女同性恋、男同性恋和双性恋成年人与异性恋成年人的心理健康状况比较：两项具有全国代表性的英国家庭概率抽样调查结果

The mental health of lesbian, gay, and bisexual adults compared with heterosexual adults: results of two nationally representative English household probability samples.

作者信息

Pitman Alexandra, Marston Louise, Lewis Gemma, Semlyen Joanna, McManus Sally, King Michael

机构信息

UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.

Camden and Islington NHS Foundation Trust, St Pancras Hospital, London, NW1 0PE, UK.

出版信息

Psychol Med. 2021 Feb 17:1-10. doi: 10.1017/S0033291721000052.

DOI:10.1017/S0033291721000052

PMID:33592165

Abstract

BACKGROUND

Evidence on inequalities in mental health in lesbian, gay, and bisexual people arises primarily from non-random samples.

AIMS

To use a probability sample to study change in mental health inequalities between two survey points, 7 years apart; the contribution of minority stress; and whether associations vary by age, gender, childhood sexual abuse, and religious identification.

METHODS

We analysed data from 10 443 people, in two English population-based surveys (2007 and 2014), on common mental disorder (CMD), hazardous alcohol use, and illicit drug use. Multivariable models were adjusted for age, gender, and economic factors, adding interaction terms for survey year, age, gender, childhood sexual abuse, and religious identification. We explored bullying and discrimination as mediators.

RESULTS

Inequalities in risks of CMD or substance misuse were unchanged between 2007 and 2014. Compared to heterosexuals, bisexual, and lesbian/gay people were more likely to have CMD, particularly bisexual people [adjusted odds ratio (AOR) = 2.86; 95% CI 1.83-4.46], and to report alcohol misuse and illicit drug use. When adjusted for bullying, odds of CMD remained elevated only for bisexual people (AOR = 3.21; 95% CI 1.64-6.30), whilst odds of alcohol and drug misuse were unchanged. When adjusted for discrimination, odds of CMD and alcohol misuse remained elevated only for bisexual people (AOR = 2.91; 95% CI 1.80-4.72; and AOR = 1.63; 95% CI 1.03-2.57 respectively), whilst odds of illicit drug use remained unchanged. There were no interactions with age, gender, childhood sexual abuse, or religious identification.

CONCLUSIONS

Mental health inequalities in non-heterosexuals have not narrowed, despite increasing societal acceptance. Bullying and discrimination may help explain the elevated rate of CMD in lesbian women and gay men but not in bisexual people.

摘要

背景

关于女同性恋、男同性恋和双性恋者心理健康不平等的证据主要来自非随机样本。

目的

使用概率样本研究相隔7年的两个调查点之间心理健康不平等的变化；少数群体压力的作用；以及这些关联是否因年龄、性别、童年期性虐待和宗教认同而有所不同。

方法

我们分析了来自两项基于英国人口的调查（2007年和2014年）中10443人的数据，内容涉及常见精神障碍（CMD）、有害饮酒和非法药物使用。多变量模型针对年龄、性别和经济因素进行了调整，并增加了调查年份、年龄、性别、童年期性虐待和宗教认同的交互项。我们将欺凌和歧视作为中介因素进行了探究。

结果

2007年至2014年期间，CMD或物质滥用风险的不平等状况没有变化。与异性恋者相比，双性恋者以及女同性恋者/男同性恋者更有可能患有CMD，尤其是双性恋者[调整后的优势比（AOR）=2.86；95%置信区间1.83 - 4.46]，并且更有可能报告有害饮酒和非法药物使用情况。在对欺凌进行调整后，仅双性恋者患CMD的几率仍然较高（AOR = 3.21；95%置信区间1.64 - 6.30），而有害饮酒和药物滥用的几率没有变化。在对歧视进行调整后，仅双性恋者患CMD和有害饮酒的几率仍然较高（分别为AOR = 2.91；95%置信区间1.80 - 4.72；以及AOR = 1.63；95%置信区间1.03 - 2.57），而非法药物使用的几率没有变化。不存在与年龄、性别、童年期性虐待或宗教认同的交互作用。