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Lifetime risk and persistence of psychiatric disorders across ethnic groups in the United States
Open accessAbstract
Background. Recent research in the United States has demonstrated striking health disparities across ethnic groups. Despite a longstanding interest in ethnic disadvantage in psychiatric epidemiology, patterns of psychiatric morbidity across ethnic groups have never been examined in a nationally representative sample. Method. Ethnic differences in psychiatric morbidity are analyzed using data from the National Comorbidity Survey (NCS). The three largest ethnic groups in the United States – Hispanics, Non-Hispanic Blacks and Non-Hispanic Whites – were compared with respect to lifetime risk and persistence of three categories of psychiatric disorder: mood disorder, anxiety disorder, and substance use disorder. Results. Where differences across ethnic groups were found in lifetime risk, socially disadvantaged groups had lower risk. Relative to Non-Hispanic Whites, Hispanics had lower lifetime risk of substance use disorder and Non-Hispanic Blacks had lower lifetime risk of mood, anxiety and substance use disorders. Where differences were found in persistence of disorders, disadvantaged groups had higher risk. Hispanics with mood disorders were more likely to be persistently ill as were Non-Hispanic Blacks with respect to both mood disorders and anxiety disorders. Closer examination found these differences to be generally consistent across population subgroups. Conclusions. Members of disadvantaged ethnic groups in the United States do not have an increased risk for psychiatric disorders. Members of these groups, however, do tend to have more persistent disorders. Future research should focus on explanations for these findings, including the possibility that these comparisons are biased, and on potential means of reducing the disparity in persistence of disorders across ethnic groups.
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“This disproportionate exposure to race-related stressors may partly explain the higher prevalence and persistence rates of mood and anxiety disorders among Black, Asian, and Latinx groups compared with non-Latinx White groups [12,13].”
From App-Based Mindfulness Meditation for People of Color Who Experience Race-Related Stress: Protocol for a Randomized Controlled Trial (2022) · cites this paper as [12]
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“Moreover, by asking respondents about their current as opposed to their lifetime disorders, we enhanced the accuracy of our research, in light of a relatively strong tendency, among mentally ill minority individuals, to have serious, persistent disorders [11].”
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Disparities in psychosocial functioning in a diverse sample of adults with anxiety disorders
Moitra, E., Lewis‐Fernández, R., Stout, R. L., Angert, E., Weisberg, R. B., & Keller, M. B. (2014) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2014.02.002 · Cited by 21
Innovative Directions to Advance Mental Health Disparities Research
Barksdale, C. L., Pérez‐Stable, E. J., & Gordon, J. A. (2022) · American Journal of Psychiatry · doi:10.1176/appi.ajp.21100972 · Cited by 24
Upenieks, L., Louie, P., & Hill, T. D. (2022) · Society and Mental Health · doi:10.1177/21568693221119786 · Cited by 23
“…health refers to the surprising and persistent finding in social epidemiology that black Americans exhibit similar or better mental health than white Americans, despite chronic exposure to psychosocial stressors, such as poverty and discrimination (Breslau et al. 2005, 2006; Williams et al. 2007).”
BackgroundFamily Influences on the Use of Mental Health Services among African Americans
Villatoro, A. P., & Aneshensel, C. S. (2014) · Journal of Health and Social Behavior · doi:10.1177/0022146514533348 · Cited by 24
“Moreover, African Americans have relatively high rates of disorders that carry substantial need for treatment including severe, disabling, persistent, and chronic disorders (e.g., Breslau et al. 2005; Williams et al. 2007; for an exception, see Harris et al. 2005).”
