Jan-Ole H Gmelin1, Ymkje Anna De Vries2,3, Laura Baams4, Sergio Aguilar-Gaxiola5, Jordi Alonso6,7,8, Guilherme Borges9, Brendan Bunting10, Graca Cardoso11, Silvia Florescu12, Oye Gureje13, Elie G Karam14,15,16, Norito Kawakami17, Sing Lee18, Zeina Mneimneh19, Fernando Navarro-Mateu20,21, José Posada-Villa22, Charlene Rapsey23, Tim Slade24, Juan Carlos Stagnaro25, Yolanda Torres26, Ronald C Kessler27, Peter de Jonge28. 1. Department of Developmental Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands. j.h.gmelin@rug.nl. 2. Department of Developmental Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands. 3. Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. 4. Department of Pedagogy and Educational Sciences, University of Groningen, Groningen, The Netherlands. 5. Center for Reducing Health Disparities, UC Davis Health System, Sacramento, CA, USA. 6. Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain. 7. Pompeu Fabra University (UPF), Barcelona, Spain. 8. CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. 9. National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico. 10. School of Psychology, Ulster University, Londonderry, UK. 11. Lisbon Institute of Global Mental Health and Chronic Diseases Research Center, NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal. 12. National School of Public Health, Management and Development, Bucharest, Romania. 13. Department of Psychiatry, University College Hospital, Ibadan, Nigeria. 14. Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon. 15. Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon. 16. Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon. 17. Department of Digital Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. 18. Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong. 19. Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA. 20. IDRAAC, Beirut, Lebanon. 21. UDIF-SM, Subdirección General de Planificación, Innovación y Cronicidad, Servicio Murciano de Salud, IMIB-Arrixaca, CIBERESP-Murcia, Murcia, Spain. 22. Colegio Mayor de Cundinamarca University, Faculty of Social Sciences, Bogota, Colombia. 23. Department of Psychological Medicine, University of Otago, Dunedin, Otago, New Zealand. 24. The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia. 25. Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina. 26. Center for Excellence on Research in Mental Health, CES University, Medellin, Colombia. 27. Department of Health Care Policy, Harvard Medical School, Boston, MA, USA. 28. Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands.
Abstract
PURPOSE: Lesbian, gay, and bisexual (LGB) individuals, and LB women specifically, have an increased risk for psychiatric morbidity, theorized to result from stigma-based discrimination. To date, no study has investigated the mental health disparities between LGB and heterosexual AQ1individuals in a large cross-national population-based comparison. The current study addresses this gap by examining differences between LGB and heterosexual participants in 13 cross-national surveys, and by exploring whether these disparities were associated with country-level LGBT acceptance. Since lower social support has been suggested as a mediator of sexual orientation-based differences in psychiatric morbidity, our secondary aim was to examine whether mental health disparities were partially explained by general social support from family and friends. METHODS: Twelve-month prevalence of DSM-IV anxiety, mood, eating, disruptive behavior, and substance disorders was assessed with the WHO Composite International Diagnostic Interview in a general population sample across 13 countries as part of the World Mental Health Surveys. Participants were 46,889 adults (19,887 males; 807 LGB-identified). RESULTS: Male and female LGB participants were more likely to report any 12-month disorder (OR 2.2, p < 0.001 and OR 2.7, p < 0.001, respectively) and most individual disorders than heterosexual participants. We found no evidence for an association between country-level LGBT acceptance and rates of psychiatric morbidity between LGB and heterosexualAQ2 participants. However, among LB women, the increased risk for mental disorders was partially explained by lower general openness with family, although most of the increased risk remained unexplained. CONCLUSION: These results provide cross-national evidence for an association between sexual minority status and psychiatric morbidity, and highlight that for women, but not men, this association was partially mediated by perceived openness with family. Future research into individual-level and cross-national sexual minority stressors is needed.
PURPOSE: Lesbian, gay, and bisexual (LGB) individuals, and LB women specifically, have an increased risk for psychiatric morbidity, theorized to result from stigma-based discrimination. To date, no study has investigated the mental health disparities between LGB and heterosexual AQ1individuals in a large cross-national population-based comparison. The current study addresses this gap by examining differences between LGB and heterosexual participants in 13 cross-national surveys, and by exploring whether these disparities were associated with country-level LGBT acceptance. Since lower social support has been suggested as a mediator of sexual orientation-based differences in psychiatric morbidity, our secondary aim was to examine whether mental health disparities were partially explained by general social support from family and friends. METHODS: Twelve-month prevalence of DSM-IV anxiety, mood, eating, disruptive behavior, and substance disorders was assessed with the WHO Composite International Diagnostic Interview in a general population sample across 13 countries as part of the World Mental Health Surveys. Participants were 46,889 adults (19,887 males; 807 LGB-identified). RESULTS: Male and female LGB participants were more likely to report any 12-month disorder (OR 2.2, p < 0.001 and OR 2.7, p < 0.001, respectively) and most individual disorders than heterosexual participants. We found no evidence for an association between country-level LGBT acceptance and rates of psychiatric morbidity between LGB and heterosexualAQ2 participants. However, among LB women, the increased risk for mental disorders was partially explained by lower general openness with family, although most of the increased risk remained unexplained. CONCLUSION: These results provide cross-national evidence for an association between sexual minority status and psychiatric morbidity, and highlight that for women, but not men, this association was partially mediated by perceived openness with family. Future research into individual-level and cross-national sexual minority stressors is needed.
Authors: Michael King; Joanna Semlyen; Sharon See Tai; Helen Killaspy; David Osborn; Dmitri Popelyuk; Irwin Nazareth Journal: BMC Psychiatry Date: 2008-08-18 Impact factor: 3.630