The national center on indigenous Hawaiian behavioral health study of prevalence of psychiatric disorders in native Hawaiian adolescents

  • Andrade N
  • Hishinuma E
  • McDermott J
 et al. 
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Objectives: The prevalence rates of disorders among a community-based
sample of Hawaiian youths were determined and compared to previously
published epidemiological studies.
Method: Using a two-phase design, 7,317 adolescents were surveyed (60%
participation rate), from which 619 were selected in a modified random
sample during the 1992-1993 to 1995-1996 school years: 590 selected
randomly and 29 at risk (i.e., Center for Epidermologic
Studies-Depression score of 35 and suicidal risk) from grades 9-12. The
Diagnostic Interview Schedule for Children-Version 2.3, was used to
determine DSM-III-R diagnoses. Prevalence rates, weighted for ethnicity,
Center for Epidemiologic Studies-Depression scores, and suicide
attempts, were calculated for any diagnosis and various disorders.
Meta-analyses compared the Hawaii sample to four community-based studies
(randomly selected youths from community populations) and two high-risk
studies (homeless, low-income, or high unemployment communities).
Results: Hawaiian females had the highest rate for any diagnosis
(37.7%; 95% confidence interval {[}CI] 28.4%-48.0%) and non-Hawaiian
males had the lowest rate (19.6%; 95% Cl 14.8%-25.5%). Hawaiian
males (26.8%; 95% Cl 18.20/,37.5%) and non-Hawaiian females (27.9%;
95% Cl 22.2/34.4%) had intermediate and comparable rates. Overall,
Hawaiians had significantly higher rates (32.7%; 95% Cl 26.1%-40.1%)
than non-Hawaiians (23.7%; 95% Cl 19.9%-28.0%) when controlling for
gender, and girls had significantly higher rates (30.8%; 95% Cl
25.8%-36.3%) than boys (21.1%; 95% Cl 16.8%-26.1%) when
controlling for ethnicity. These findings were primarily the result of
the significant differences in rates regarding anxiety disorders.
Meta-analyses showed the Hawaiian youth rate for any diagnosis was
comparable to high-risk studies and nearly three times higher than the
community studies.
Conclusions: Hawaiian youths, especially females, are at high risk.
Research on the sociocultural factors that underpin both the genesis of
and protection from psychopathology is imperative for Hawaiian and
non-Hawaiian mixed-ethnicity youths.

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  • N N Andrade

  • E S Hishinuma

  • J F McDermott

  • R C Johnson

  • D A Goebert

  • G K Makini

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