BackgroundCook, J. Α., Mock, L. O., Jonikas, J. A., Burke-Miller, J. K., Carter, T. M., Taylor, A., Petersen, C. A., Grey, D. D., & Gruenenfelder, D. (2009) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2008.539 · Cited by 20
“Our finding regarding early onset of many disorders during the teenage years points to the need for primary prevention efforts directed toward women and their children.(34) These include home visiting programs for pregnant teens and new parents; crisis nurseries and respite child care; parenting classes for new mother…”
BackgroundVida Alegre: Preliminary Findings of a Depression Intervention for Immigrant Latino Mothers
Piedra, L. M., & Byoun, S.-J. (2011) · Research on Social Work Practice · doi:10.1177/1049731511424168 · Cited by 21
Ornelas, I. J., & Hong, S. (2012) · Substance Use & Misuse · doi:10.3109/10826084.2012.716482 · Cited by 20
Jonsson, K. R., Vartanova, I., & Södergren, M. (2018) · Health & Place · doi:10.1016/j.healthplace.2018.03.010 · Cited by 20
Jones, A. L., Cochran, S. D., Rafferty, J. A., Taylor, R. J., & Mays, V. M. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17197007 · Cited by 20
“As in other studies, persistence was defined as the proportion of adults with a lifetime psychiatric disorder who continued to meet diagnosis criteria in the twelve months that proceeded their interview date [34,43].”
BackgroundInfluentialParhami, I., FONG, T. W., Siani, A., Carlotti, C., & Khanlou, H. (2012) · AIDS and Behavior · doi:10.1007/s10461-012-0386-8 · Cited by 19
“While some believe that minorities are at decreased risk for psychiatric disorders [36], others maintain that cultural factors affect both patient reporting and clinician interpretation of psychiatric disorders [37].”
BackgroundInequalities in the Incidence of Psychotic Disorders Among Racial and Ethnic Groups
Chung, W. W., Jiang, S., Milham, M. P., Merikangas, K. R., & Paksarian, D. (2023) · American Journal of Psychiatry · doi:10.1176/appi.ajp.20220917 · Cited by 19
Assessing Racial/Ethnic Differences in the Social Consequences of Early-Onset Psychiatric Disorder
Cook, B. L., Carson, N. J., & Alegria, M. M. (2010) · Journal of Health Care for the Poor and Underserved · doi:10.1353/hpu.0.0289 · Cited by 18
Testimony Therapy With Ritual: A Pilot Randomized Controlled Trial*
Esala, J. J., & Taing, S. (2017) · Journal of Traumatic Stress · doi:10.1002/jts.22163 · Cited by 19
The Relationship Between Mixed Race/Ethnicity, Developmental Assets, and Mental Health Among Youth
Garcia, G. M., Hedwig, T., Hanson, B. L., Rivera, M. A. P., & Smith, C. A. (2018) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-018-0501-2 · Cited by 19
Wortzel, J. R., Norden, J. G., Turner, B. E., Haynor, D. R., Kent, S. T., Al‐Hamdan, M. Z., Avery, D., & Norden, M. J. (2018) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2018.12.017 · Cited by 18
Mutic, A. D., Barr, D. B., Hertzberg, V., Dunlop, A., Brennan, P., & McCauley, L. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18073614 · Cited by 18
“Unfortunately, some populations of African Americans are less likely to be diagnosed and treated for depressive symptoms compared to White patients [50], and across subgroups, African Americans are more likely to have persistent disorders after becoming ill [51].”
Metadata
- Authors
- BRESLAU, J., KENDLER, K. S., SU, M., GAXIOLA-AGUILAR, S., & KESSLER, R. C.
- Affiliations
- Harvard University (US)
- Virginia Commonwealth University (US)
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2004-09-29
- Volume
- 35
- Issue
- 3
- Pages
- 317-327
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- PMC
- PMC2748985
- OpenAlex
- W2119176293
- Cited by
- 642
- References
- 55
- Citations by year
- 2026: 11 · 2025: 23 · 2024: 31 · 2023: 27 · 2022: 38 · 2021: 33 · 2020: 31 · 2019: 25 · 2018: 44 · 2017: 27 · 2016: 34 · 2015: 31 · 2014: 42 · 2013: 33 · 2012: 34
- FWCI
- 22.66
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute of Mental Health (5 KO1 MH66057-02, K01MH066057)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Health › Health disparities and outcomes
- Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
- Keywords
- ethnic disparities, psychiatric morbidity, lifetime risk, mood disorders, anxiety disorders, substance use disorders, Hispanic Americans, African Americans, social deprivation, National Comorbidity Survey
- MeSH terms
- Adolescent, Adult, Aged, Mental Disorders, Ethnicity, Female, Health Surveys, Humans, Male, Middle Aged, Morbidity, Risk Factors, Social Class, United States
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