Rimes Katharine A, Broadbent Matthew, Holden Rachel, Rahman Qazi, Hambrook David, Hatch Stephani L, Wingrove Janet
King's College London,Institute of Psychiatry, Psychology & Neuroscience,London SE5 8AF.
South London and Maudsley NHS Foundation Trust,London SE5 8AZ.
Behav Cogn Psychother. 2018 May;46(3):332-349. doi: 10.1017/S1352465817000583. Epub 2017 Oct 5.
Lesbian, gay and bisexual individuals experience more anxiety and depression than heterosexual people. Little is known about their comparative treatment response to psychological interventions.
To compare sociodemographic/clinical characteristics and treatment outcomes across sexual orientation groups, for adults receiving primary care psychological interventions from Improving Access to Psychological Therapies (IAPT) services in London, adjusting for possible confounders.
Data from 188 lesbian women, 222 bisexual women, 6637 heterosexual women, 645 gay men, 75 bisexual men and 3024 heterosexual men were analysed from pre-treatment and last treatment sessions. Males and females were analysed separately.
Before treatment, lesbian and bisexual women were more likely to report clinical levels of impairment (Work and Social Adjustment Scale) than heterosexual women; there were no significant differences in depression (PHQ-9) or anxiety (GAD-7). Bisexual men were more likely to meet depression caseness than gay men but less likely to meet anxiety caseness than gay or heterosexual men. Compared with heterosexual women, lesbian and bisexual individuals showed smaller reductions in depression and impairment, controlling for age, ethnicity, employment, baseline symptoms, number of sessions and intervention type. Bisexual women experienced significantly smaller reductions in anxiety than heterosexual women and were less likely to show recovery or reliable recovery. There were no significant differences in treatment outcomes between gay, bisexual and heterosexual men.
Reasons for poorer outcomes in lesbian and bisexual women require investigation, for example lifetime trauma or stigma/discrimination regarding gender or sexual orientation in everyday life or within therapy services.
女同性恋、男同性恋和双性恋者比异性恋者更容易出现焦虑和抑郁。对于他们对心理干预的比较治疗反应知之甚少。
比较伦敦改善心理治疗可及性（IAPT）服务中接受初级保健心理干预的成年人不同性取向群体的社会人口统计学/临床特征和治疗结果，并对可能的混杂因素进行调整。
分析了188名女同性恋女性、222名双性恋女性、6637名异性恋女性、645名男同性恋男性、75名双性恋男性和3024名异性恋男性治疗前和最后一次治疗时的数据。男性和女性分别进行分析。
治疗前，女同性恋和双性恋女性比异性恋女性更有可能报告临床水平的功能损害（工作和社会适应量表）；在抑郁（PHQ-9）或焦虑（GAD-7）方面没有显著差异。双性恋男性比男同性恋男性更有可能达到抑郁病例标准，但比男同性恋或异性恋男性达到焦虑病例标准的可能性更小。与异性恋女性相比，在控制年龄、种族、就业、基线症状、治疗次数和干预类型后，女同性恋和双性恋者的抑郁和功能损害减轻幅度较小。双性恋女性的焦虑减轻幅度明显小于异性恋女性，且恢复或可靠恢复的可能性较小。男同性恋、双性恋和异性恋男性在治疗结果上没有显著差异。
女同性恋和双性恋女性治疗效果较差的原因需要进行调查，例如终生创伤或日常生活或治疗服务中与性别或性取向相关的耻辱感/歧视。
