Skip to main content
    • Aa
    • Aa
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 46
  • Cited by
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Bas-Sarmiento, Pilar Saucedo-Moreno, María José Fernández-Gutiérrez, Martina and Poza-Méndez, Miriam 2016. Mental Health in Immigrants Versus Native Population: A Systematic Review of the Literature. Archives of Psychiatric Nursing,

    Ferraiolo, Natalie Pinedo, Miguel McCurley, Jessica Burgos, Jose Luis Vargas-Ojeda, Adriana Carolina Rodriguez, Michael A. and Ojeda, Victoria D. 2016. Depressive symptoms among patients at a clinic in the red light district of Tijuana, Mexico. International Journal of Culture and Mental Health, Vol. 9, Issue. 2, p. 151.

    Frazer, Andrew L. Rubens, Sonia Johnson-Motoyama, Michelle DiPierro, Moneika and Fite, Paula J. 2016. Acculturation Dissonance, Acculturation Strategy, Depressive Symptoms, and Delinquency in Latina/o Adolescents. Child & Youth Care Forum,

    Lacey, Krim K. Jackson, James S. and Matusko, Niki 2016. Drug Use Trajectories Among Minority Youth.

    Lewis-Fernández, R. Morcillo, C. Wang, S. Duarte, C. S. Aggarwal, N. K. Sánchez-Lacay, J. A. and Blanco, C. 2016. Acculturation dimensions and 12-month mood and anxiety disorders across US Latino subgroups in the National Epidemiologic Survey of Alcohol and Related Conditions. Psychological Medicine, Vol. 46, Issue. 09, p. 1987.

    Oznobishin, Olga and Kurman, Jenny 2016. Family obligations and individuation among immigrant youth: Do generational status and age at immigration matter?. Journal of Adolescence, Vol. 51, p. 103.

    Salas-Wright, Christopher P. Vaughn, Michael G. Schwartz, Seth J. and Córdova, David 2016. An “immigrant paradox” for adolescent externalizing behavior? Evidence from a national sample. Social Psychiatry and Psychiatric Epidemiology, Vol. 51, Issue. 1, p. 27.

    Szaflarski, Magdalena Cubbins, Lisa A. Bauldry, Shawn Meganathan, Karthikeyan Klepinger, Daniel H. and Somoza, Eugene 2016. Major Depressive Disorder and Dysthymia at the Intersection of Nativity and Racial–Ethnic Origins. Journal of Immigrant and Minority Health, Vol. 18, Issue. 4, p. 749.

    Arévalo, Sandra P. Tucker, Katherine L. and Falcón, Luis M. 2015. Beyond cultural factors to understand immigrant mental health: Neighborhood ethnic density and the moderating role of pre-migration and post-migration factors. Social Science & Medicine, Vol. 138, p. 91.

    Borges, Guilherme Zamora, Beatriz García, José Orozco, Ricardo Cherpitel, Cheryl J. Zemore, Sarah E. and Breslau, Joshua 2015. Symptoms of anxiety on both sides of the US–Mexico border: The role of immigration. Journal of Psychiatric Research, Vol. 61, p. 46.

    Budhwani, Henna Hearld, Kristine Ria and Chavez-Yenter, Daniel 2015. Generalized Anxiety Disorder in racial and ethnic minorities: A case of nativity and contextual factors. Journal of Affective Disorders, Vol. 175, p. 275.

    Deckert, Andreas Winkler, Volker Meisinger, Christa Heier, Margit and Becher, Heiko 2015. Suicide and external mortality pattern in a cohort of migrants from the former Soviet Union to Germany. Journal of Psychiatric Research, Vol. 63, p. 36.

    Durbin, A. Moineddin, R. Lin, E. Steele, L. S. and Glazier, R. H. 2015. Examining the relationship between neighbourhood deprivation and mental health service use of immigrants in Ontario, Canada: a cross-sectional study. BMJ Open, Vol. 5, Issue. 3, p. e006690.

