 的年轻人相比，来自 SBx 的年轻女性的每种障碍患病率更高（例如，过去一年 SUD 的患病率为 9.2%对 4.1%；MDD/GAD 的患病率为 14%对 6.8%）。在 SBx 的年轻男性中，烟草依赖和非法 SUD 发生率较高。在两个环境中，男性发生非法 SUD 的调整后比值比均高于女性，而女性的 GAD 则高于男性。MDD 与性别无关。成年早期的障碍（除了酒精使用障碍和 GAD）与儿童时期的障碍有关。例如，童年期的外化障碍先于 MDD（男性和女性）和非法 SUD（仅女性）。
在一个种族歧视等逆境集中的环境中长大的年轻女性患精神障碍的风险很高。在某些高贫困环境中，年轻男性出现 MDD 的频率可能与女性一样高。预防精神障碍的干预措施可能需要针对特定性别和儿童时期的障碍。然而，针对年轻男性的 SUD 预防可能需要解决其他因素。
