title: Psychiatric disorders and mental health treatment in American Indians and Alaska Natives: results of the National Epidemiologic Survey on Alcohol and Related Conditions.
abstract: 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.
  
  
  
  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].
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Division of Community Behavioral Health, Department of Psychiatry and Behavioral Sciences, University of New Mexico, MSC09 5030, 1 UNM, Albuquerque, NM, USA. MBraveHeart@salud.unm.edu.|New York State Psychiatric Institute, New York, NY, 87131-0001, USA. MBraveHeart@salud.unm.edu.
authors.forename: Maria Yellow Horse
authors.initials: MY
authors.lastname: Brave Heart
authors.affiliation: New York State Psychiatric Institute, New York, NY, 87131-0001, USA.|Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA.
authors.forename: Roberto
authors.initials: R
authors.lastname: Lewis-Fernández
authors.affiliation: Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: Janette
authors.initials: J
authors.lastname: Beals
authors.affiliation: New York State Psychiatric Institute, New York, NY, 87131-0001, USA.|Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA.|Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Hasin
authors.affiliation: New York State Psychiatric Institute, New York, NY, 87131-0001, USA.|School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Luisa
authors.initials: L
authors.lastname: Sugaya
authors.affiliation: New York State Psychiatric Institute, New York, NY, 87131-0001, USA.
authors.forename: Shuai
authors.initials: S
authors.lastname: Wang
authors.affiliation: National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA.
authors.forename: Bridget F
authors.initials: BF
authors.lastname: Grant
authors.affiliation: New York State Psychiatric Institute, New York, NY, 87131-0001, USA.|National Institute on Drug Abuse, Bethesda, MD, USA.
authors.forename: Carlos
authors.initials: C
authors.lastname: Blanco
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000413:Alaska / Q000453:epidemiology; D000072957:Alaska Natives / Q000523:psychology / Q000706:statistics & numerical data*; D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000523:psychology / Q000706:statistics & numerical data*; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000628:therapy; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult
keywords: American Indian or Alaska Native; DSM-IV disorders; Non-Hispanic whites; Psychiatric epidemiology; Treatment-seeking