Tri-ethnic variations of co-morbid substance and alcohol use disorders in schizophrenia.
OBJECTIVE
This study examined the differential prevalence of substance and alcohol use disorders among European Americans, African Americans, and Latinos with schizophrenia (n = 6424) who received public mental health services in San Diego County during fiscal year 2002-2003.


METHODS
Data were obtained from the public mental health database used by the San Diego County Mental Health System. Chi-Square analyses and stepwise logistic regression analyses were used to examine differences regarding the prevalence of substance and alcohol use among clients with schizophrenia and schizoaffective disorder, and to analyze the sociodemographic variables associated with this co-morbidity.


RESULTS
Significant differences in the prevalence of diagnosed co-morbidity were found across the ethnic groups. Rates of co-morbid diagnosis among African Americans (25%) were significantly higher than those among European Americans (22%) and Latinos (19%). Logistic regression results revealed ethnicity was a significant predictor of co-morbid substance and alcohol use, as was being homeless and male. Among Latinos, language preference was also a significant predictor. Latinos who denoted English as their primary language were 1.7 times more likely to be diagnosed with co-morbid substance or alcohol use disorders than Latinos who denoted Spanish.


CONCLUSIONS
Among people with schizophrenia, there were significant differences in prevalence rates and predictors of diagnosed co-morbid substance and alcohol use disorders. Future research is needed to examine the relationship among language preference, level of acculturation, and subsequent diagnosing barriers for Latinos. Among African Americans, the reasons behind increased co-morbidity rates need to be examined, and homelessness should be carefully addressed among all three ethnic groups.
University of California San Diego, Department of Psychiatry, Division of Geriatric Psychiatry (116A-1), 3350 La Jolla Village Drive, San Diego, CA 92161, USA. lpmontro@ucsd.edu
Lori P
LP
Montross
Concepcion
C
Barrio
Ann-Marie
AM
Yamada
Laurie
L
Lindamer
Shahrokh
S
Golshan
Piedad
P
Garcia
Dahlia
D
Fuentes
Rebecca E
RE
Daly
Richard L
RL
Hough
Dilip V
DV
Jeste
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D019973:Alcohol-Related Disorders / Q000453:epidemiology* / Q000208:ethnology / Q000523:psychology; D016009:Chi-Square Distribution; D003156:Community Mental Health Services; D015897:Comorbidity; D003625:Data Collection; D003710:Demography; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008605:Mental Health Services; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D012189:Retrospective Studies; D012559:Schizophrenia / Q000150:complications* / Q000208:ethnology; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000208:ethnology / Q000523:psychology; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data*