    Durbin, Anna Moineddin, Rahim Lin, Elizabeth Steele, Leah S. and Glazier, Richard H. 2015. Mental health service use by recent immigrants from different world regions and by non-immigrants in Ontario, Canada: a cross-sectional study. BMC Health Services Research, Vol. 15, Issue. 1,

    Hasin, Deborah S. and Grant, Bridget F. 2015. The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) Waves 1 and 2: review and summary of findings. Social Psychiatry and Psychiatric Epidemiology, Vol. 50, Issue. 11, p. 1609.

    Hearld, Kristine Ria Budhwani, Henna and Chavez-Yenter, Daniel 2015. Panic attacks in minority Americans: The effects of alcohol abuse, tobacco smoking, and discrimination. Journal of Affective Disorders, Vol. 174, p. 106.

    Rask, Shadia Castaneda, Anu E Koponen, Päivikki Sainio, Päivi Stenholm, Sari Suvisaari, Jaana Juntunen, Teppo Halla, Tapio Härkänen, Tommi and Koskinen, Seppo 2015. The association between mental health symptoms and mobility limitation among Russian, Somali and Kurdish migrants: a population based study. BMC Public Health, Vol. 15, Issue. 1,

    Rook, Graham A.W. Lowry, Christopher A. and Raison, Charles L. 2015. Hygiene and other early childhood influences on the subsequent function of the immune system. Brain Research, Vol. 1617, p. 47.

    Wilson, Alyssa N. Salas-Wright, Christopher P. Vaughn, Michael G. and Maynard, Brandy R. 2015. Gambling prevalence rates among immigrants: A multigenerational examination. Addictive Behaviors, Vol. 42, p. 79.

    Arévalo, Sandra P. Tucker, Katherine L. and Falcón, Luis M. 2014. Life events trajectories, allostatic load, and the moderating role of age at arrival from Puerto Rico to the US mainland. Social Science & Medicine, Vol. 120, p. 301.


Immigration to the USA and risk for mood and anxiety disorders: variation by origin and age at immigration

  • J. Breslau (a1), G. Borges (a2), Y. Hagar (a3), D. Tancredi (a4) and S. Gilman (a5)
  • DOI:
  • Published online: 12 November 2008

Risk for mood and anxiety disorders associated with US-nativity may vary across immigrant groups.


Using data from the National Epidemiological Study of Alcohol and Related Conditions (NESARC), we examined the association of lifetime risk for mood and anxiety disorders with US-nativity and age at immigration across seven subgroups of the US population defined by country or region of ancestral origin: Mexico, Puerto-Rico, Cuba, Central and South America, Western Europe, Eastern Europe, and Africa and the Caribbean. Discrete time survival models were used to compare lifetime risk between the US-born, immigrants who arrived in the USA prior to the age of 13 years and immigrants who arrived in the USA at the age of 13 years or older.


The association of risk for mood and anxiety disorders with US-nativity varies significantly across ancestral origin groups (p<0.001). Among people from Mexico, Eastern Europe, and Africa or the Caribbean, risk for disorders is lower relative to the US-born among immigrants who arrived at the age of 13 years or higher (odds ratios in the range 0.34–0.49) but not among immigrants who arrived prior to the age of 13 years. There is no association between US-nativity and risk for disorder among people from Western Europe and Puerto Rico.


Low risk among immigrants relative to the US-born is limited to groups among whom risk for mood and anxiety disorder is low in immigrants who spent their pre-adolescent years outside of the USA.

Corresponding author
*Address for correspondence: J. Breslau, Ph.D., Sc.D., University of California, Davis, School of Medicine, Department of Internal Medicine, Center for Reducing Health Disparities, 2921 Stockton Blvd., Sacramento, CA 95817, USA. (Email:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

AF Abraido-Lanza , MT Chao , KR Florez (2005). Do healthy behaviors decline with greater acculturation? Implications for the Latino mortality paradox. Social Science and Medicine 61, 12431255.

