ORIGINAL PAPER

Social Psychiatry and Psychiatric Epidemiology

, Volume 41, Issue 12, pp 927-934

First online:

Co-occurrence of mental and physical illness in US Latinos

  • Alexander N. OrtegaAffiliated withDept. of Health Services, University of California Los Angeles, School of Public Health Email author 
  • , Jonathan M. FeldmanAffiliated withFerkauf Graduate School of Psychology, Yeshiva University
  • , Glorisa CaninoAffiliated withBehavioral Sciences Research Institute, University of Puerto Rico Medical Sciences Campus
  • , Kenneth SteinmanAffiliated withDivision of Health Behavior & Health Promotion, School of Public Health, Ohio State University
  • , Margarita AlegríaAffiliated withCenter for Multicultural Mental Health Research, Dept. of Psychiatry, Cambridge Health Alliance and Harvard Medical School

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Abstract

Background

This study describes the prevalence of comorbid physical and mental health problems in a national sample of US Latinos. We examined the co-occurrence of anxiety and depression with prevalent physical chronic illnesses in a representative sample of Latinos with national origins from Mexico, Cuba, Puerto Rico, and other Latin American countries.

Method

We used data on 2,554 Latinos (75.5% response rate) ages 18 years and older from the National Latino and Asian American Study (NLAAS). The NLAAS was based on a stratified area probability sample design, and the sample came from the 50 states and Washington, DC. Survey questionnaires were delivered both in person and over the telephone in English and Spanish. Psychiatric disorders were assessed using the World Mental Health Survey Initiative version of the World Health Organization Composite International Diagnostic Interview (WMH-CIDI). Physical chronic illness was assessed by self-reported history.

Results

Puerto Ricans had the highest prevalence of meeting criteria for any comorbid psychiatric disorder (more than one disorder). Puerto Ricans had the highest prevalence (22%) of subject-reported asthma history, while Cubans had the highest prevalence (33%) of cardiovascular disease. After accounting for age, sex, household income, number of years in the US, immigrant status, and anxiety or depression, anxiety was associated with diabetes and cardiovascular disease, in the entire sample. Depression and co-occurring anxiety and depression were positively associated with having a history of asthma but not with other physical diseases, in the entire sample. Interestingly, Puerto Ricans with a depressive disorder had a lower odds of having a history of cardiovascular disease than Puerto Ricans without a depressive disorder. The relationship between chronic physical and mental illness was not confounded by immigration status or number of years in the US.

Discussion

Despite previous findings that link acculturation with both chronic physical and mental illness, this study does not find that number of years in the US nor nativity explain the prevalence of psychiatric-medical comorbidities. This study demonstrates the importance of considering psychiatric and medical comorbidity among specific ethnic groups, as different patterns emerge than when using aggregate ethnic measures. Research is needed on both the pathways and the mechanisms of comorbidity for the specific Latino groups.

Key words

comorbidity Hispanic Americans Latinos mental health physical illness medical chronic disease