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Mental Illness in US Latinos Addressed in Survey, Outreach Efforts

Mental Illness in US Latinos Addressed in Survey, Outreach Efforts

Early findings from a national study are shedding light on differences in the type and prevalence of mental disorders in US-born and immigrant Latinos, as well as differences among Latinos from various countries of origin.

US-born Latinos experience more psychiatric disorders than their immigrant parents, according to the National Latino and Asian American Study (NLAAS), a nationally representative community household survey that estimates the prevalence of mental disorders and rates of mental health service use by Latinos and Asian Americans in the United States.

Using data from the NLAAS, Alegría and associates1 examined lifetime and past-year prevalence rates of depressive, anxiety, and substance use disorders and overall psychiatric disorders in 4 Latino subgroups: Mexican, Puerto Rican, Cuban, and those of other Latino descent.

Immigrants appear to have lower rates of psychiatric disorders than third-generation Latinos in the United States, said Margarita Alegría, PhD, professor of psychiatry at Harvard Medical School and lead author of the article on prevalence. The lifetime prevalence of the selected psychiatric disorders for US-born Latinos is 36.8%, compared with 23.8% for foreign-born Latinos, and the past-year prevalence is 18.6% for those who were US-born and 13% for those who were foreign-born.2

The Latino portion of the NLAAS, Alegría told Psychiatric Times, is more comprehensive than some other national studies on Latinos and is particularly important because Latinos already account for 14% of the nation's total population and this will climb to 24% by 2050. The researchers used the World Health Organization's World Mental Health Composite International Diagnostic Interview to evaluate the prevalence rates of psychiatric disorders and conducted interviews in English or Spanish as needed.

Hypothesizing that contextual, social, and immigration factors may play significant roles in Latinos' risk of psychiatric disorders, the researchers examined possible correlates, including gender, ethnic subgroup, nativity, generational status, English-language proficiency, length of residence in the United States, and age at migration.

Differences by geographic origin
Overall lifetime psychiatric disorder prevalence estimates are similar for men (28.1%) and women (30.2%), but when subgroups were compared, differences emerged. Lifetime and past-year prevalence rates were highest for Puerto Ricans on the mainland.

"Puerto Ricans . . . tend to be higher in some disorders than the Cubans, Mexicans, or other Latino group, and they tend to have higher rates of anxiety disorders, in particular, posttraumatic stress disorder, compared to other ethnic groups," said Alegría, who also directs the Center for Multicultural Mental Health Research at Cambridge Health Alliance in Massachusetts.

Explanations for the elevated rates of past-year psychiatric disorders among Puerto Rican men and women in the report included the tendency to express illness symptoms differently from other Latinos; more exposure to traumatic events; higher rates of unemployment and underemployment than other US Latino groups; and overrepresentation of households headed by single women, who might be experiencing both gender role stress and separation from family members.

Relative to their Puerto Rican counterparts, Mexican men and women are less likely to have a history of depressive disorders and Cuban men are less likely to have a history of anxiety disorders or substance use disorders. Similarly, the odds of a history of substance use disorders are significantly lower for both Cuban and Mexican women than for Puerto Rican women.

Alegría explained that the lower rates of depressive disorders among Mexicans might be because they tend to be a very cohesive group that lives in enclaves throughout the United States. Consequently, they are able to sustain close relationships and not experience the erosion of family ties and networks.

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