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Co-occurrence of mental and physical illness in US Latinos

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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.

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Acknowledgements

This work was supported by National Institute of Mental Health grants U01-MH062209–05, R01-MH069849 and R01-MH54827 and National Heart Lung and Blood Institute grant U01-HL072519. We thank Dr. Zhun Cao for help in the data analysis, Dr. William Vega for useful comments on an earlier draft of the paper, and Mr. Bobby Kortright for help in formatting the paper.

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Authors and Affiliations

  1. Dept. of Health Services, University of California Los Angeles, School of Public Health, Box 951772, Los Angeles, CA, 90095-1772, USA

    Alexander N. Ortega PhD

  2. Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA

    Jonathan M. Feldman PhD

  3. Behavioral Sciences Research Institute, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico

    Glorisa Canino PhD

  4. Division of Health Behavior & Health Promotion, School of Public Health, Ohio State University, Columbus, OH, USA

    Kenneth Steinman PhD

  5. Center for Multicultural Mental Health Research, Dept. of Psychiatry, Cambridge Health Alliance and Harvard Medical School, Sommerville, MA, USA

    Margarita Alegría PhD

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  1. Alexander N. Ortega PhD
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Correspondence to Alexander N. Ortega PhD.

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Ortega, A.N., Feldman, J.M., Canino, G. et al. Co-occurrence of mental and physical illness in US Latinos. Soc Psychiat Epidemiol 41, 927–934 (2006). https://doi.org/10.1007/s00127-006-0121-8

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