Prevalence of Psychiatric Morbidity and Alcohol use Disorders Among Adolescent Indigenous Tribals from Three Indian States.

Background: Among the Indian adolescents, the prevalence of psychiatric morbidity and alcohol use disorders (AUD) are 7.3% and 1.3%. However, no separate data are available for indigenous tribal populations. This study estimated the prevalence of psychiatric morbidity and AUD and associated socio-demographic factors among adolescents in the tribal communities in three widely varying states in India. Methods: Using validated Indian versions of the MINI 6.0, MINI Kid 6.0, and ICD-10 criteria, we conducted a cross-sectional survey from January to May 2019 in three Indian sites: Valsad, Gujarat (western India); Nilgiris, Tamil Nadu (south India); and East Khasi Hills district of Meghalaya (north-east India) on 623 indigenous tribal adolescents. Results: Aggregate prevalence of any psychiatric morbidity was 15.9% (95% CI: 13.1-19.0) (males: 13.6%, 95% CI: 10.0-18.1; females: 17.9%, 95% CI: 13.9-22.6), with site-wise statistically significant differences: Gujarat: 23.8% (95% CI: 18.1-30.2), Meghalaya: 17.1% (95% CI: 12.4-22.7), Tamil Nadu: 6.2% (95% CI: 3.2-10.5). The prevalence of diagnostic groups was mood disorders 6.4% (n = 40), neurotic- and stress-related disorders 9.1% (n = 57), phobic anxiety disorder 6.3% (n = 39), AUD 2.7% (n = 17), behavioral and emotional disorders 2.7% (n = 17), and obsessive-compulsive disorder 2.2% (n = 14). These differed across the sites. Conclusion: The prevalence of psychiatric morbidity in adolescent tribals is approximately twice the national average. The most common psychiatric morbidities reported are mood (affective) disorders, neurotic- and stress-related disorders, phobic anxiety disorder, AUD, behavioral and emotional disorders, andobsessive-compulsive disorder.

A Three-Site Study of Alcohol Consumption among Adolescents from Indigenous Tribes in India.

BACKGROUND: Alcohol use disorder is elevated among members of indigenous tribes in India, like native populations in several other countries. Despite constituting 8.6% of the Indian population, tribals are among the most geographically isolated, socioeconomically underdeveloped, and underserved communities in the country. Based on the experience from our centers (in Tamil Nadu, Meghalaya, and Gujarat), we are aware of escalating alcohol use among tribal communities. The aims of this study are (a) to estimate alcohol use and psychiatric morbidity among teenagers from indigenous tribes, and (b) pilot test a psychoeducational efficacy study. METHODS: The biphasic study is being conducted in three states of India: Tamil Nadu in South, Meghalaya in Northeast, and Gujarat in West. Phase 1 is a cross-sectional study of tribal adolescents at each site. The MINI 6.0/MINI Kid 6.0 questionnaire was used to estimate extent of psychiatric morbidity and substance addiction. Phase 2 is an intervention trial of 40 participants at each site to assess the effectiveness of NIMHANS LSE module in protecting the tribal adolescents from alcohol use. CONCLUSIONS: The desired primary outcome will be forestalling the onset of alcohol use among this group. This paper focuses on the methodology and strategies to be used to achieve the objectives.

Sexuality and 'silence' among Khasi youth of Meghalaya, Northeast India.

The importance of sex education has been well documented in the literature, but there exists a lack of research involving indigenous youth in India. This paper describes perceptions, knowledge and attitudes towards sex education, sexuality, pre-marital sex, rape and homosexuality among indigenous students from the matrilineal Khasi tribe attending a university in Meghalaya in northeast India. Qualitative and quantitative data were collected during and after reproductive health, sexuality and life skills courses. Despite the impression of sexual permissiveness of indigenous peoples that exists in India, students reported a societal silence on issues related to sexuality. Lack of appropriate words in the indigenous language potentially contributes to this silence. Although co-habitation is common and culturally acceptable, students disapproved of pre-marital sex. The influence of Christianisation was also perceived in the frequent reference to sin and guilt associated with masturbation, homosexuality, pre-marital sex and abortion. Students reported that the sex education received in school was 'childish' and inadequate for their adult needs. Many had unrealistic images of what constituted 'normal' sex and also blamed women for rape. The majority of indigenous students expressed the need for non-judgmental fora for discussions on sexual health and for sexuality education.