D Acevedo-Garcia , J Pan , HJ Jun , TL Osypuk , KM Emmons (2005). The effect of immigrant generation on smoking. Social Science and Medicine 61, 12231242.

E Alderete , WA Vega , B Kolody , S Aguilar-Gaxiola (2000). Effects of time in the United States and Indian ethnicity on DSM-III-R psychiatric disorders among Mexican-Americans in California. Journal of Nervous and Mental Disease 188, 90100.

M Alegria , G Canino , FS Stinson , BF Grant (2006). Nativity and DSM-IV psychiatric disorders among Puerto Ricans, Cuban Americans, and non-Latino Whites in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry 67, 5665.

M Alegria , N Mulvaney-Day , M Torres , A Polo , Z Cao , G Canino (2007 a). Prevalence of psychiatric disorders across Latino subgroups in the United States. American Journal of Public Health 97, 6875.

M Alegria , PE Shrout , M Woo , P Guarnaccia , W Sribney , D Vila , A Polo , Z Cao , N Mulvaney-Day , M Torres , G Canino (2007 b). Understanding differences in past year psychiatric disorders for Latinos living in the US. Social Science and Medicine 65, 214230.

M Alegria , W Sribney , M Woo , M Torres , P Guarnaccia (2007 c). Looking beyond nativity: the relation of age of immigration, length of residence, and birth cohorts to the risk of onset of psychiatric disorders among Latinos. Research in Human Development 4, 1947.

M Alegría , G Canino , P Shrout , M Woo , N Duan , D Vila , M Torres , C Chen , X Meng (2008). Prevalence of mental illness in immigrant and non-immigrant U.S. Latino groups. American Journal of Psychiatry 165, 359369.

PD Allison (1982). Discrete-time methods for the analysis of event histories. Sociological Methodology 13, 6198.

J Alonso , M Angermeyer , S Bernert , R Bruffaerts , T Brugha , H Bryson , G de Girolamo , R Graaf , K Demyttenaere , I Gasquet , J Haro , S Katz , R Kessler , V Kovess , J Lépine , J Ormel , G Polidori , L Russo , G Vilagut , J Almansa , S Arbabzadeh-Bouchez , J Autonell , M Bernal , M Buist-Bouwman , M Codony , A Domingo-Salvany , M Ferrer , S Joo , M Martínez-Alonso , H Matschinger , F Mazzi , Z Morgan , P Morosini , C Palacín , B Romera , N Taub , W Vollebergh ; ESEMeD/MHEDEA 2000 Investigators, European Study of the Epidemiology of Mental Disorders (ESEMeD) Project (2004). Prevalence of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatrica Scandinavica Supplementum 109 (Suppl. 420), 2127.

D Bhugra (2004). Migration and mental health. Acta Psychiatrica Scandinavica 109, 243258.

SM Blake , R Ledsky , C Goodenow , L O'Donnell (2001). Recency of immigration, substance use, and sexual behavior among Massachusetts adolescents. American Journal of Public Health 91, 794798.

J Breslau , S Aguilar-Gaxiola , G Borges , RC Castilla-Puentes , KS Kendler , ME Medina-Mora , M Su , RC Kessler (2007 a). Mental disorders among English-speaking Mexican immigrants to the US compared to a national sample of Mexicans. Psychiatry Research 151, 115122.

J Breslau , S Aguilar-Gaxiola , G Borges , KS Kendler , M Su , RC Kessler (2007 b). Risk for psychiatric disorder among immigrants and their US-born descendants: evidence from the National Comorbidity Survey Replication. Journal of Nervous and Mental Disease 195, 189195.

J Breslau , DF Chang (2006). Psychiatric disorders among foreign-born and US-born Asian-Americans in a US national survey. Social Psychiatry and Psychiatric Epidemiology 41, 943950.

MA Burnam , RL Hough , M Karno , JI Escobar , CA Telles (1987). Acculturation and lifetime prevalence of psychiatric disorders among Mexican-Americans in Los Angeles. Journal of Health and Social Behavior 28, 89102.

