THE NATURAL-HISTORY OF MEDICAL AND PSYCHIATRIC-DISORDERS IN AN AMERICAN-INDIAN COMMUNITY

In 1969, a Pacific Northwest American Indian community cohort (n = 100 ) was interviewed for the presence of physical and psychiatric illness es. Tle same community was studied again in 1988. This study describes the outcome among the original 100 subjects. The schedule for Affecti ve Disorders and Schizophrenia Lifetime Version (SADS-L) served as the basic interview instrument, supplemented by data from medical records , death certificates, and medical and community informants. Twenty-fiv e subjects had died, 13 from cardiovascular disorders and seven from a lcohol-related illnesses. Among the 46 subjects re-interviewed, hypert ension, heart disease, and diabetes had become significant sources of medical morbidity. Alcoholism was the most significant cause of psychi atric morbidity, particularly among males. This study indicates that g reater attention should be focused upon prevention and treatment of al coholism, cardiovascular disorders, and diabetes in this community and in other American Indian populations.