Rentería Roberto, Andersson Claes, Bendtsen Marcus, Mortier Philippe, Auerbach Randy P, Bantjes Jason, Baumeister Harald, Berman Anne H, Bootsma Erik, Bruffaerts Ronny, Cohut Irina F, Crockett Marcelo A, Cuijpers Pim, David Oana A, Ebert David D, Gutierrez-García Raúl A, Hasking Penelope A, Hunt Xanthe, Hurks Petra, Husky Mathilde M, Jimenez Ana Lucia, Kählke Fanny, Küchler Ann-Marie, Mac-Ginty Scarlett, Mak Arthur D P, Martínez Vania, McLafferty Margaret, Monroy-Velasco Iris R, Murray Elaine K, O'Neill Siobhan, Papasteri Claudiu C, Paz Priscilla, Popescu Codruta A, Robinson Kealagh, Salemink Elske, Siu Oi-Ling, Stein Dan J, Struijs Sascha Y, Tomoiaga Cristina, van Luenen Sanne, Vigo Daniel V, