Psychiatric disorders among foreign-born and US-born Asian-Americans in a US national survey

Background Among Hispanics, Non-Hispanic Whites and Non-Hispanic Blacks studies have found lower risk for psychiatric disorders among the foreign-born than among the US-born. We examine the association of nativity and risk for psychiatric disorder in a national sample of the Asian-American (AA) population. Methods Data on 1,236 AAs from the National Epidemiological Survey of Alcohol and Related Conditions (NESARC) are analyzed using logistic regression and discrete time survival models to specify differences between the foreign-born and US-born in the lifetime occurrence of mood, anxiety and substance use disorders. Results Foreign-born AAs had significantly lower risk for all classes of disorder compared with US-born AAs (OR = 0.16-0.59). Risk for all classes of disorder was lowest for those foreign-born AAs who arrived in the US as adults. Among foreign-born AAs risk of first onset was lowest relative to the US-born in years prior to their arrival in the US and tended to rise to levels equal to that of the US-born with longer duration of residence in the US. Conclusions Among AAs, risk for psychiatric disorders is lower among the foreign-born than among the US-born. The pattern of change in risk over time suggests that both the developmental timing and the duration of experience in the US contribute to increases in risk.