Significance of endorsement of psychotic symptoms by US Latinos.
In US regional studies, Latinos frequently endorse psychotic symptoms associated with impairment and mental health service use, yet do not meet criteria for psychotic disorder. Using a nationally representative Latino sample (N = 2554), we examined the prevalence of psychotic symptoms, their relationship to psychotic disorder, their correlates, and their relationship to mental health outcomes. In this sample, 9.5% (SE = 0.7) endorsed 1 or more lifetime psychotic symptoms, yet 93% of endorsers did not meet Structured Clinical Interview for DSM-IV criteria for psychotic disorders. Endorsement was associated with physical and emotional distress, particularly lifetime anxiety and current substance use disorder. Acculturation to US society and reliance on spiritual/religious help were also associated with psychotic symptom endorsement. These symptoms have substantial clinical significance, being independently associated with suicidal ideation, mental health-related disability, and outpatient mental health service utilization. Endorsed psychotic symptoms in Latinos may constitute a clinically significant marker of general psychiatric vulnerability rather than a sign of psychotic disorder.
Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, New York, USA. rlewis@nyspi.cpmc.columbia.edu
Roberto
R
Lewis-Fernández
Marcela
M
Horvitz-Lennon
Carlos
C
Blanco
Peter J
PJ
Guarnaccia
Zhun
Z
Cao
Margarita
M
Alegría
D000293:Adolescent; D000328:Adult; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology* / Q000706:statistics & numerical data*; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D012720:Severity of Illness Index; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D055815:Young Adult