Psychiatric disorders and mental health treatment in American Indians and Alaska Natives: results of the National Epidemiologic Survey on Alcohol and Related Conditions

Soc Psychiatry Psychiatr Epidemiol. 2016 Jul;51(7):1033-46. doi: 10.1007/s00127-016-1225-4. Epub 2016 May 2.

Abstract

Purpose: To examine the prevalence of common psychiatric disorders and associated treatment-seeking, stratified by gender, among American Indians/Alaska Natives and non-Hispanic whites in the United States. Lifetime and 12-month rates are estimated, both unadjusted and adjusted for sociodemographic correlates.

Method: Analyses were conducted with the American Indians/Alaska Native (n = 701) and Non-Hispanic white (n = 24,507) samples in the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions [(NESARC) n = 43,093].

Results: Overall, 70 % of the American Indian/Alaska Native men and 63 % of the women met criteria for at least one Diagnostic and Statistical Manual-IV lifetime disorder, compared to 62 and 53 % of Non-Hispanic white men and women, respectively. Adjusting for sociodemographic correlates attenuated the differences found. Nearly half of American Indians/Alaska Natives had a psychiatric disorder in the previous year; again, sociodemographic adjustments explained some of the differences found. Overall, the comparisons to non-Hispanic whites showed differences were more common among American Indian/Alaska Native women than men. Among those with a disorder, American Indian/Alaska Native women had greater odds of treatment-seeking for 12-month anxiety disorders.

Conclusion: As the first study to provide national estimates, by gender, of the prevalence and treatment of a broad range of psychiatric disorders among American Indians/Alaska Natives, a pattern of higher prevalence of psychiatric disorder was found relative to Non-Hispanic whites. Such differences were more common among women than men. Prevalence may be overestimated due to cultural limitations in measurement. Unmeasured risk factors, some specific to American Indians/Alaska Natives, may also partially explain these results.

Keywords: American Indian or Alaska Native; DSM-IV disorders; Non-Hispanic whites; Psychiatric epidemiology; Treatment-seeking.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Alaska / epidemiology
  • Alaska Natives / psychology
  • Alaska Natives / statistics & numerical data*
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / psychology
  • Diagnostic and Statistical Manual of Mental Disorders
  • Female
  • Humans
  • Indians, North American / psychology
  • Indians, North American / statistics & numerical data*
  • Male
  • Mental Disorders / epidemiology*
  • Mental Disorders / therapy
  • Mental Health Services / statistics & numerical data*
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Prevalence
  • Risk Factors
  • Sex Factors
  • Surveys and Questionnaires
  • United States / epidemiology
  • White People / psychology
  • White People / statistics & numerical data
  • Young Adult