Race/ethnicity, nativity, and lifetime risk of mental disorders in US adults
Race/ethnicity, nativity, and lifetime risk of mental disorders in US adults
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DOI：
10.1007/s00127-018-1644-5
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发表时间：
2019-05-01
影响因子：
4.4
通讯作者：
Alegria, Margarita
中科院分区：
文献类型：
--
作者：
Alvarez, Kiara;Fillbrunn, Mirko;Alegria, Margarita
目的目前还没有对种族/族裔和出生地如何交叉来解释亚裔、黑人、拉丁裔和白人成年人终生精神障碍患病率的差异进行全面的研究。本研究旨在估计终生精神障碍风险的种族/族裔差异，并研究不同出生地的群体差异如何变化。方法在美国四项调查的 20,000 多名受访者的全国代表性样本中，使用生存模型来估计 DSM-IV 焦虑、情绪和物质使用障碍的终生风险的种族/民族和出生地差异。结果亚洲人终生精神障碍患病率最低 (23.5%)，其次是黑人 (37.0%)、拉丁裔（38.8%）和白人（45.6%）。即使在根据出生进行调整后，亚洲人和黑人患所有疾病的终生风险也低于白人。拉丁裔和白人在调整出生后也有类似的风险。移民前几年，外国出生的受访者患疾病的风险最低。情绪和物质使用障碍存在显着的种族/民族和出生地相互作用。对于至少一位在美国出生的父母的白人来说，出现情绪障碍的几率更高。在美国出生的受访者中，亚洲人出现药物滥用障碍的几率更高；对于拉丁美洲人来说，至少有一位父母在美国出生的人的患病率更高。 结论 父母在外国出生与精神障碍的低风险相关，但在不同种族/族裔群体或障碍中的情况并不相同。对于拉丁裔和白人来说，接触美国环境可能会增加精神障碍的风险。需要对文化过程（包括白人之间的文化过程）进行调查，以了解群体差异。
PurposeThere has been no comprehensive examination of how race/ethnicity and nativity intersect in explaining differences in lifetime prevalence of mental disorders among Asian, Black, Latino, and White adults. This study aims to estimate racial/ethnic differences in lifetime risk of mental disorders and examine how group differences vary by nativity.MethodsSurvival models were used to estimate racial/ethnic and nativity differences in lifetime risk of DSM-IV anxiety, mood, and substance use disorders in a nationally representative sample of over 20,000 respondents to four US surveys.ResultsAsians had the lowest lifetime prevalence of mental disorders (23.5%), followed by Blacks (37.0%), Latinos (38.8%), and Whites (45.6%). Asians and Blacks had lower lifetime risk than Whites for all disorders even after adjusting for nativity; Latinos and Whites had similar risk after adjusting for nativity. Risk of disorder onset was lowest for foreign-born respondents in years before migration. There were significant race/ethnicity and nativity interactions for mood and substance use disorders. Odds of mood disorder onset were higher for Whites with at least one US-born parent. Odds of substance use disorder onset among Asians were higher for US-born respondents; for Latinos, they were higher for those with at least one US-born parent.ConclusionsParental foreign-born nativity is associated with a low risk of mental disorders, but not uniformly across racial/ethnic groups or disorders. Exposure to the US context may be associated with greater mental disorder risk for Latinos and Whites particularly. Investigations of cultural processes, including among Whites, are needed to understand group differences.