Minority stress factors as mediators of sexual orientation disparities in mental health treatment: a longitudinal population-based study

被引:113
作者
Branstrom, Richard [1 ,2 ,3 ]
机构
[1] Karolinska Inst, Div Psychol, Dept Clin Neurosci, Nobels Vag 9, S-17177 Stockholm, Sweden
[2] Stockholm Univ, Stress Res Inst, Stockholm, Sweden
[3] Yale Univ, Yale Sch Publ Hlth, Social & Behav Sci Div, Dept Chron Dis Epidemiol, New Haven, CT USA
基金
瑞典研究理事会;
关键词
PSYCHIATRIC-DISORDERS; PHYSICAL HEALTH; SOCIAL SUPPORT; BISEXUAL POPULATIONS; UNITED-STATES; LIFE-SPAN; GAY; SUICIDE; VICTIMIZATION; GENDER;
D O I
10.1136/jech-2016-207943
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background Substantial mental health disparities between lesbian, gay and bisexual (LGB) individuals compared with heterosexuals have been identified. The aim was to examine potential sexual orientation-based disparities in mental health treatment in a prospectively analysed population-based sample in Sweden and to explore potential moderators and mediators. Method 30 730 individuals from the Stockholm Public Health Cohort were followed up with questionnaires and registry-based health record data on psychiatric healthcare visits and prescription drug use between 1 January 2011 and 31 December 2011. Results In adjusted analyses, gay and lesbian individuals were more likely to receive treatment for anxiety disorders (adjusted ORs (AOR) = 3.80; 95% CI 2.54 to 5.69) and to use antidepressant medication (AOR= 2.13; 95% CI 1.62 to 2.79); and bisexuals were more likely to receive treatment for mood disorders (AOR = 1.58; 95% CI 1.00 to 2.48), anxiety disorders (AOR = 3.23; 95% CI 2.22 to 4.72) and substance use disorders (AOR = 1.91; 95% CI 1.12 to 3.25), and to use antidepressant medication (AOR = 1.91; 95% CI 1.12 to 3.25) when compared with heterosexuals. The largest mental health treatment disparities based on sexual orientation were found among bisexual women, gay men and younger lesbian women. More frequent experiences of victimisation/threat of violence and lack of social support could partially explain these disparities. Conclusions This study shows a substantially elevated risk of poor mental health among LGB individuals as compared with heterosexuals. Findings support several factors outlined in the minority stress theory in explaining the mechanisms behind these disparities.
引用
收藏
页码:446 / 452
页数:7
相关论文
共 40 条
[1]  
[Anonymous], HLTH LESB GAY BISEX
[2]  
[Anonymous], 2013, AF2E
[3]  
[Anonymous], 1993, INT STAT CLASS DIS R, V10th
[4]  
Badgett M.Lau., 2007, Bias in the workplace: Consistent evidence of sexual orientation and gender identity discrimination
[5]   Victimization over the life span: A comparison of lesbian, gay, bisexual, and heterosexual siblings [J].
Balsam, KF ;
Rothblum, ED ;
Beauchaine, TP .
JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY, 2005, 73 (03) :477-487
[6]   Sexual orientation disparities in mental health: the moderating role of educational attainment [J].
Barnes, David M. ;
Hatzenbuehler, Mark L. ;
Hamilton, Ava D. ;
Keyes, Katherine M. .
SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY, 2014, 49 (09) :1447-1454
[7]  
Bildt C., 2004, FACKMEDLEMMARS UPPFA
[8]   Dimensions of Sexual Orientation and the Prevalence of Mood and Anxiety Disorders in the United States [J].
Bostwick, Wendy B. ;
Boyd, Carol J. ;
Hughes, Tonda L. ;
McCabe, Sean Esteban .
AMERICAN JOURNAL OF PUBLIC HEALTH, 2010, 100 (03) :468-475
[9]   Sexual orientation disparities in physical health: age and gender effects in a population-based study [J].
Branstrom, Richard ;
Hatzenbuehler, Mark L. ;
Pachankis, John E. .
SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY, 2016, 51 (02) :289-301
[10]   Sexual Minority Youth Victimization and Social Support: The Intersection of Sexuality, Gender, Race, and Victimization [J].
Button, Deeanna M. ;
O'Connell, Daniel J. ;
Gealt, Roberta .
JOURNAL OF HOMOSEXUALITY, 2012, 59 (01) :18-43