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Racial/ethnic differences in 12-month prevalence and persistence of mood, anxiety, and substance use disorders: Variation by nativity and socioeconomic status.
Compr Psychiatry. 2019 02; 89:52-60.CP

Abstract

BACKGROUND

Despite equivalent or lower lifetime and past-year prevalence of mental disorder among racial/ethnic minorities compared to non-Latino Whites in the United States, evidence suggests that mental disorders are more persistent among minorities than non-Latino Whites. But, it is unclear how nativity and socioeconomic status contribute to observed racial/ethnic differences in prevalence and persistence of mood, anxiety, and substance disorders.

METHOD

Data were examined from a coordinated series of four national surveys that together assessed 21,024 Asian, non-Latino Black, Latino, and non-Latino White adults between 2001 and 2003. Common DSM-IV mood, anxiety, and substance disorders were assessed using the Composite International Diagnostic Interview. Logistic regression analyses examined how several predictors (e.g., race/ethnicity, nativity, education, income) and the interactions between those predictors were associated with both 12-month disorder prevalence and 12-month prevalence among lifetime cases. For the second series of analyses, age of onset and time since onset were used as additional control variables to indirectly estimate disorder persistence.

RESULTS

Non-Latino Whites demonstrated the highest unadjusted 12-month prevalence of all disorder types (p < 0.001), though differences were also observed across minority groups. In contrast, Asian, Latino, and Black adults demonstrated higher 12-month prevalence of mood disorders among lifetime cases than Whites (p < 0.001) prior to adjustments Once we introduced nativity and other relevant controls (e.g., age, sex, urbanicity), US-born Whites with at least one US-born parent demonstrated higher 12-month mood disorder prevalence than foreign-born Whites or US-born Whites with two foreign parents (OR = 0.51, 95% CI = [0.36, 0.73]); this group also demonstrated higher odds of past-year mood disorder than Asian (OR = 0.59, 95% CI = [0.42, 0.82]) and Black (OR = 0.70, 95% CI = [0.58, 0.83]) adults, but not Latino adults (OR = 0.89, 95% CI = [0.74, 1.06]). Racial/ethnic differences in 12-month mood and substance disorder prevalence were moderated by educational attainment, especially among adults without a college education. Additionally, racial/ethnic minority groups with no more than a high school education demonstrated more persistent mood and substance disorders than non-Latino Whites; these relationships reversed or disappeared at higher education levels.

CONCLUSION

Nativity may be a particularly relevant consideration for diagnosing mood disorder among non-Latino Whites; additionally, lower education appears to be associated with increased relative risk of persistent mood and substance use disorders among racial/ethnic minorities compared to non-Latino Whites.

Authors+Show Affiliations

Recovery Research Institute, Center for Addiction Medicine, Massachusetts General Hospital, 151 Merrimac Street 6th Floor, Boston, MA 02114, United States; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02215, United States. Electronic address: cvilsaint@mgh.harvard.edu.Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 830, Boston, MA 02114, United States; Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115-5899, United States. Electronic address: anemoyer@mgh.harvard.edu.Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 830, Boston, MA 02114, United States; Department of Medicine, Harvard Medical School, 55 Fruit Street Boston, MA 02114, United States. Electronic address: mfillbrunn@mgh.harvard.edu.Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115-5899, United States. Electronic address: sadikova@hcp.med.harvard.edu.Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115-5899, United States. Electronic address: ronkadm@hcp.med.harvard.edu.Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115-5899, United States. Electronic address: sampson@hcp.med.harvard.edu.Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02215, United States; Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 830, Boston, MA 02114, United States; Department of Medicine, Harvard Medical School, 55 Fruit Street Boston, MA 02114, United States. Electronic address: kalvarez2@mgh.harvard.edu.Boston University, Wheelock College of Educaion & Human Development, Two Silber Way, Boston, MA 02215, United States.. Electronic address: jggreen@bu.edu.Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA 02138, United States. Electronic address: kmclaughlin@fas.harvard.edu.Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Kresge Building Room 615, Boston, MA 02115, United States. Electronic address: ruijia.chen@mail.harvard.edu.Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Kresge Building Room 615, Boston, MA 02115, United States; Department of African and African American Studies, Harvard University, Barker Center, 12 Quincy St., Cambridge, MA 02138, United States. Electronic address: dwilliam@hsph.harvard.edu.Institute for Social Research, 5057 ISR, 426 Thompson St., Ann Arbor, MI 48104, United States. Electronic address: jamessj@umich.edu.Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02215, United States; Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, 50 Staniford Street, Suite 830, Boston, MA 02114, United States; Department of Medicine, Harvard Medical School, 55 Fruit Street Boston, MA 02114, United States. Electronic address: malegria@mgh.harvard.edu.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

