Mental disorders among English-speaking Mexican immigrants to the US compared to a national sample of Mexicans

Breslau, Joshua; Aguilar-Gaxiola, Sergio; Borges, Guilherme; Castilla-Puentes, Ruby Cecilia; Kendler, Kenneth S.; Medina-Mora, Maria-Elena; Su, Maxwell; Kessler, Ronald C.

doi:10.1016/j.psychres.2006.09.011

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Volume 151, Issue 1 , Pages 115-122, 30 May 2007

Mental disorders among English-speaking Mexican immigrants to the US compared to a national sample of Mexicans

Joshua Breslau
- Department of Internal Medicine, University of California, Davis, School of Medicine, Sacramento, CA, USA
- Corresponding author. University of California, Davis, School of Medicine Center for Reducing Health Disparities CRISP, Suite 1400, 2921 Stockton Blvd. Sacramento, CA 95817, USA. Tel.: +1 916 703 9195; fax: +1 916 703 9116.
Sergio Aguilar-Gaxiola
- Department of Internal Medicine, University of California, Davis, School of Medicine, Sacramento, CA, USA
Guilherme Borges
- Mexican Institute of Psychiatry, Mexico City, Mexico
Ruby Cecilia Castilla-Puentes
- Department of Psychiatry, School of Medicine, University of North Carolina, and GlaxoSmithKline, Inc., Collegeville, PA, USA
Kenneth S. Kendler
- Departments of Psychiatry and Human Genetics, Medical College of Virginia/Virginia Commonwealth University, Richmond, VA, USA
Maria-Elena Medina-Mora
- Mexican Institute of Psychiatry, Mexico City, Mexico
Maxwell Su
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA

Received 10 May 2006; received in revised form 6 September 2006; accepted 20 September 2006.

Abstract

Our understanding of the relationship between immigration and mental health can be advanced by comparing immigrants pre- and post-immigration with residents of the immigrants' home countries. DSM-IV anxiety and mood disorders were assessed using identical methods in representative samples of English-speaking Mexican immigrants to the US, a subsample of the US National Comorbidity Survey Replication (NCSR), and Mexicans, the Mexican National Comorbidity Survey (MNCS). Retrospective reports of age of onset of disorders and, in the immigrant sample, age of immigration were analyzed to study the associations of pre-existing mental disorders with immigration and of immigration with the subsequent onset and persistence of mental disorders. Pre-existing anxiety disorders predicted immigration (OR=3.0; 95% CI 1.2–7.4). Immigration predicted subsequent onset of anxiety (OR=1.9; 95% CI 0.9–3.9) and mood (OR=2.3; 95% CI 1.3–4.0) disorders and persistence of anxiety (OR=3.7 95% CI 1.2–11.2) disorders. The results are inconsistent with the “healthy immigrant” hypothesis (that mentally healthy people immigrate) and partly consistent with the “acculturation stress” hypothesis (i.e., that stresses of living in a foreign culture promote mental disorder). Replication and extension of these results in a larger bi-national sample using a single field staff are needed.