英国青少年心理健康-肥胖共病、自我伤害和自杀未遂中的种族和性取向不平等。
Ethnic and sexual orientation inequalities in mental health-obesity comorbidity, self-harm, and attempted suicide among British adolescents.
机构信息
Department of Population Health Sciences, School of Life Course and Population Sciences, King's College London, Guy's Campus, London, UK.
Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
出版信息
Soc Psychiatry Psychiatr Epidemiol. 2024 Sep;59(9):1471-1482. doi: 10.1007/s00127-024-02658-6. Epub 2024 Mar 26.
PURPOSE
Mental illness and obesity (MH-OB) may co-occur in adolescence and have a strong risk to track into adulthood. Using an intersectional framework, we explored associations between ethnic-sexual identities and MH-OB comorbidity in adolescents. We examined the risk of self-harm (SH) and attempted suicide (AS) by comorbidity status and ethnic-sexual identities.
METHODS
Participants included 9,789 adolescents (aged 17 years) from the UK-wide Millennium Cohort Study with data on self-identified ethnicity and sexuality. Participants were categorised as White-heterosexual, White-sexual minority (SM), Ethnic Minority (EM) heterosexual or EM-SM adolescents. We used multivariable logistic regression to examine associations between 1.dual ethnic-sexual identities and MH-OB comorbidity, 2.risk for self-harm (or attempted suicide) in relation to comorbidity and ethnic-sexual identities (including interactions between the comorbidity and ethnic-sexual identities variables to assess whether risk for self-harm differed by ethnic-sexual identities and comorbidity status).
RESULTS
Comorbidity was higher among White-SM (OR = 3.73, 95%CI 2.42-5.75) and EM-SM (OR = 1.96, 1.03-3.73) adolescents. SM identities (OR = 3.02, 2.41-3.78 for White-SM) and having comorbidity (OR = 2.83, 2.03-3.95) were independently associated with SH or AS. Risk of SH among White-heterosexual individuals was greater among comorbid individuals (40%) relative to non-comorbid individuals (19%). Risk of SH was higher in SM individuals (58% vs. 41% in White-SM and 50% vs. 29% in EM-SM individuals with and without comorbidity, respectively). Risk of AS was 5% and 19% in comorbid and non-comorbid White-heterosexual individuals, respectively; the corresponding figures for White-SM individuals were 14% and 17%.
CONCLUSION
Irrespective of ethnicity, SM adolescents have a significantly greater risk of SH and AS. Comorbidity further amplifies this risk.
目的
精神疾病和肥胖症（MH-OB）可能在青少年时期同时发生，并具有很强的风险追踪到成年期。使用交叉框架，我们探讨了青少年时期种族性别认同与 MH-OB 共病之间的关联。我们检查了共病状态和种族性别认同与自伤（SH）和自杀未遂（AS）风险之间的关系。
方法
参与者包括来自英国全国千年队列研究的 9789 名青少年（年龄为 17 岁），他们的数据包括自我认同的种族和性别。参与者被归类为白人异性恋者、白人少数性取向者（SM）、少数族裔（EM）异性恋者或 EM-SM 青少年。我们使用多变量逻辑回归来检验 1.双重种族性别认同与 MH-OB 共病之间的关联，2.与共病和种族性别认同相关的自伤（或自杀未遂）风险（包括共病和种族性别认同变量之间的相互作用，以评估自伤风险是否因种族性别认同和共病状态而异）。
结果
白人 SM（OR=3.73，95%CI 2.42-5.75）和 EM-SM（OR=1.96，1.03-3.73）青少年的共病率较高。SM 身份（OR=3.02，2.41-3.78 对于白人 SM）和共病（OR=2.83，2.03-3.95）与 SH 或 AS 独立相关。白人异性恋个体中，共病个体（40%）相对于非共病个体（19%）SH 风险更高。SM 个体的 SH 风险更高（在白人 SM 个体中，共病个体为 58%，非共病个体为 41%，在 EM-SM 个体中，共病个体为 50%，非共病个体为 29%）。共病和非共病白人异性恋个体中 AS 的风险分别为 5%和 19%；对于白人 SM 个体，相应的数字分别为 14%和 17%。
结论
无论种族如何，SM 青少年的 SH 和 AS 风险显著增加。共病进一步放大了这种风险。
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