Differences in mental health symptoms and attempted suicide among Puerto Rican drug users in Puerto Rico and Massachusetts

This study examines differences in self-reported mental health symptoms and suicide attempts between a sample of Puerto Rican injection drug users (IDUs) residing on the Island of Puerto Rico and in Massachusetts. Intravenous drug use has been associated with elevated suicide risks (Dinwiddie,Reich, Cloninger, 1992) and HIV infection (Baez-Feliciano, Gomez, Fernandez-Santos, Quintana, Rios-Olivares and Hunter-Mellado, 2008). However, little is known about whether Puerto Rican IDUs on the Island report similar rates of mental health symptoms including suicide attempts as those in US mainland.

Methods: 171 adult IDUs on the Island and 208 adult IDUs in Massachusetts were surveyed in 2007-2008. Bivariate and logistic regression analyses tested the association between residing on the Island versus the US mainland and self-reported attempted suicides (during past 30 days), controlling for the participants' demographic characteristics. Psychiatric symptoms were assessed using the Addiction Severity Index (McGahan,Griffith, Parente, McLellan,1986).

Findings: Bivariate statistical analyses reveal that Puerto Rican Island IDUs were significantly less likely to report psychiatric symptoms of depression (67.3%) or anxiety (61.4%) compared to their US mainland counterparts, who reported 81.3% and 80.8%, respectively. In contrast, Puerto Rican IDUs on the Island reported significantly higher rates of suicide attempts (19.2%) than those in Massachusetts (8.2%). Logistic regression analysis identified that Puerto Rican Island IDUs had a 4.8 times greater likelihood of attempted suicide compared to US mainland participants controlling for eight independent variables. Findings suggest the need for culturally appropriate mental health assessments and improved suicide prevention efforts for Puerto Rican IDUs on both locales.