摘要：We examined co-occurrence of (comorbid) alcohol, drug, and non–substance use psychiatric disorders in a population sample of Mexican-origin adults from rural and urban areas of central California. Co-occurring lifetime rates of alcohol or other drug disorders with non–substance use psychiatric disorders, or both, were 8.3% for men and 5.5% for women and were 12.3% for the US born and 3.5% for immigrants. Alcohol abuse or dependence with co-occurring psychiatric disorders is a primary disorder among Mexican-origin adult males (7.5% lifetime prevalence). US-born men and women are almost equally likely to have co-occuring disorders involving substances. Cobormidity is expected to increase in the Mexican-origin population owing to acculturation effects of both sexes. In recent years, there has been a growing interest in the co-occurrence of alcohol and drug use disorders and other psychiatric disorders. Comorbidity refers to the cooccurrence of any 2 disorders, whereas the term “dual diagnoses” is specific to co-occurring substance (alcohol or other drugs) and non–substance abuse disorders. Comorbidity involving dual diagnoses poses special problems. It is often marked by greater functional impairment and selfdestructive behavior, and clinical treatment is more problematic because there are multiple, distinctive, and often refractory disorders. 1– 5 Mood, anxiety, and antisocial personality disorders commonly co-occur with alcohol and other drug disorders. 6 National population survey data have been used to identify the high prevalence of psychiatric comorbidity among substance abuse disorders and other forms of psychopathology in the US population. 2 Information is still lacking about comorbidity patterns in specific ethnic groups. We present information for Mexican-origin people (Mexican immigrants and US-born Mexican Americans) from population survey data. Within the US Latino community, alcohol and drug use disorders have been identified as major health problems, particularly for males. 7, 8 Most epidemiologic surveys treat Latinos as one homogenous group; consequently, intragroup and even intergroup differences are typically obscured. For example, in the National Longitudinal Alcohol Epidemiologic Survey (NLAES), race and ethnicity are frequently presented in terms of Blacks and non-Blacks and exclude data specific to Latinos altogether. 9 An accurate depiction of the Latino population is difficult because it comprises multiple racial groups from different nations of origin, and the relatively small number of some nationalities in these surveys (e.g., Dominicans, Guatemalans, Colombians) makes it difficult to conduct detailed analyses. Nevertheless, the most recent prevalence estimates suggest that Latinos are just as likely as White Americans to become dependent on drugs and are more likely than White Americans to persist in dependence on them. 10 Additionally, Latinos who are regular drinkers are just as likely as other ethnic and racial groups to engage in heavy drinking or to become intoxicated on a weekly or more frequent basis. 11 Wide variations in alcohol consumption (frequency and quantity) have been reported among Latino subgroups, with higher levels among Mexican-origin people and the lowest levels reported among people of Caribbean origin. 12 Increasingly, the evidence suggests that the propensity for more frequent drinking will increase with intergenerational changes in acculturation. 13