30594752

Citation

Vilsaint, Corrie L., et al. "Racial/ethnic Differences in 12-month Prevalence and Persistence of Mood, Anxiety, and Substance Use Disorders: Variation By Nativity and Socioeconomic Status." Comprehensive Psychiatry, vol. 89, 2019, pp. 52-60.
Vilsaint CL, NeMoyer A, Fillbrunn M, et al. Racial/ethnic differences in 12-month prevalence and persistence of mood, anxiety, and substance use disorders: Variation by nativity and socioeconomic status. Compr Psychiatry. 2019;89:52-60.
Vilsaint, C. L., NeMoyer, A., Fillbrunn, M., Sadikova, E., Kessler, R. C., Sampson, N. A., Alvarez, K., Green, J. G., McLaughlin, K. A., Chen, R., Williams, D. R., Jackson, J. S., & Alegría, M. (2019). Racial/ethnic differences in 12-month prevalence and persistence of mood, anxiety, and substance use disorders: Variation by nativity and socioeconomic status. Comprehensive Psychiatry, 89, 52-60. https://doi.org/10.1016/j.comppsych.2018.12.008
Vilsaint CL, et al. Racial/ethnic Differences in 12-month Prevalence and Persistence of Mood, Anxiety, and Substance Use Disorders: Variation By Nativity and Socioeconomic Status. Compr Psychiatry. 2019;89:52-60. PubMed PMID: 30594752.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Racial/ethnic differences in 12-month prevalence and persistence of mood, anxiety, and substance use disorders: Variation by nativity and socioeconomic status. AU - Vilsaint,Corrie L, AU - NeMoyer,Amanda, AU - Fillbrunn,Mirko, AU - Sadikova,Ekaterina, AU - Kessler,Ronald C, AU - Sampson,Nancy A, AU - Alvarez,Kiara, AU - Green,Jennifer Greif, AU - McLaughlin,Katie A, AU - Chen,Ruijia, AU - Williams,David R, AU - Jackson,James S, AU - Alegría,Margarita, Y1 - 2018/12/19/ PY - 2018/08/01/received PY - 2018/11/20/revised PY - 2018/12/15/accepted PY - 2018/12/31/pubmed PY - 2020/2/11/medline PY - 2018/12/31/entrez KW - Disorder persistence KW - Disorder prevalence KW - Ethnicity KW - Mental health KW - Race KW - Socioeconomic status SP - 52 EP - 60 JF - Comprehensive psychiatry JO - Compr Psychiatry VL - 89 N2 - BACKGROUND: Despite equivalent or lower lifetime and past-year prevalence of mental disorder among racial/ethnic minorities compared to non-Latino Whites in the United States, evidence suggests that mental disorders are more persistent among minorities than non-Latino Whites. But, it is unclear how nativity and socioeconomic status contribute to observed racial/ethnic differences in prevalence and persistence of mood, anxiety, and substance disorders. METHOD: Data were examined from a coordinated series of four national surveys that together assessed 21,024 Asian, non-Latino Black, Latino, and non-Latino White adults between 2001 and 2003. Common DSM-IV mood, anxiety, and substance disorders were assessed using the Composite International Diagnostic Interview. Logistic regression analyses examined how several predictors (e.g., race/ethnicity, nativity, education, income) and the interactions between those predictors were associated with both 12-month disorder prevalence and 12-month prevalence among lifetime cases. For the second series of analyses, age of onset and time since onset were used as additional control variables to indirectly estimate disorder persistence. RESULTS: Non-Latino Whites demonstrated the highest unadjusted 12-month prevalence of all disorder types (p < 0.001), though differences were also observed across minority groups. In contrast, Asian, Latino, and Black adults demonstrated higher 12-month prevalence of mood disorders among lifetime cases than Whites (p < 0.001) prior to adjustments Once we introduced nativity and other relevant controls (e.g., age, sex, urbanicity), US-born Whites with at least one US-born parent demonstrated higher 12-month mood disorder prevalence than foreign-born Whites or US-born Whites with two foreign parents (OR = 0.51, 95% CI = [0.36, 0.73]); this group also demonstrated higher odds of past-year mood disorder than Asian (OR = 0.59, 95% CI = [0.42, 0.82]) and Black (OR = 0.70, 95% CI = [0.58, 0.83]) adults, but not Latino adults (OR = 0.89, 95% CI = [0.74, 1.06]). Racial/ethnic differences in 12-month mood and substance disorder prevalence were moderated by educational attainment, especially among adults without a college education. Additionally, racial/ethnic minority groups with no more than a high school education demonstrated more persistent mood and substance disorders than non-Latino Whites; these relationships reversed or disappeared at higher education levels. CONCLUSION: Nativity may be a particularly relevant consideration for diagnosing mood disorder among non-Latino Whites; additionally, lower education appears to be associated with increased relative risk of persistent mood and substance use disorders among racial/ethnic minorities compared to non-Latino Whites. SN - 1532-8384 UR - https://www.unboundmedicine.com/medline/citation/30594752/Racial/ethnic_differences_in_12_month_prevalence_and_persistence_of_mood_anxiety_and_substance_use_disorders:_Variation_by_nativity_and_socioeconomic_status_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0010-440X(18)30210-4 DB - PRIME DP - Unbound Medicine ER -