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LGBTQ 人群中的创伤后应激障碍:系统评价和荟萃分析。

Post-traumatic stress disorder among LGBTQ people: a systematic review and meta-analysis.

机构信息

Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.

Dipartimento ad Attività Integrata di Salute Mentale e Dipendenze Patologiche, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.

出版信息

Epidemiol Psychiatr Sci. 2023 Jul 11;32:e44. doi: 10.1017/S2045796023000586.


DOI:10.1017/S2045796023000586
PMID:37431310
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10387489/
Abstract

AIMS: Lesbian, gay, bisexual, transgender and queer people (LGBTQ) are at increased risk of traumatization. This systematic review aimed to summarize data regarding the risk of post-traumatic stress disorder (PTSD) for LGBTQ people and their subgroups. METHODS: Medline, Scopus, PsycINFO and EMBASE were searched until September 2022. Studies reporting a comparative estimation of PTSD among LGBTQ population and the general population (i.e., heterosexual/cisgender), without restrictions on participants' age and setting for the enrolment, were identified. Meta-analyses were based on odds ratio (OR and 95% confidence intervals [CI]), estimated through inverse variance models with random effects. RESULTS: The review process led to the selection of 27 studies, involving a total of 31,903 LGBTQ people and 273,842 controls, which were included in the quantitative synthesis. Overall, LGBTQ people showed an increased risk of PTSD (OR: 2.20 [95% CI: 1.85; 2.60]), although there was evidence of marked heterogeneity in the estimate ( = 91%). Among LGBTQ subgroups, transgender people showed the highest risk of PTSD (OR: 2.52 [95% CI: 2.22; 2.87]) followed by bisexual people (OR: 2.44 [95% CI: 1.05; 5.66]), although these comparisons are limited by the lack of data for other sexual and gender minorities, such as intersex people. Interestingly, the risk of PTSD for bisexual people was confirmed also considering lesbian and gay as control group (OR: 1.44 [95% CI: 1.07; 1.93]). The quality of the evidence was low. CONCLUSIONS: LGBTQ people are at higher risk of PTSD compared with their cisgender/heterosexual peers. This evidence may contribute to the public awareness on LGBTQ mental health needs and suggest supportive strategies as well as preventive interventions (e.g., supportive programs, counselling, and destigmatizing efforts) as parts of a tailored health-care planning aimed to reduce psychiatric morbidity in this at-risk population.

摘要

目的:女同性恋、男同性恋、双性恋、跨性别和酷儿(LGBTQ)人群遭受创伤的风险增加。本系统评价旨在总结 LGBTQ 人群及其亚组发生创伤后应激障碍(PTSD)的风险数据。

方法:检索了 Medline、Scopus、PsycINFO 和 EMBASE,截至 2022 年 9 月。确定了报告 LGBTQ 人群与一般人群(即异性恋/顺性别)中 PTSD 比较发生率的研究,对参与者的年龄和登记地点没有限制。采用基于逆方差模型的随机效应估计比值比(OR 和 95%置信区间 [CI])进行荟萃分析。

结果:审查过程导致选择了 27 项研究,共涉及 31903 名 LGBTQ 人群和 273842 名对照者,这些研究被纳入定量综合分析。总体而言,LGBTQ 人群发生 PTSD 的风险增加(OR:2.20 [95%CI:1.85;2.60]),尽管估计存在明显的异质性(=91%)。在 LGBTQ 亚组中,跨性别者发生 PTSD 的风险最高(OR:2.52 [95%CI:2.22;2.87]),其次是双性恋者(OR:2.44 [95%CI:1.05;5.66]),尽管这些比较受到缺乏其他性少数群体(如间性人)的数据的限制。有趣的是,考虑到同性恋和异性恋作为对照组,双性恋者发生 PTSD 的风险也得到了证实(OR:1.44 [95%CI:1.07;1.93])。证据质量低。

结论:与顺性别/异性恋者相比,LGBTQ 人群发生 PTSD 的风险更高。这一证据可能有助于提高公众对 LGBTQ 心理健康需求的认识,并建议支持性策略以及预防干预措施(例如,支持性计划、咨询和消除污名化努力),作为旨在减少高危人群精神疾病发病率的个体化医疗保健计划的一部分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a77c/10387489/9e7fdebbf703/S2045796023000586_fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a77c/10387489/cd0cc5e8dde1/S2045796023000586_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a77c/10387489/16c38bcdca61/S2045796023000586_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a77c/10387489/fed93acd8f9b/S2045796023000586_fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a77c/10387489/0d7be951ad7e/S2045796023000586_fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a77c/10387489/9e7fdebbf703/S2045796023000586_fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a77c/10387489/cd0cc5e8dde1/S2045796023000586_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a77c/10387489/16c38bcdca61/S2045796023000586_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a77c/10387489/fed93acd8f9b/S2045796023000586_fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a77c/10387489/0d7be951ad7e/S2045796023000586_fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a77c/10387489/9e7fdebbf703/S2045796023000586_fig5.jpg

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本文引用的文献

[1]
Independent contribution of polygenic risk for schizophrenia and cannabis use in predicting psychotic-like experiences in young adulthood: testing gene × environment moderation and mediation.

Psychol Med. 2023-4

[2]
Self-harm and suicidality among LGBTIQ people: a systematic review and meta-analysis.

Int Rev Psychiatry. 2022

[3]
Intimate Partner Violence Perpetration Among Sexual Minority People and Associated Factors: A Systematic Review of Quantitative Studies.

Sex Res Social Policy. 2022-9-8

[4]
Health Disparities Among Lesbian, Gay, and Bisexual Service Members and Veterans.

Am J Prev Med. 2022-10

[5]
Childhood maltreatment mediates the effect of the genetic background on psychosis risk in young adults.

Transl Psychiatry. 2022-6-1

[6]
Experience of discrimination during COVID-19 pandemic: the impact of public health measures and psychological distress among refugees and other migrants in Europe.

BMC Public Health. 2022-5-11

[7]
A systematic review of the neural correlates of sexual minority stress: towards an intersectional minority mosaic framework with implications for a future research agenda.

Eur J Psychotraumatol. 2022

[8]
Identifying Posttraumatic Stress Disorder and Disparity Among Transgender Veterans Using Nationwide Veterans Health Administration Electronic Health Record Data.

LGBT Health. 2022

[9]
The association of probable PTSD at baseline and pain-related outcomes after chronic pain rehabilitation: A comparison of DSM-5 and ICD-11 criteria for PTSD.

Eur J Pain. 2022-3

[10]
Mental health conditions in Lesbian, Gay, Bisexual, Transgender, Queer and Asexual youth in Brazil: A call for action.

J Affect Disord. 2022-2-1

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