Significance of endorsement of psychotic symptoms by US Latinos.

Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, New York, USA.
The Journal of nervous and mental disease (Impact Factor: 1.81). 06/2009; 197(5):337-47. DOI: 10.1097/NMD.0b013e3181a2087e
Source: PubMed

ABSTRACT 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.


Available from: Margarita Alegria, Oct 10, 2014
  • [Show abstract] [Hide abstract]
    ABSTRACT: Immigrants report more psychotic symptoms than native-born populations. This study used data from the U.S.-based, nationally representative and culturally validated National Latino and Asian American Study to investigate whether refugees are at higher risk of psychotic symptoms than voluntary migrants. In this study, refugee status predicted more psychotic symptoms. Effects remained significant in most models after controlling for demographic covariates and traumatic experiences, however the direction of the effect differed for pre- versus post-migration periods. The study concludes that refugees are at higher risk for developing psychotic symptoms, which arise among refugees more often in the pre-migration period and less often post-migration.
    Journal of Immigrant & Refugee Studies 07/2013; 11(3):299-314. DOI:10.1080/15562948.2013.801737
  • [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVE This study determined the prevalence of psychotic symptoms among racial-ethnic groups in a representative sample of American adults and explored the relationship of these symptoms with race-ethnicity, psychological distress, and dysfunction. METHODS Data from the Collaborative Psychiatric Epidemiology Surveys were used, which combines three nationally representative surveys: the National Comorbidity Survey Replication, National Survey of American Life, and National Latino and Asian American Study. The sample comprised 16,423 respondents, and the analysis adjusted for design effects. RESULTS The adjusted lifetime and 12-month prevalence rates of psychotic symptoms were 11.6% and 1.4%, respectively. Latinos and blacks had higher lifetime rates (13.6% and 15.3%, respectively) than whites (9.7%) and Asians (9.6%). In logistic regression analysis, lifetime reports of psychotic symptoms were associated with Latino ethnicity, a lifetime diagnosis of a substance use disorder or posttraumatic stress disorder, lifetime psychological distress, and current dysfunction (limitations in daily activities). Prevalence rates of psychotic symptoms among respondents with and without lifetime distress, respectively, were as follows: Asian, 5.4% and 6.4%; Latino, 19.9% and 8.2%; black, 21.1% and 9.9%; and white, 13.1% and 5.1%. CONCLUSIONS Race-ethnicity was differentially associated with psychotic symptoms, with Latinos reporting more lifetime symptoms than other groups after the analysis controlled for other factors. Little evidence was found that psychotic symptoms are "idioms of distress"; respondents who reported lifetime psychotic symptoms were prone to a higher lifetime prevalence of distress, and this association was not specific to any racial-ethnic group. Although psychotic symptoms are often transient, their presence appears to signal a propensity to experience distress.
    Psychiatric services (Washington, D.C.) 08/2013; 64(11). DOI:10.1176/ · 1.99 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Health psychology researchers have begun to focus greater attention on people's beliefs about health/illness since these beliefs can clearly affect behavior. This cross-sectional study aimed at (1) identifying the most common factors psychotic patients attribute their illness to and (2) assessing the association between causal attribution and illness perception (cognitive, emotional, and comprehensibility dimensions). Sixty-two patients (56.5% females) who had been treated for psychosis at a public psychiatric hospital in Mexico answered the Angermeyer and Klusmann Illness Attribution Scale and the Brief Illness Perception Questionnaire. Results showed that most patients attributed psychosis onset to social factors and that attribution to their personality might have an overwhelmingly negative effect on their lives. Acknowledging psychotic patient attributional beliefs and considering them in clinical practice could improve treatment efficacy and overall recovery success. This is particularly important in psychosis, since symptoms are often severe and/or persistent and require long-term treatment.
    12/2014; 2014:969867. DOI:10.1155/2014/969867