Conway Kevin P, Swendsen Joel D, Dierker Lisa, Canino Glorisa, Merikangas Kathleen R
Division of Clinical Neuroscience and Behavioral Research, National Institute on Drug Abuse, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland 20892-9589, USA.
Am J Prev Med. 2007 Jun;32(6 Suppl):S219-25. doi: 10.1016/j.amepre.2007.02.033.
Although acculturation to the United States has been associated with an increase in substance, mood, and anxiety disorders in Latino populations, few studies have examined this concept relative to comorbidity among these syndromes.
This study compares the prevalence and patterns of psychiatric comorbidity among Puerto Ricans with substance use disorders living in San Juan (Puerto Rico) to those who have migrated to New Haven (Connecticut) and examines the association between acculturation-related stress and the prevalence and patterns of psychiatric comorbidity among those who have migrated to New Haven.
Lifetime levels of nearly all comorbid psychiatric disorders among respondents with substance use disorders were generally similar across sites. However, the risk of any co-occurring psychiatric disorder was higher among substance use disorder cases in New Haven who reported high levels of total acculturation stress and family-specific acculturation stress. These findings were generally accounted for by associations between affective disorders and high scores on these indicators of acculturation stress.
The overall prevalence and patterns of psychiatric comorbidity are remarkably similar among Puerto Rican substance abusers whether they live in San Juan or have migrated to New Haven, thereby demonstrating robustness to differences in geographic location. Nevertheless, the degree of acculturation-related family stress is positively associated with co-occurring substance and psychiatric disorders, particularly affective disorders. Intervention in family strain related to the acculturation process may diminish the development of comorbid mental disorders and assist in implementing successful treatment of substance abuse.
尽管融入美国社会与拉丁裔人群中物质使用、情绪及焦虑障碍的增加有关，但很少有研究探讨这些综合征共病方面的这一概念。
本研究比较了居住在圣胡安（波多黎各）患有物质使用障碍的波多黎各人以及已移民至纽黑文（康涅狄格州）的波多黎各人中精神疾病共病的患病率及模式，并研究了与融入相关的压力与移民至纽黑文者中精神疾病共病的患病率及模式之间的关联。
患有物质使用障碍的受访者中，几乎所有共病精神疾病的终生患病率在各地点总体相似。然而，在纽黑文报告总体融入压力和家庭特定融入压力水平较高的物质使用障碍病例中，任何共病精神疾病的风险更高。这些发现通常可由情感障碍与这些融入压力指标的高分之间的关联来解释。
波多黎各药物滥用者中精神疾病共病的总体患病率及模式，无论他们居住在圣胡安还是已移民至纽黑文，都非常相似，从而表明对地理位置差异具有稳健性。然而，与融入相关的家庭压力程度与共病的物质使用和精神疾病，特别是情感障碍呈正相关。对与融入过程相关的家庭压力进行干预可能会减少共病精神障碍的发生，并有助于成功实施药物滥用治疗。
