Bhatia Devika, Berg Owen, Davies Robert, Mikulich Gilbertson Susan, Sakai Joseph
University of Colorado School of Medicine, Anschutz Health Sciences Building, Suite 5242, 1890 N Revere Ct, Aurora, CO, 80045, USA.
Child Psychiatry Hum Dev. 2023 Nov 29. doi: 10.1007/s10578-023-01630-w.
Sexual minority youth (SMY) represent a population vulnerable to several adverse health consequences. Specifically, SMY experience depression and substance use at substantially higher rates than heterosexual peers. Better understanding the relationship between depression and substance use among SMY may help reduce morbidity and mortality. We hypothesize that depression will moderate increased substance use rates seen in SMY. Weighted logistical analyses of covariance, adjusted for race/ethnicity, sex, and age, compared the relationship between sexual identity, depression, and substance use (14 outcomes), using data from the 2019 Youth Risk Behavior Survey (n = 13,677) of high school students. SMY reported depression at rates nearly double than heterosexual peers (63.9% vs 33.0%). Except for vaping and alcohol, SMY had significantly higher odds of all SU (aORs 1.41-2.45, p < 0.001-0.0011). After adjusting for depression, odds of all SMY substance use decreased; most relationships remained significant (aORs 0.73-1.89), though the relationship between SMY and lifetime cannabis use became non-significant. The relationship between SMY and current vaping became significant and the relationship between SMY and alcohol and binge-drinking remained non-significant. SMY are at higher risk for use of most substances and depression compared to heterosexual youth. As depression consistently plays a role in the relationship between sexual minority status and adolescent substance use across a wide variety of substances, it may be a modifiable risk factor for substance use among sexual minority youth that should be screened for and treated. This study additionally provides important information for future studies examining nuances of SMY substance use patterns.
性少数群体青少年（SMY）是一个易受多种不良健康后果影响的群体。具体而言，SMY经历抑郁和物质使用的比率远高于异性恋同龄人。更好地理解SMY中抑郁与物质使用之间的关系可能有助于降低发病率和死亡率。我们假设抑郁将调节SMY中较高的物质使用率。使用2019年高中生青少年风险行为调查（n = 13677）的数据，在对种族/族裔、性别和年龄进行调整后，通过加权逻辑协方差分析比较了性取向、抑郁和物质使用（14种结果）之间的关系。SMY报告抑郁的比率几乎是异性恋同龄人的两倍（63.9%对33.0%）。除了电子烟和酒精外，SMY在所有物质使用方面的几率显著更高（调整后比值比为1.41 - 2.45，p < 0.001 - 0.0011）。在对抑郁进行调整后，所有SMY物质使用的几率降低；大多数关系仍然显著（调整后比值比为0.73 - 1.89），尽管SMY与终生大麻使用之间的关系变得不显著。SMY与当前电子烟使用之间的关系变得显著，而SMY与酒精和暴饮之间的关系仍然不显著。与异性恋青少年相比，SMY使用大多数物质和患抑郁症的风险更高。由于抑郁在性少数群体身份与青少年物质使用之间的关系中始终发挥作用，涉及多种物质，它可能是性少数群体青少年物质使用的一个可改变的风险因素，应进行筛查和治疗。本研究还为未来研究性少数群体青少年物质使用模式的细微差别提供了重要信息。
