Prevalence and Patterning of Mental Disorder in Three Cohorts of Black and White Americans Through Adolescence

Abstract

The tendency for Blacks to report similar or lower rates of mental disorder than Whites is well-established. However, whether these disparities are stable across cohorts of Black and White Americans is not well understood. In the current study, we examined Black-White differences in the lifetime prevalence of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition mood, anxiety, impulse control, substance use and any disorders across 3 cohorts of Blacks and Whites aged 4 to 18. Using merged data from the National Comorbidity Survey Replication (2001-2003) and the National Comorbidity Survey Adolescent Supplement (2001-2004), we observed a change in the Black-White patterning of mental disorder between 1957 and 2004. Blacks born between 1957-1969 reported lower rates of anxiety disorders relative to their White counterparts (odds ratio (OR)=0.69, 95% confidence interval (CI): 0.52-0.91), Blacks born between 1970-1982 reported no difference in the rates of anxiety disorders relative to Whites (OR=0.97, 95% CI: 0.76-1.25), and Blacks born between 1983-1991 reported higher rates of anxiety disorders relative to Whites (OR=1.30, 95% CI: 1.18-1.43). Similar but less distinct trends were observed for mood, impulse control, and any disorders. Our results suggest that the Black-White patterning of mental disorder has changed across cohorts, to the disadvantage of Black Americans.