Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles.
Department of Psychology, Fielding School of Public Health, University of California, Los Angeles.
J Consult Clin Psychol. 2017 Dec;85(12):1111-1121. doi: 10.1037/ccp0000243. Epub 2017 Aug 31.
The authors investigated sexual orientation differences in risk for mental health morbidity, functional limitations/disability, and mental health services use among adults interviewed in the nationally representative 2013-2014 National Health Interview Survey.
Respondents were 68,816 adults (67,152 heterosexual and 1,664 lesbian, gay, and bisexual [LGB] individuals), age 18 and older. Fully structured interviews assessed sexual orientation identity, health status, and services use. Using sex-stratified analyses while adjusting for demographic confounding, the authors compared LGB and heterosexual individuals for evidence of mental health-related impairments and use of mental health services.
LGB adults, as compared to heterosexual adults, demonstrated higher prevalence of mental health morbidity and functional limitations. However, this varied by gender with LGB women evidencing elevated risk for both mental health and substance abuse (MHSA) and non-MHSA limitations. Among men, sexual orientation differences clustered among MHSA-related limitations. Overall, LGB adults were more likely than heterosexual adults to use services, with the source of functional limitations moderating these effects among men.
MHSA-related morbidity is a significant concern among LGB individuals and is associated with higher levels of functional limitations/disability. The findings highlight that LGB persons use MHSA-related treatment at higher rates than heterosexuals do, and, among men, are more likely to do so absent MHSA or non-MHSA-related functional limitations. This presents a unique set of concerns within the integrated care setting, including the need to deliver culturally competent care sensitive to the context of probable sex differences among LGB individuals. (PsycINFO Database Record
作者调查了在全国代表性的 2013-2014 年全国健康访谈调查中接受采访的成年人中，性取向差异与心理健康发病率、功能障碍/残疾和心理健康服务使用之间的关系。
受访者为 68816 名成年人（67152 名异性恋者和 1664 名同性恋、双性恋和双性恋者），年龄在 18 岁及以上。采用完全结构化访谈评估性取向认同、健康状况和服务使用情况。作者使用性别分层分析，同时调整人口统计学混杂因素，比较了 LGB 和异性恋个体在心理健康相关障碍和心理健康服务使用方面的证据。
与异性恋成年人相比，LGB 成年人表现出更高的心理健康发病率和功能障碍发生率。然而，这因性别而异，LGB 女性表现出更高的心理健康和物质滥用（MHS）以及非 MHS 障碍风险。在男性中，性取向差异集中在 MHS 相关障碍上。总体而言，LGB 成年人比异性恋成年人更有可能使用服务，而男性的功能障碍来源则调节了这些影响。
MHS 相关发病率是 LGB 个体的一个重要关注点，与更高水平的功能障碍/残疾有关。这些发现强调了 LGB 人群比异性恋者更有可能使用 MHS 相关治疗，而在男性中，他们更有可能在没有 MHS 或非 MHS 相关功能障碍的情况下这样做。这在综合护理环境中提出了一组独特的问题，包括需要提供文化上有能力的、对 LGB 个体中可能存在的性别差异敏感的关怀。
