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American Indian Depression Study

American Indian Depression Study



James Shore, MD; Spero Manson, Ph.D.

James Shore, MD; Spero Manson, Ph.D.



This study sought to develop diagnostic instrumentation by which to reliably and validly identify depression in American Indian communities in order to answer 2 major questions: 

  1. How is depression conceptualized and experienced by American Indians; and
  2. to what extent is this view similar to those of other cultural groups?



This project utilized a case-control design to determine the psychometric properties and performance characteristics of state-of-the-art diagnostic protocols (DIS and SADS-L) when used with members of this special population.  This study also elicited the cultural constructions of ADM disorders in these communities, blending them with DSM-III diagnostic criteria in an attempt to improve the cultural relevance of the protocols in question.



Conducted among the Hopi, Blackfeet, and Confederate tribes of the Warm Springs Indian Reservations (Wasco, Sahaptin, and Paiute), the participants were 26.9% (n=53) male; 4.6%(9) were < 20 years old, 25.4% (n=50) 20-29 years old, 23.8% (n=47) 30-39 years old, 27.4% (n=54) 40-49 years old, 11.2% (n=22) 50-59 years old, and 7.6 % (n=15) were 60 + years old.


  1. Center for Epidemiologic Studies Depression Scale (CES-D)
  2. Diagnostic Interview Schedule
  3. Schedule for Affective Disorders and Schizophrenia, lifetime version (SADS-L)
  4. Depression
  5. Alcohol use
  6. Somatization
  7. Demographic information


Manson, S.M., Shore, J.H., Bloom, J.D., Keepers, G., & Neligh, G. (1987).  Alcohol abuse and major affective disorders: Advances in epidemiologic research among American Indians.  In D. Spicer et al. (Eds.), The Epidemiology of Alcohol Use and Abuse Among U.S. Ethnic Minority Groups.  National Institute of Alcohol Abuse and Alcoholism Monographs.  Washington, D.C.: U.S. Government Printing Office.

Manson, S.M., Shore, J.H., & Bloom, J.D. (1985).  The depressive experience in American  Indian Communities: A challenge for Psychiatric theory and diagnosis.  In A. Kleinman & B. Good (Eds.), Culture and depression: Studies in the anthropology and cross-cultural psychiatry of affect and disorder.  Berkeley: University of California Press.

Manson, S. M. (1994). Culture and depression: Discovering variations in the experience of illness. In W. J. Lonner & R. S. Malpass (Eds.), Psychology and culture (pp. 285-290). Needham, MA: Allyn and Bacon.

Manson, S. M. (1995). Culture and major depression: Current challenges in the diagnosis of mood disorders. Psychiatric Clinics of North America, 18(3), 487-501.

Manson, S. M. (1995). Mental health status and needs of the American Indian and Alaska Native elderly. In D. Padgett (Ed.), Handbook on ethnicity, aging and mental health (pp. 132-141). Westport, CT: Greenwood Press.

Shore, J.M., Manson, S.M., Bloom, J.D., Keepers, G., & Neligh, G. (1987).  A pilot study of depression among American Indian patients with research diagnostic criteria.  American Indian and Alaska Native Mental Health Research, 1(2). 4-15.

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