Common mental disorders among Indigenous people living in regional, remote and metropolitan Australia: a cross-sectional study

Nasir, Bushra F. and Toombs, Maree T. and Kondalsamy-Chennakesavan, Srinivas and Kisely, Steve and Gill, Neeraj S. and Black, Emma and Hayman, Noel and Ranmuthugala, Geetha and Beccaria, Gavin and Ostini, Remo and Nicholson, Geoffrey C. (2018) Common mental disorders among Indigenous people living in regional, remote and metropolitan Australia: a cross-sectional study. BMJ Open, 8 (6 - Article e020196). pp. 1-11.

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Objective: To determine, using face-to-face diagnostic interviews, the prevalence of common mental disorders (CMD) in a cohort of adult Indigenous Australians, the cultural acceptability of the interviews, the rates of comorbid CMD and concordance with psychiatrists’ diagnoses.

Design: Cross-sectional study July 2014–November 2016. Psychologists conducted Structured Clinical Interviews
for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision Axis I Disorders (SCID-I) (n=544). Psychiatrists interviewed a subsample (n=78).

Setting: Four Aboriginal Medical Services and the general community located in urban, regional and remote areas of Southern Queensland and two Aboriginal Reserves located in New South Wales.

Participants: Indigenous Australian adults.

Outcome measures: Cultural acceptability of SCID-I interviews, standardised rates of CMD, comorbid CMD and concordance with psychiatrist diagnoses.

Results: Participants reported that the SCID-I interviews were generally culturally acceptable. Standardised rates (95% CI) of current mood, anxiety, substance use and any mental disorder were 16.2% (12.2% to 20.2%), 29.2% (24.2% to 34.1%), 12.4% (8.8% to 16.1%) and 42.2% (38.8% to 47.7%), respectively—6.7-fold, 3.8-fold, 6.9- fold and 4.2-fold higher, respectively, than those of the Australian population. Differences between this Indigenous cohort and the Australian population were less marked for 12-month (2.4-fold) and lifetime prevalence (1.3-fold). Comorbid mental disorder was threefold to fourfold higher. In subgroups living on traditional lands in Indigenous reserves and in remote areas, the rate was half that of those living in mainstream communities. Moderate-to- good concordance with psychiatrist diagnoses was found.

Conclusions: The prevalence of current CMD in this Indigenous population is substantially higher than previous estimates. The lower relative rates of non-current disorders are consistent with underdiagnosis of previous events. The lower rates among Reserve and remote area residents point to the importance of Indigenous peoples’ connection to their traditional lands and culture, and a potentially important protective factor. A larger study with random sampling is required to determine the population prevalence of CMD in Indigenous Australians.

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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: Open access This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http:// creativecommons. org/licenses/ by- nc/ 4.0/ © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Faculty / Department / School: Current - Faculty of Health, Engineering and Sciences - School of Psychology and Counselling
Date Deposited: 07 Jan 2019 06:55
Last Modified: 14 Jan 2019 22:20
Uncontrolled Keywords: Indigenous; Australia; DSM; SCID
Fields of Research : 11 Medical and Health Sciences > 1199 Other Medical and Health Sciences > 119999 Medical and Health Sciences not elsewhere classified
11 Medical and Health Sciences > 1117 Public Health and Health Services > 111701 Aboriginal and Torres Strait Islander Health
17 Psychology and Cognitive Sciences > 1701 Psychology > 170109 Personality, Abilities and Assessment
11 Medical and Health Sciences > 1117 Public Health and Health Services > 111714 Mental Health
Socio-Economic Objective: C Society > 92 Health > 9202 Health and Support Services > 920209 Mental Health Services
Funding Details:
Identification Number or DOI: 10.1136/ bmjopen-2017-020196

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