Prevalence and correlates of dual diagnoses in U.S. Latinos.
OBJECTIVE
To examine the population prevalence, patterns of onset, and important demographic covariates for dual (co-occurring) diagnoses of substance and non-substance mental disorders.


METHODS
A nationally representative sample of U.S. Latino adults was interviewed face-to-face.


METHODS
Estimates were made using data from the National Latino and Asian Services Survey (NLAAS) using the World Health Organization CIDI, DSM-IV criteria, for case ascertainment.


RESULTS
U.S. born Latinos are much more likely to report a dual diagnoses than are foreign born Latinos in both sexes; 16.88% vs. 5.02% for males (p<0.000), and 7.48% vs. 0.58% for women (p<.000). Total dual diagnoses prevalence was 6.79%, with non-substance mental disorder occurring first 70% of the time, with an earlier age of onset for U.S. Latinos. Immigrants were less likely to be positive for dual diagnoses (OR=0.234, p=<0.0001), or any substance disorder diagnosis (OR=0.261, p=<.0001), if they reported lifetime substance use when compared to U.S. born Latinos.


CONCLUSIONS
Latino adults residing in the U.S. have one-fourth the risk of dual diagnoses compared to the U.S. population. Most of this difference is accounted for by lower rates of substance and non-substance disorders and a lower propensity for progression from substance use to substance use disorders, combined with a later age of onset for mental disorders among immigrants. Immigrant women rarely reported dual diagnoses. We recommend bio-behavioral models and transnational studies to identify life course factors contributing to dual diagnoses among U.S. born Latinos.
Vega
William A
WA
David Geffen School of Medicine-UCLA, Los Angeles, CA 90024-4142, USA. wvega@mednet.ucla.edu
Canino
Glorisa
G
Cao
Zhun
Z
Alegria
Margarita
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D003625:Data Collection / Q000379:methods; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006630:Hispanic or Latino / Q000208:ethnology* / Q000523:psychology*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000208:ethnology* / Q000523:psychology*; D008875:Middle Aged; D015995:Prevalence; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000208:ethnology* / Q000523:psychology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult