The National Center on Indigenous Hawaiian Behavioral Health study of prevalence of psychiatric disorders in native Hawaiian adolescents.
OBJECTIVE
The prevalence rates of disorders among a community-based sample of Hawaiian youths were determined and compared to previously published epidemiological studies.


METHODS
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 >or=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.
Andrade
Naleen N
NN
National Center on Indigenous Hawaiian Behavioral Health, Department of Psychiatry, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, Hawai'i 96813, USA. andraden@dop.hawaii.edu
Hishinuma
Earl S
ES
McDermott
John F
JF
Johnson
Ronald C
RC
Goebert
Deborah A
DA
Makini
George K
GK
Nahulu
Linda B
LB
Yuen
Noelle Y C
NY
McArdle
John J
JJ
Bell
Cathy K
CK
Carlton
Barry S
BS
Miyamoto
Robin H
RH
Nishimura
Stephanie T
ST
Else
'Iwalani R N
'R
Guerrero
Anthony P S
AP
Darmal
Arsalan
A
Yates
Alayne
A
Waldron
Jane A
JA
D000046:Academic Medical Centers; D000293:Adolescent; D003710:Demography; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000208:ethnology* / Q000523:psychology; D044382:Population Groups / Q000523:psychology* / Q000706:statistics & numerical data*; D015995:Prevalence; D011795:Surveys and Questionnaires