Department of Developmental Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands.
Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Soc Psychiatry Psychiatr Epidemiol. 2022 Nov;57(11):2319-2332. doi: 10.1007/s00127-022-02320-z. Epub 2022 Jul 19.
Lesbian, gay, and bisexual (LGB) individuals, and LB women specifically, have an increased risk for psychiatric morbidity, theorized to result from stigma-based discrimination. To date, no study has investigated the mental health disparities between LGB and heterosexual AQ1individuals in a large cross-national population-based comparison. The current study addresses this gap by examining differences between LGB and heterosexual participants in 13 cross-national surveys, and by exploring whether these disparities were associated with country-level LGBT acceptance. Since lower social support has been suggested as a mediator of sexual orientation-based differences in psychiatric morbidity, our secondary aim was to examine whether mental health disparities were partially explained by general social support from family and friends.
Twelve-month prevalence of DSM-IV anxiety, mood, eating, disruptive behavior, and substance disorders was assessed with the WHO Composite International Diagnostic Interview in a general population sample across 13 countries as part of the World Mental Health Surveys. Participants were 46,889 adults (19,887 males; 807 LGB-identified).
Male and female LGB participants were more likely to report any 12-month disorder (OR 2.2, p < 0.001 and OR 2.7, p < 0.001, respectively) and most individual disorders than heterosexual participants. We found no evidence for an association between country-level LGBT acceptance and rates of psychiatric morbidity between LGB and heterosexualAQ2 participants. However, among LB women, the increased risk for mental disorders was partially explained by lower general openness with family, although most of the increased risk remained unexplained.
These results provide cross-national evidence for an association between sexual minority status and psychiatric morbidity, and highlight that for women, but not men, this association was partially mediated by perceived openness with family. Future research into individual-level and cross-national sexual minority stressors is needed.
同性恋、双性恋和跨性别（LGBT）者，尤其是跨性别女性，患有精神疾病的风险增加，这被认为是基于污名的歧视所致。迄今为止，尚无研究在大型跨国人群中比较 LGBT 与异性恋个体，以调查心理健康方面的差异。本研究通过在 13 项跨国调查中比较 LGBT 与异性恋参与者之间的差异，并探讨这些差异是否与国家层面的 LGBT 接纳程度相关，来填补这一空白。由于较低的社会支持被认为是导致精神疾病基于性取向差异的一个中介因素，我们的次要目标是检验心理健康方面的差异是否部分由来自家庭和朋友的一般社会支持来解释。
在世界心理健康调查中，通过世界卫生组织综合国际诊断访谈对 13 个国家的一般人群样本进行了 DSM-IV 焦虑、情绪、饮食、破坏性行为和物质障碍 12 个月的患病率评估。参与者共有 46889 名成年人（男性 19887 名，LGB 认同者 807 名）。
男性和女性 LGBT 参与者比异性恋参与者更有可能报告任何 12 个月的障碍（OR2.2，p<0.001 和 OR2.7，p<0.001），并且更有可能报告大多数个体障碍。我们没有发现国家层面的 LGBT 接纳程度与 LGBT 和异性恋参与者之间的精神疾病发病率之间存在关联的证据。然而，在跨性别女性中，精神障碍的风险增加部分是由于与家庭的一般开放性较低所致，尽管大部分风险仍未得到解释。
这些结果为性少数群体地位与精神疾病之间的关联提供了跨国证据，并强调对于女性，但不是男性，这种关联部分是通过与家庭的感知开放性来解释的。需要进一步研究个体和跨国性少数群体压力源。
