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Ethnic Groups Differ in How Poor Self-Rated Mental Health Reflects Psychiatric Disorders

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Journal of Racial and Ethnic Health Disparities Aims and scope Submit manuscript

Abstract

Aim

This study aimed to explore cross-ethnic variation in the pattern of the associations between psychiatric disorders and self-rated mental health (SRMH) in the USA.

Methods

This cross-sectional study used data from the Collaborative Psychiatric Epidemiology Surveys (CPES), 2001–2003, a national household probability sample. The study enrolled 18,237 individuals who were either Non-Hispanic White (n = 7587), African American (n = 4746), Mexican (n = 1442), Cuban (n = 577), Puerto Rican (n = 495), Other Hispanic (n = 1106), Vietnamese (n = 520), Filipino (n = 508), Chinese (n = 600) or Other Asian (n = 656). SRMH was the outcome. Independent variables were psychiatric disorders including major depressive disorder [MDD], general anxiety disorder [GAD], social phobia, alcohol abuse, binge eating disorders, panic disorder, and post-traumatic stress disorder [PTSD], measured by the Composite International Diagnostic Interview (CIDI). Demographic (age and gender) and socioeconomic (education and income) factors were covariates.

Results

The only psychiatric disorder which was universally associated with SRMH across all ethnic groups was MDD. More psychiatric disorders were associated with poor SRMH in Non-Hispanic Whites than any other ethnic groups. Among African Americans, demographic and socioeconomic factors could fully explain the associations between psychiatric disorders and SRMH. Among Mexican and Other Hispanics, demographic and socioeconomic factors could only explain the association between some but not all psychiatric disorders and SRMH. In all other ethnic groups, demographic and socioeconomic factors did not explain the link between psychiatric disorders and SRMH.

Conclusion

Although SRMH is a useful tool for estimation of mental health needs of populations, poor SRMH may not have universal meanings across ethnically diverse populations. Ethnic groups differ in how their poor SRMH reflects psychiatric conditions and the role of demographic and socioeconomic factors in explaining such links. These ethnic differences may be a source of measurement bias in cross-ethnic health comparisons.

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Acknowledgements

This was a secondary analysis on public-access data set of the Collaborative Psychiatric Epidemiology Surveys (CPES). The CPES is mainly funded by the National Institute of Mental Health (NIMH), and has been conducted by the Institute of Social Research, University of Michigan. Data was downloaded from the Interuniversity Consortium for Political and Social Research (ICPSR), University of Michigan. Assari is supported by the Heinz C. Prechter Bipolar Research Fund and the Richard Tam Foundation at the University of Michigan Depression Center.

Funding Information

The Collaborative Psychiatric Epidemiology Survey (CPES) program consists of four cooperative agreement grants: U01 MH60220, P.I. Ronald Kessler; U01 MH57716, P.I. James Jackson; U01 MH62209, P.I. Margarita Alegria; and U01 MH62207, P.I. David Takeuchi.

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Authors and Affiliations

  1. Department of Psychiatry, School of Medicine, University of Michigan, Ann Arbor, MI, USA

    Shervin Assari

  2. Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA

    Shervin Assari

  3. Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA

    Shervin Assari

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Shervin Assari designed the current work, analyzed the data, and drafted the manuscript. He also revised the manuscript and confirmed the final draft.

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Correspondence to Shervin Assari.

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Informed consent was obtained from all individual participants included in the study. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of Interest

Shervin Assari declares that he has no conflicts of interest.

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Assari, S. Ethnic Groups Differ in How Poor Self-Rated Mental Health Reflects Psychiatric Disorders. J. Racial and Ethnic Health Disparities 5, 728–736 (2018). https://doi.org/10.1007/s40615-017-0417-2

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