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

  • Andrade N
  • Hishinuma E
  • McDermott Jr. J
 et al. 
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Abstract

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 Epidemiologic 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 Hawai'i 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% CI 14.8%-25.5%). Hawaiian males (26.8%; 95% CI 18.2%-37.5%) and non-Hawaiian females (27.9%; 95% CI 22.2%-34.4%) had intermediate and comparable rates. Overall, Hawaiians had significantly higher rates (32.7%; 95% CI 26.1%-40.1%) than non-Hawaiians (23.7%; 95% CI 19.9%-28.0%) when controlling for gender, and girls had significantly higher rates (30.8%; 95% CI 25.8%-36.3%) than boys (21.1%; 95% CI 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. Copyright 2006 © American Academy of Child and Adolescent Psychiatry.

Author-supplied keywords

  • Academic Medical Centers
  • Adolescents
  • Center for Epidemiological Studies Depression Scal
  • Demography
  • Diagnostic Interview Schedule for Children-Version
  • Epidemiology
  • Hawaii
  • Humans
  • Mental Disorders
  • Native Hawaiians
  • Population Groups
  • Prevalence rates
  • Questionnaires
  • adolescent
  • adult
  • anxiety disorder
  • article
  • child psychiatry
  • confidence interval
  • controlled study
  • diagnostic and statistical manual of mental disord
  • ethnology
  • female
  • gender
  • homelessness
  • human
  • juvenile
  • lowest income group
  • major clinical study
  • male
  • mental disease
  • prevalence
  • priority journal
  • suicide attempt
  • unemployment

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Authors

  • N N Andrade

  • E S Hishinuma

  • J F McDermott Jr.

  • R C Johnson

  • D A Goebert

  • G K Makini Jr.

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