Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
Department of Preventive Medicine and Biostatistics, Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, MD 20817, USA.
Mil Med. 2022 Jul 1;187(7-8):e969-e977. doi: 10.1093/milmed/usab326.
Mental health disparities and differences have been identified amongst all age groups, including adolescents. However, there is a lack of research regarding adolescents within the Military Health System (MHS). The MHS is a universal health care system for military personnel and their dependents. Research has indicated that the MHS removes many of the barriers that contribute to health disparities. Additional investigations with this population would greatly contribute to our understanding of disparities and health services delivery without the barrier of access to care.
This study analyzed the diagnostic trends of anxiety, depression, and impulse control disorders and differences within a national sample of adolescents of active-duty military parents. The study utilized 2006 to 2014 data in the MHS Data Repository for adolescents ages 13-18. The study identified 183,409 adolescents with at least one diagnosis. Multivariable logistic regressions were conducted to assess the differences and risks for anxiety, depression, and impulse control disorders in the identified sample.
When compared to White Americans, minority patients had a higher likelihood of being diagnosed with an impulse control disorder (odds ratio [OR] = 1.43; confidence interval [CI] 1.39-1.48) and a decreased likelihood of being diagnosed with a depressive disorder (OR = 0.98; CI 0.95-1.00) or anxiety disorder (OR = 0.80; CI 0.78-0.83). Further analyses examining the subgroups of minorities revealed that, when compared to White Americans, African American adolescents have a much higher likelihood of receiving a diagnosis of an impulse control disorder (OR = 1.66; CI 1.61-1.72) and a lower likelihood of receiving a diagnosis of a depressive disorder (OR = 0.93; CI 0.90-0.96) and an anxiety disorder (OR = 0.75; CI 0.72-0.77).
This study provides strong support for the existence of race-based differences in adolescent mental health diagnoses. Adolescents of military families are a special population with unique experiences and stressors and would benefit from future research focusing on qualitative investigations into additional factors mental health clinicians consider when making diagnoses, as well as further exploration into understanding how best to address this special population's mental health needs.
心理健康差异和差距在所有年龄段都存在,包括青少年。然而,在军事卫生系统(MHS)中,针对青少年的研究却很少。MHS 是为军事人员及其家属提供的普遍医疗保健系统。研究表明,MHS 消除了导致健康差异的许多障碍。对这一人群进行更多的研究将极大地促进我们对差异和卫生服务提供的理解,而不会因获得护理的障碍而受到影响。
本研究分析了全国现役军人父母的青少年群体中焦虑、抑郁和冲动控制障碍的诊断趋势和差异。该研究利用 MHS 数据存储库中的 2006 年至 2014 年数据,对 13-18 岁的青少年进行了研究。该研究确定了 183409 名至少有一个诊断的青少年。采用多变量逻辑回归评估了所识别样本中焦虑、抑郁和冲动控制障碍的差异和风险。
与美国白人相比,少数民族患者更有可能被诊断为冲动控制障碍(优势比 [OR] = 1.43;置信区间 [CI] 1.39-1.48),而被诊断为抑郁障碍(OR = 0.98;CI 0.95-1.00)或焦虑障碍(OR = 0.80;CI 0.78-0.83)的可能性较低。进一步分析少数民族亚组发现,与美国白人相比,非裔美国青少年更有可能被诊断为冲动控制障碍(OR = 1.66;CI 1.61-1.72),而被诊断为抑郁障碍(OR = 0.93;CI 0.90-0.96)和焦虑障碍(OR = 0.75;CI 0.72-0.77)的可能性较低。
本研究为青少年心理健康诊断中存在基于种族的差异提供了有力支持。军人家庭的青少年是一个具有独特经历和压力源的特殊群体,他们将受益于未来的研究,重点关注定性调查,以了解心理健康临床医生在做出诊断时考虑的其他因素,以及进一步探索如何满足这一特殊群体的心理健康需求。