Mental Health Problems More Common in Gays, Lesbians, Bisexuals

Perceived Discrimination Based on Sexual Orientation May Be Partly to Blame

Megan Brooks

February 03, 2011

February 3, 2011 — England's gay, lesbian, and bisexual populations are more likely to experience mental health problems than their heterosexual counterparts, a new survey suggests.

Investigators say the survey confirms similar research conducted in North America and Holland that suggests that nonheterosexual people are at higher risk for a mental disorder, suicidal ideation, substance misuse, and self-harm than heterosexual people.

Elevated levels of psychiatric problems in nonheterosexual people are "very worrying and call not only for a response by professionals in primary care and mental health services but also efforts at prevention," Apu Chakraborty, PhD, MSc, MRCPsych, of the Department of Mental Health Sciences, University College London, United Kingdom, and colleagues conclude.

The survey also suggests that discrimination against gay, lesbian, and bisexual individuals may contribute to the higher levels of mental problems seen in these populations.

They caution, however, that "conclusions about causality need to be tentative" given the cross-sectional nature of the survey. Still, they say their observations lend "some support to the perceived discrimination–social stressor hypothesis for genesis of mental health problems in the nonheterosexual population of England."

The findings are published in the February issue of the British Journal of Psychiatry.

Host of Mental Woes

Dr. Chakraborty and colleagues studied rates of mental disorders in a representative sample of 7403 adults living in the United Kingdom using the Adult Psychiatric Morbidity Survey 2007.

The 650 people (8.8%) who identified themselves as nonheterosexual (both in orientation and sexual partnership, separately) were more apt to report a whole host of mental woes, including unhappiness, neurotic disorders overall, depressive symptoms, generalized anxiety disorder, obsessive-compulsive disorder (OCD), phobic disorder, probable psychosis, suicidal thoughts and actions, self-harm, and alcohol and drug dependence.

For example, 4.1% of nonheterosexual people reported having had a depressive episode in the week before the survey compared with only 2.1% of heterosexual people, 10.4% of nonheterosexual people reported alcohol dependence compared with 5.4% of heterosexual people, and 8.6% of nonheterosexual people reported self-harming compared with 4.6% of heterosexual people.

Overall, 40.1% of heterosexual people described themselves as being fairly or very happy compared with just 30.3% of nonheterosexual people.

All of these associations remained significant after adjustment for sociodemographic variables, the researchers report. For the nonheterosexual group, the adjusted odds ratios for the mental health outcomes were roughly 1.5 to greater than 2-fold higher relative to the heterosexual group, whereas that for happiness was significantly reduced.

Prior-year consultations with health professionals for mental health reasons were more common in nonheterosexual than heterosexual individuals.

Discrimination Damaging

The researchers also found that nonheterosexual people were significantly more likely to report discrimination on grounds of sexuality, although the absolute level of discrimination was "comparatively low," the researchers say. A total of 4.9% of nonheterosexual people reported experiencing such discrimination in the last 12 months compared with 1.6% in the heterosexual group.

"Perceived discrimination was associated with both harmful effects on quality of life and indicators of psychiatric morbidity in the total sample," the researchers report. In particular, in the nonheterosexual group, discrimination on the grounds of sexual orientation predicted certain neurotic disorders, such as OCD, even after adjusting for confounding variables.

Although the association between discrimination and OCD was somewhat "unexpected," the researchers say, it jives with a recent systematic review of associated OCD symptoms with self-reported racial discrimination.

The study authors have disclosed no relevant financial relationships.

Br J Psychiatry. 2011;198:143-148.

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