Lorimy L, Cosquer M, Barron E, Jousselme C
Centre hospitalier Sud francilien, 40, avenue Serge-Dassault, 91100 Corbeil-Essonnes, France.
SHU Fondation vallée, 7, rue Benserade, 94257 Gentilly cedex, France.
Encephale. 2021 Feb;47(1):15-20. doi: 10.1016/j.encep.2020.02.009. Epub 2020 Jun 7.
Although homosexuality is a subject often addressed by the media, little is said about homosexuality in adolescents who are particularly affected by the question of sexual orientation. This work aims to study the mental health of adolescents who report being exclusively attracted to members of the same sex. We explore the evidence for an association between homosexuality and depression, suicide attempts, and consulting a psychiatrist or a psychologist.
We used data from the cross-sectional study "Adolescent Portraits - A Multicenter Epidemiological Survey in Schools in 2013" (CHU Fondation Vallée, Inserm CESP U1018). Data were gathered through the use of an anonymous, self-administered questionnaire (348 questions) given to students between the "4" and "terminaleschool" years (comparable to the 8th and 12th grade in the U.S. education system) in three contrasting French geographical areas. The risk of depression was measured using the Adolescent Depression Rating Scale (ADRS).
The results reflect the survey responses provided by 15,235 young people. Of these, 1.5 % reported only being attracted to members of the same sex (homosexual group). This group contained twice as many girls as boys. Students who did not report sexual attraction, who reported bisexual attraction, or who did not answer the question were excluded from the results (830 students). In the homosexual group, 24 % presented with depression versus 11.5 % of those attracted exclusively to members of the opposite sex (heterosexual group). There is also a significant difference between sexes: 13.2 % of boys in the homosexual group were depressed compared to 29.3 % of girls in the same group; 6.7 % of boys in the heterosexual group reported being depressed versus 16.1 % of girls in the same group. In the heterosexual group, 10.7 % of respondents reported having already made at least one suicide attempt versus 20.7 % of those in the homosexual group. There was a difference according to sex, since 6.3 % of boys in the heterosexual group had a history of attempted suicide versus 14.9 % of girls in the same group. This gap disappeared completely within the homosexual group, as 21.4 % of boys and 20.4 % of girls had already made at least one suicide attempt at the time of the survey. Depressed adolescents in the homosexual group also reported a higher number of previous suicide attempts than those in the heterosexual group (46.9 % versus 31.6 %). In terms of sex, 25.3 % of depressed boys in the heterosexual group made at least one suicide attempt versus 34.1 % of girls. In the homosexual group, 44.4 % of depressed boys reported having made at least one suicide attempt versus 47.5 % of depressed girls. Adolescents in the homosexual group were significantly more likely to report having consulted a psychiatrist or psychologist than those in the heterosexual group (14.6 % versus 6.5 %), regardless of sex (16.7 % versus 4.7 % for boys; 13.5 % versus 8.2 % for girls). This difference was also found among depressed subjects (26.0 % in the homosexual group versus 15.4 % in the heterosexual group). Sexual activity (having already had sex) was higher in the homosexual group than in the heterosexual group (53.7 % versus 37.5 %), and this difference remained significant after adjusting for age. Fifty percent of the sexually active homosexual respondents reported having engaged in sexual activity of a homosexual nature versus 0.7 % of sexually active heterosexual respondents. In the homosexual group, mental suffering appeared to be more severe among sexually active subjects, in terms of dark thoughts (64 % versus 46 %) and a prior history of attempted suicide (29.3 % versus 10 %), but not in terms of depression (27.9 % versus 18.9 %; NS).
Young people who reported being exclusively attracted to members of the same sex presented a higher level of mental distress compared to those who reported being attracted to members of the opposite sex. This was especially the case for boys. These findings led to the identification of risk and protective factors that can inform the development of appropriate preventive measures.
尽管同性恋是媒体经常提及的话题，但对于受性取向问题影响尤为严重的青少年同性恋群体，相关讨论却很少。本研究旨在探讨那些称自己只被同性吸引的青少年的心理健康状况。我们将探究同性恋与抑郁、自杀未遂以及咨询精神科医生或心理医生之间的关联证据。
我们使用了来自横断面研究“青少年画像——2013年学校多中心流行病学调查”（CHU Fondation Vallée，Inserm CESP U1018）的数据。数据通过向法国三个不同地理区域中处于“4年级”至“高中毕业班”（相当于美国教育体系中的8年级至12年级）的学生发放匿名自填问卷（共348个问题）收集。使用青少年抑郁评定量表（ADRS）来测量抑郁风险。
结果反映了15235名年轻人的调查回复。其中，1.5%的人称自己只被同性吸引（同性恋群体）。该群体中女孩数量是男孩的两倍。未报告有性吸引、报告有双性吸引或未回答该问题的学生被排除在结果之外（830名学生）。在同性恋群体中，24%的人有抑郁症状，而在只被异性吸引的人群（异性恋群体）中这一比例为11.5%。不同性别之间也存在显著差异：同性恋群体中13.2%的男孩有抑郁症状，而该群体中女孩的这一比例为29.3%；异性恋群体中6.7%的男孩称有抑郁症状，而该群体中女孩的这一比例为16.1%。在异性恋群体中，10.7%的受访者称至少有过一次自杀未遂经历，而在同性恋群体中这一比例为20.7%。不同性别间存在差异，异性恋群体中6.3%的男孩有自杀未遂史，而该群体中女孩的这一比例为14.9%。在同性恋群体中，这一差距完全消失，因为在调查时21.4%的男孩和20.4%的女孩至少有过一次自杀未遂经历。同性恋群体中抑郁的青少年报告的既往自杀未遂次数也高于异性恋群体（46.9%对31.6%）。就性别而言，异性恋群体中25.3%抑郁的男孩至少有过一次自杀未遂经历，而女孩的这一比例为34.1%。在同性恋群体中，44.4%抑郁的男孩称至少有过一次自杀未遂经历，而抑郁女孩的这一比例为47.5%。同性恋群体中的青少年比异性恋群体中的青少年更有可能报告曾咨询过精神科医生或心理医生（14.6%对6.5%），无论性别如何（男孩为16.7%对4.7%；女孩为13.5%对8.2%）。在抑郁受试者中也发现了这种差异（同性恋群体中为26.0%，异性恋群体中为15.4%）。同性恋群体中的性活动（已经发生过性行为）比例高于异性恋群体（53.7%对37.5%），在调整年龄后这一差异仍然显著。50%有性活动的同性恋受访者称有过同性性行为，而有性活动的异性恋受访者中这一比例为0.7%。在同性恋群体中，就消极想法（64%对46%）和既往自杀未遂史（29.3%对10%）而言，有性活动的受试者的心理痛苦似乎更严重，但在抑郁方面并非如此（27.9%对18.9%；无显著差异）。
与那些称被异性吸引的年轻人相比，称只被同性吸引的年轻人表现出更高水平的心理困扰。男孩尤其如此。这些发现有助于识别风险和保护因素，为制定适当的预防措施提供参考。
