| U.S.-Born Mexican Americans and Non-Hispanic
Whites at Increased Risk for Psychiatric Disorders
Findings Raise New Questions About Influence of Culture
According to the results of a National Institutes of Health (NIH)
study, reported in the December issue of the Archives of General
Psychiatry (Volume 61), Mexican Americans and non-Hispanic
Whites* born in the United States have
a higher risk for developing psychiatric disorders than their foreign-born
counterparts who have immigrated to the United States. The psychiatric
disorders included alcohol and drug use disorders, major depression,
dysthymia, mania, hypomania, panic disorder, social and specific
phobia, and general anxiety disorder.
Based on the 2001-2002 National Epidemiologic Survey on Alcohol
and Related Conditions (NESARC), the analysis is the first
to consider immigration status in conjunction with psychiatric morbidity
in each of four comparison groups: U.S.-born Mexican Americans,
Mexican immigrants to the United States, U.S.-born non-Hispanic
Whites, and non-Hispanic White* immigrants
to the United States. Earlier studies compared psychiatric disorder
rates among U.S.- and foreign-born Mexican Americans to either rates
for U.S.-born non-Hispanic Whites or rates for the entire U.S. population,
thereby confounding immigration status and ethnicity.
"The remarkable pattern seen in these results defies explanation
based on current knowledge," according to George Kunos, M.D.,
Ph.D., Scientific Director, Division of Intramural Biological and
Clinical Research at the National Institute on Alcohol Abuse and
Alcoholism (NIAAA), the NIH institute that conducted the study.
"Additional careful research is required to fully understand
the influences of individual and environmental factors in the causes
of psychiatric disorders."
"As often occurs, our epidemiologists researchers who study
conditions and behaviors across large population groups pose new
and intriguing questions for researchers in other disciplines,"
he said. "Although it may be some time before scientists fully
understand the causes of these disorders, service providers and
policy makers have immediate use for the results."
Lead author Bridget Grant, Ph.D., Chief of the Laboratory of Biometry
and Epidemiology in NIAAA's intramural research program, and her
colleagues found that non-Hispanic Whites' lifetime rate of experiencing
a psychiatric disorder (51.2 percent) was far greater overall than
that for all Mexican Americans (36.7 percent). Psychiatric disorders
were more prevalent among U.S.-born survey participants (47.6 percent
among Mexican Americans and 52.5 percent among non-Hispanic Whites)
than among their foreign-born counterparts (28.5 percent and 32.3
percent, respectively). Lifetime rates of alcohol use disorder and
specific mood and anxiety disorder among U.S.-born Mexican Americans
and non-Hispanic Whites were nearly twice those of their foreign-born
counterparts. Drug use disorder rates among U.S.-born non-Hispanic
Whites were more than twice those of their foreign-born counterparts,
whereas the corresponding rates among U.S.-born Mexican Americans
(12 percent) were eight times those of Mexican Americans born outside
the United States (1.7 percent).
After controlling for age, sex, marital status, place of residence,
geographic region, education, and family income, the authors examined
relationships among the four comparison groups and each psychiatric
disorder. They determined that, with few exceptions, risk for all
the psychiatric disorders assessed was significantly greater among
U.S.-born than foreign-born non-Hispanic Whites and among U.S.-born
than foreign-born Mexican Americans.
"Foreign-born study participants were at lower risk of major
psychiatric disorders even though they may have experienced greater
stress due to low socioeconomic status or adapting to a new culture,"
noted Dr. Grant. "This is consistent with the 'healthy migrant'
model that predicts that foreign-born persons in good health are
more likely than those in poor health to immigrate to the United
States. However, this hypothesis does not explain the study's finding
that risk for drug dependence and specific mood and anxiety disorders
was similar among foreign-born non-Hispanic Whites and U.S.-born
Mexican Americans." Also weighing against the healthy migrant
model, the authors report, is the fact that psychiatric disorder
rates among foreign-born Mexican American immigrants are similar
to but not lower than rates in Mexico City.
The study findings suggest that acculturation has negative effects
on the mental health of both Mexican Americans and non-Hispanic
Whites and that cultural retention (i.e., the preservation of traditional
family networks and customs) has protective effects on the mental
health of Mexican Americans, according to the authors: "While
foreign-born Mexican Americans and non-Hispanic Whites did not differ
in the risk of psychiatric disorders, U.S.-born Mexican Americans
had a clear advantage over U.S.-born non-Hispanic Whites."
Identifying the specific components of various cultures that may
reduce possible negative effects of acculturation on mental health
or protect against psychopathology holds great promise in helping
to guide future prevention and treatment efforts, the authors conclude.
The NESARC is a representative survey of the U.S. civilian noninstitutionalized
population aged 18 years and older. With more than 43,000 adult
Americans participating, the NESARC is the largest study ever conducted
of the co-occurrence of alcohol and drug use disorders and other
psychiatric disorders as defined by the American Psychiatric Association's
Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition
(DSM-IV) among U.S. adults. Earlier NESARC reports (see
2004 News Releases at www.niaaa.nih.gov)
estimate the prevalence of alcohol and drug use disorders, mood
and anxiety disorders, personality disorders, and the co-occurrence
of alcohol use disorders with other psychiatric conditions.
For an interview with Dr. Grant, please contact the NIAAA Press
Office at (301) 443-0595 or (301) 443-3860. For
a copy of the study, media representatives may contact the NIAAA
Press Office or firstname.lastname@example.org.
Full text will be accessible to the public at 3:00 PM CT on December
6 at www.archgenpsychiatry.com.
The National Institute on Alcohol Abuse and Alcoholism, a component
of the National Institutes of Health, U.S. Department of Health
and Human Services, conducts and supports approximately 90 percent
of the U.S. research on the causes, consequences, prevention, and
treatment of alcohol abuse, alcoholism, and alcohol problems and
disseminates research findings to science, practitioner, policy
making, and general audiences. Additional alcohol research information
is available at www.niaaa.nih.gov.
Additional information on drug abuse and dependence is available
from the National Institute on Drug Abuse at www.nida.nih.gov.
Additional information on other psychiatric disorders is available
from the National Institute of Mental Health at www.nimh.nih.gov.
* Terms used by the NESARC conform to
OMB Statistical Directive #15, Standards for Maintaining, Collecting,
and Presenting Federal Data on Race and Ethnicity, as adopted April