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Prevalence of Mental Disorders from Adolescence Through Early Adulthood in American Indian and First Nations Communities

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Abstract

Indigenous communities lack representation in psychiatric epidemiology despite disproportionate exposure to risk factors. We document the cumulative and 12-month prevalence of psychiatric disorders across the early life course among a sample of Indigenous young adults and compare prospective and retrospective reporting of lifetime mental disorders. This community-based participatory research includes data from 735 Indigenous people from 8 reservations/reserves. Personal interviews were conducted between 2002–2010 and 2017–2018 totaling 9 waves; diagnostic assessments of DSM-IV-TR alcohol abuse/dependence, marijuana use/dependence, other substance abuse/dependence, generalized anxiety disorder, major depressive disorder, dysthymic disorder, and attention deficit/hyperactivity disorder occurred at waves 1 (mean age = 11.1 years), 4 (mean age = 14.3 years), 6 (mean age = 16.2 years), 8 (mean age = 18.3 years), and 9 (mean age = 26.3 years). Cumulative lifetime psychiatric disorders reached 77.3% and lifetime comorbidity 56.4% by wave 9. Past-year prevalence and comorbidity at wave 9 were 28.7% and 6.7%, respectively. Substance use disorders (SUDs) were most common with peak past-year prevalence observed when participants were on average 16.3 years old then declining thereafter. Trends in early life course psychiatric disorders in this study with Indigenous participants highlight cultural variations in psychiatric epidemiology including surprisingly low rates of internalizing disorders in the face of risk factors, disproportionately high rates of early-onset and lifetime SUD, and lower rates of past-year SUD in early adulthood compared with prior research.

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Notes

  1. N = 11 families enrolled at wave 1 of the study in two remote First Nations communities but were not re-interviewed at subsequent waves and thus are excluded from the current sampling frame (i.e., we did not attempt to contact them for inclusion in the longitudinal study).

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Acknowledgments

The Healing Pathways team includes David Bruyere, Laura Bruyere, Annabelle Jourdain, Priscilla Simard, Trisha Bruyere, Jake Becker, Laureen Bruyere, Frances Whitfield, GayeAnn Allen, Tina Handeland, Victoria Soulier, Bagwajikwe Madosh, Betty Jo Graveen, Clinton Isham, Carol Jenkins, Bill Butcher Jr., Delores Fairbanks, Devin Fineday, Bernadette Gotchie, Gloria Mellado, Christina Howard Marilyn Bowstring, Gary Charwood, Gina Stender, Roberta Roybal, Jim Bedeau, Kathy Dudley, Geraldine Brun, June Holstein, Frances Miller, Brenna Pemberton, Ed Strong, Barbara Thomas, Charity Prentice-Pemberton, FaLeisha Jourdain, Penny King, Valerie King, Linda Perkins, Christie Prentice, Gabe Henry, Howard Kabestra, Dallas Medicine, Glenn Cameron, Jackie Cameron, Gerilyn Fisher, Virginia Pateman, Irene Scott, Cindy McDougall, Whitney Accobee Celeste Cloud, Pat Moran, Stephanie Williams, Natalie Bergstrom, Bonnie Badboy, Elizabeth Kent, Sue Trnka, and Laurie Vilas.

Funding

The research reported in this manuscript was supported by the National Institute on Drug Abuse of the National Institutes of Health under Award Number R01 DA039912 (M. Walls, PI). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Department of International Health; Center for American Indian Health, Johns Hopkins University, 1915 South Street, Duluth, MN, 55812, USA

    Melissa Walls, Kaley Herman, Miigis Gonzalez & Jessica H. L. Elm

  2. Department of Sociology, Oklahoma State University, Stillwater, OK, USA

    Kelley J. Sittner

  3. Department of Sociology, University of Nebraska-Lincoln, Lincoln, NE, USA

    Les B. Whitbeck & Dan R. Hoyt

  4. Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA

    Dane Hautala

  5. Department of Family Medicine & Biobehavioral Health, University of Minnesota Medical School, Duluth Campus, Duluth, MN, USA

    Melinda Dertinger

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  1. Melissa Walls
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Correspondence to Melissa Walls.

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Walls, M., Sittner, K.J., Whitbeck, L.B. et al. Prevalence of Mental Disorders from Adolescence Through Early Adulthood in American Indian and First Nations Communities. Int J Ment Health Addiction 19, 2116–2130 (2021). https://doi.org/10.1007/s11469-020-00304-1

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