Key demographic and mental disorder diagnostic differences between Australian First Nations and non-First Nations clinic-referred children and adolescents assessed in a culturally appropriate and safe way

• Published in: Australian & New Zealand Journal of Psychiatry
• Main Authors: Vance, Alasdair, Winther, Jo, McGaw, Janet, White, Selena
• Other Authors: Medical Research Future Fund Million Minds Program Grant
• Format: Article in Journal/Newspaper
• Language: English
• Published: SAGE Publications 2021
• Subjects: Indian; First Nations
• Online Access: http://dx.doi.org/10.1177/00048674211063819; http://journals.sagepub.com/doi/pdf/10.1177/00048674211063819; http://journals.sagepub.com/doi/full-xml/10.1177/00048674211063819

Objective: Increased point prevalence rates of oppositional defiant disorder and conduct disorder have been reported in American Indian and Canadian First Nations children and adolescents. To date, in Australia, there has been no published examination of standardized Diagnostic and Statistical Manual mental disorder diagnoses in First Nations children and adolescents, determined after addressing key cultural methodological issues. Methods: In all, 113 First Nations children and adolescents and 217 non-First Nations young people, aged 6–16 years, age, gender, mental disorder symptom severity, symptom-linked distress and impairment matched were recruited in a case control study. Also, 112 typically developing non-First Nations participants, age and gender matched to the other two clinical groups as a second comparison group were recruited. Diagnostic and Statistical Manual mental disorder diagnoses via semi-structured clinical interview, social adversity status and full scale IQ were determined in all participants with cultural validity and reliability of the impairing patterns of symptoms in First Nations young people determined by First Nations mental health staff and Aboriginal Health Liaison Officers. Full scale IQ and social adversity status were appropriately controlled in the Logistic Regression analyses of Diagnostic and Statistical Manual mental disorder diagnoses between the two clinical groups. Results: Oppositional defiant disorder was the only diagnostic and statistical manual mental disorder diagnosis that differed between the First Nations and non-First Nations clinical groups, adjusting for confounding by social adversity status and full scale IQ in the multivariable model. The point prevalence of oppositional defiant disorder was 2.94 times higher (95% confidence interval: 1.14–7.69) among the First Nations compared to the non-First Nations clinical group. Conclusion: Key known risk factors for oppositional defiant disorder can be identified early and holistically managed in First Nations young ...