Cuffe S P, Waller J L, Cuccaro M L, Pumariega A J, Garrison C Z
William S. Hall Psychiatric Institute, University of South Carolina School of Medicine, Columbia, USA.
J Am Acad Child Adolesc Psychiatry. 1995 Nov;34(11):1536-43. doi: 10.1097/00004583-199511000-00021.
Most children and adolescents with mental illness remain untreated. Evidence suggests that race is a factor in the referral of children for treatment. This study examines race and gender differences in treatment of adolescent psychiatric disorders.
During a two-stage, school-based, epidemiological study of depression, data were collected on 478 adolescents. Instruments included the Schedule for Affective Disorders and Schizophrenia for School-Age Children and the Children's Global Assessment Scale.
Twenty-two percent of the sample had contact with professionals during the prior year, including 56% of adolescents with a psychiatric diagnosis. Significant odds ratios (ORs) were found between all diagnoses and treatment. Trends for undertreatment of females and African-Americans were evident in univariable and multivariable models. The OR (0.34) for African-American females was significant in the multivariable model. African-Americans were significantly more likely to receive only one or two treatment contacts.
Data suggest race and gender differences in the treatment of adolescent psychiatric disorders. Possible explanations include referral bias, low cultural competence of mental health professionals, and cultural differences in the expression and tolerance of symptoms and help-seeking behaviors. Further study of factors influencing treatment decisions is needed.
大多数患有精神疾病的儿童和青少年仍未得到治疗。有证据表明，种族是儿童转诊接受治疗的一个因素。本研究考察青少年精神疾病治疗中的种族和性别差异。
在一项针对抑郁症的两阶段、基于学校的流行病学研究中，收集了478名青少年的数据。所使用的工具包括《学龄儿童情感障碍和精神分裂症量表》以及《儿童总体评定量表》。
22%的样本在之前一年与专业人员有过接触，其中包括56%患有精神疾病诊断的青少年。在所有诊断和治疗之间发现了显著的优势比（OR）。在单变量和多变量模型中，女性和非裔美国人治疗不足的趋势很明显。在多变量模型中，非裔美国女性的OR（0.34）具有显著性。非裔美国人显著更有可能只接受一两次治疗接触。
数据表明青少年精神疾病治疗中存在种族和性别差异。可能的解释包括转诊偏见、心理健康专业人员文化能力不足，以及症状表达、耐受性和求助行为方面的文化差异。需要进一步研究影响治疗决策的因素。
