马尼托巴省原住民儿童的心理健康:利用关联管理数据进行的基于人口的回顾性队列研究。

IF 3.3 3区 医学 Q2 PSYCHIATRY
Mariette J Chartier, Marni Brownell, Leona Star, Nora Murdock, Rhonda Campbell, Wanda Phillips-Beck, Mabel Horton, Chelsey Meade, Wendy Au, Jennifer Schultz, John-Michael Bowes, Brooke Cochrane
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引用次数: 0

摘要

目的:由于家庭和社会因素,原住民儿童比其他普通儿童面临更高的精神障碍风险,但有关他们心理健康的研究却很少。本研究将生活在保留地内和保留地外的原住民儿童与生活在马尼托巴省的所有其他儿童的确诊精神障碍和自杀行为进行了比较:由原住民和非原住民研究人员组成的研究小组利用基于人口的行政数据,将 2016 年原住民研究档案中的去标识化个人记录与马尼托巴省儿童的健康和社会信息联系起来。采用广义线性建模方法计算了精神障碍和自杀行为的调整率和比率,对原住民儿童(n = 40,574 人)和所有其他儿童(n = 197,109 人)进行了比较,并对居住在保留地内和保留地外的原住民儿童进行了比较:结果:与所有其他儿童相比,原住民儿童的精神分裂症患病率更高(调整率比(aRR)为 4.42,95% 置信区间为 0.5):4.42,95% 置信区间 (CI):3.36 至 5.82)、注意力缺陷多动障碍(ADHD;aRR:1.21,95% 置信区间 (CI):1.09 至 1.33)、药物使用障碍(aRR:5.19;95% 置信区间 (CI):4.25 至 6.33)、自杀未遂住院(aRR:6.96;95% 置信区间 (CI):4.36 至 11.13)和自杀死亡(aRR:10.63;95% 置信区间 (CI):7.08 至 15.95)。生活在保留地外的原住民儿童多动症和情绪/焦虑症的发病率明显高于生活在保留地内的原住民儿童;相比之下,生活在保留地内的原住民儿童自杀未遂的住院率是生活在保留地外的原住民儿童的两倍。当对比人群仅限于低收入地区的其他儿童时,原住民儿童在几乎所有疾病中的患病率仍然较高:结论:在马尼托巴省,原住民儿童和其他儿童的心理健康指标存在巨大差异,这表明要改善原住民儿童的心理健康,还需要做大量的工作。我们迫切需要公平地获得文化上安全的服务,这些服务应由原住民自主决定、规划和实施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Mental Health of First Nations Children in Manitoba: A Population-Based Retrospective Cohort Study Using Linked Administrative Data: La santé mentale des enfants des Premières Nations au Manitoba : une étude de cohorte rétrospective dans la population, à l'aide de données administratives liées.

Objective: First Nations children face a greater risk of experiencing mental disorders than other children from the general population because of family and societal factors, yet there is little research examining their mental health. This study compares diagnosed mental disorders and suicidal behaviours of First Nations children living on-reserve and off-reserve to all other children living in Manitoba.

Method: The research team, which included First Nations and non-First Nations researchers, utilized population-based administrative data that linked de-identified individual-level records from the 2016 First Nations Research File to health and social information for children living in Manitoba. Adjusted rates and rate ratios of mental disorders and suicide behaviours were calculated using a generalized linear modelling approach to compare First Nations children (n = 40,574) and all other children (n = 197,109) and comparing First Nations children living on- and off-reserve.

Results: Compared with all other children, First Nations children had a higher prevalence of schizophrenia (adjusted rate ratio (aRR): 4.42, 95% confidence interval (CI), 3.36 to 5.82), attention-deficit hyperactivity disorder (ADHD; aRR: 1.21, 95% CI, 1.09 to 1.33), substance use disorders (aRR: 5.19; 95% CI, 4.25 to 6.33), hospitalizations for suicide attempts (aRR: 6.96; 95% CI, 4.36 to 11.13) and suicide deaths (aRR: 10.63; 95% CI, 7.08 to 15.95). The prevalence of ADHD and mood/anxiety disorders was significantly higher for First Nations children living off-reserve compared with on-reserve; in contrast, hospitalization rates for suicide attempts were twice as high on-reserve than off-reserve. When the comparison cohort was restricted to only other children in low-income areas, a higher prevalence of almost all disorders remained for First Nations children.

Conclusion: Large disparities were found in mental health indicators between First Nations children and other children in Manitoba, demonstrating that considerable work is required to improve the mental well-being of First Nations children. Equitable access to culturally safe services is urgently needed and these services should be self-determined, planned, and implemented by First Nations people.

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来源期刊
CiteScore
7.00
自引率
2.50%
发文量
69
审稿时长
6-12 weeks
期刊介绍: Established in 1956, The Canadian Journal of Psychiatry (The CJP) has been keeping psychiatrists up-to-date on the latest research for nearly 60 years. The CJP provides a forum for psychiatry and mental health professionals to share their findings with researchers and clinicians. The CJP includes peer-reviewed scientific articles analyzing ongoing developments in Canadian and international psychiatry.
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