25 years of child and adult psychiatric epidemiology studies in Puerto Rico

A review of the psychiatric epidemiology studies of the adult and child population of Puerto Rico carried out in the last 25 years is presented and discussed. Puerto Rico has experienced a plethora of psychiatric epidemiology studies since the decade of the 80's, with 4 adult and 4 child population based studies. The overall results of these studies showed that island Puerto Ricans are not at greater risk for psychiatric disorders as compared to other US or international populations in spite of the fact that the island is besieged by many of the socio-demographic factors associated with high risk populations. If anything, it appears that important protective factors associated with good family relationships and the importance of the family in Hispanic families may be buffering island families from the development of addictive and antisocial disorders.

Prevalence and factors associated to sexual behavior in Puerto Rican adolescents

Sexual relations with intercourse (ASR-I) and high prevalence of teen pregnancies (19.2%, in 2002) among adolescents in Puerto Rico constitute a serious biopsychosocial problem. Studying the consequences and correlates of ASR-I in community and mental health samples of adolescents is important in designing and implementing sexual health programs. Randomized representative cross-sectional samples of male and female adolescents from 11-18 years old (N = 994 from the general community, N = 550 receiving mental health services) who had engaged in ASR-I were the subjects of this study. Demographic, family, and sexual data and the DISC-IV were collected from individual interviews. Logistic regression models, bivariate odds ratios, Chi-squares, and t tests were used in the statistical analysis. The mental health sample showed higher rates of ASR-I, lifetime reports of pregnancy and lower age of ASR-I onset for females. No gender difference in the prevalence of ASR-I was observed in both samples. Older adolescents from the community sample meeting psychiatric diagnosis criteria, and with lower parental monitoring, were more likely to engage in ASR-I, whereas in the mental health sample, adolescents with lower parental monitoring and parental involvement reported significantly more ASR-I. Prevalence of ASR-I and Risky Sexual Behavior (RSB) were almost identical. Adolescents with mental health disorders initiate and engage in ASR-I earlier and more frequently regardless of gender. Older adolescents are more likely to engage in ASR-I and parent-child relationships emerged as a highly relevant predictor of adolescent sexual behavior. The high correspondence between ASR-I and RSB has important clinical implications.

Prevalence and correlates of DSM-IV substance use disorders in Puerto Rico

We report the basic findings of a survey aimed at estimating rates of substance disorders in a probability sample of 4,709 household residents aged 15 to 64 years old. Lifetime use of alcohol was reported by 77.2, and 10.7 reported ever using illicit drugs. Overall, 14.7 of the sample met criteria for a lifetime substance disorder, and 4.9 for a past year disorder. The rates of lifetime disorders were 13.1 for alcohol and 4.1 for illicit drug. Past year abuse/dependence was 4.3 for alcohol and 1.3 for illicit drugs. Alcohol use disorders were associated with male gender, higher family annual income, being employed, and being married. Illicit drug use disorders were associated with male gender and younger age. Only 13.0 of respondents with a past year disorder reported using services for their disorder. A program of continuous monitoring of substance using disorders is critical to establishing and monitoring effective policies