title: Prevalence and comorbidity of mental disorders among American Indian children in the Northern Midwest.
abstract: OBJECTIVE
  To investigate the prevalence of mental disorder and comorbidity among American Indian children aged 10-12 years from four U.S. reservations and five Canadian reserves in the Northern Midwest.
  
  
  METHODS
  Specially trained Native interviewers administered the Diagnostic Interview for Children-Revised for 11 diagnostic categories to 736 tribally enrolled children (mean age 11 years) and their female caretakers.
  
  
  RESULTS
  Prevalence rates are reported by child self-report, female caretaker reports, and combined caretaker-child reports. Twenty-three percent (combined caretaker-child reports) of the children met criteria for one of the 11 disorders and 9% met criteria for two or more of the disorders. Externalizing disorders were more prevalent than internalizing disorders or substance abuse disorders. The strongest predictor of child mental disorder was a depressed female caretaker.
  
  
  CONCLUSIONS
  Nearly one-fourth of Native children met criteria for at least one mental disorder. The presence of early mental disorder is an important risk factor for substance use and mental health problems in later life. We need systematic research to identify risk and protective factors for early mental health problems and to identify barriers to services utilization so that we can develop empirically informed, culturally specific prevention programs that address these needs.
authors.affiliation: Department of Sociology, University of Nebraska at Lincoln, Lincoln, Nebraska 68588-0324, USA. lwhitbeck2@unlnotes.unl.edu
authors.forename: Les B
authors.initials: LB
authors.lastname: Whitbeck
authors.forename: Kurt D
authors.initials: KD
authors.lastname: Johnson
authors.forename: Dan R
authors.initials: DR
authors.lastname: Hoyt
authors.forename: Melissa L
authors.initials: ML
authors.lastname: Walls
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000208:ethnology; D002170:Canada / Q000453:epidemiology; D002648:Child; D015897:Comorbidity; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000208:ethnology*; D015999:Multivariate Analysis; D015995:Prevalence; D014481:United States / Q000453:epidemiology