GJ Canino , HR Bird , PE Shrout , M Rubio-Stipec , M Bravo , R Martinez , M Sesman , LM Guevara (1987). The prevalence of specific psychiatric disorders in Puerto Rico. Archives of General Psychiatry 44, 727735.

B Efron (1988). Logistic regression, survival analysis and the Kaplan–Meier curve. Journal of the American Statistical Association 83, 414425.

JI Escobar , WA Vega (2000). Mental health and immigration's AAAs: where are we and where do we go from here? Journal of Nervous and Mental Disease 188, 736740.

B Grant , D Dawson , F Stinson , P Chou , W Kay , R Pickering (2003 a). The Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV): reliability of alcohol consumption, tobacco use, family history of depression and psychiatric diagnostic modules in a general population sample. Drug and Alcohol Dependence 71, 716.

BF Grant , FS Stinson , DS Hasin , DA Dawson , SP Chou , K Anderson (2004). Immigration and lifetime prevalence of DSM-IV psychiatric disorders among Mexican Americans and non-Hispanic whites in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry 61, 12261233.

W Haenszel (1970). Studies of migrant populations. Journal of Chronic Disease 23, 289291.

W-C Hwang , C-A Chun , DT Takeuchi , HF Myers , P Siddarth (2005). Age of first onset major depression in Chinese Americans. Cultural Diversity and Ethnic Minority Psychology 11, 1627.

TP Johnson , JB VanGeest , YI Cho (2002). Migration and substance use: evidence from the US. National Health Interview Survey. Substance Use and Misuse 37, 941972.

M Karno , JM Golding , MA Burnam , RL Hough , JI Escobar , KM Wells , R Boyer (1989). Anxiety disorders among Mexican Americans and non-Hispanic Whites in Los Angeles. Journal of Nervous and Mental Disease 177, 202209.

K Markides , K Eschbach (2005). Aging, migration, and mortality: current status of research on the Hispanic paradox. Journal of Gerontology Series B: Psychological Sciences Social Sciences 60, S68S75.

AN Ortega , R Rosenheck , M Alegria , RA Desai (2000). Acculturation and the lifetime risk of psychiatric and substance use disorders among Hispanics. Journal of Nervous and Mental Disease 188, 728735.

LH Rogler (1994). International migrations. A framework for directing research. American Psychologist 49, 701708.

LH Rogler , DE Cortes , RG Malgady (1991). Acculturation and mental status among Hispanics: convergence and new directions for research. American Psychologist 46, 585597.

J Swendsen , K Merikangas (2000). The comorbidity of depression and substance use disorders. Clinical Psychology Review 20, 173189.

D Takeuchi , S Hong , K Gile , M Alegria (2007 a). Developmental contexts and mental disorders among Asian-Americans. Research in Human Development 4, 4969.

DT Takeuchi , RC-Y Chung , K-M Lin , H Shen , K Kurasaki , C-A Chun , S Sue (1998). Lifetime and twelve-month prevalence rates of major depressive episodes and dysthymia among Chinese Americans in Los Angeles. American Journal of Psychiatry 155, 14071414.

DT Takeuchi , N Zane , S Hong , DH Chae , F Gong , GC Gee , E Walton , S Sue , M Alegria (2007 b). Immigration-related factors and mental disorders among Asian Americans. American Journal of Public Health 97, 8490.

WA Vega , B Kolody , S Aguilar-Gaxiola , E Alderete , R Catalano , J Caraveo-Anduaga (1998). Lifetime prevalence of DSM-III-R psychiatric disorders among urban and rural Mexican Americans in California. Archives of General Psychiatry 55, 771778.

JE Wells , LJ Horwood (2004). How accurate is recall of key symptoms of depression? A comparison of recall and longitudinal reports. Psychological Medicine 34, 10011011.

DR Williams , R Haile , HM Gonzalez , H Neighbors , R Baser , JS Jackson (2007). The mental health of Black Caribbean immigrants: results from the National Survey of American Life. American Journal of Public Health 97, 5259.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *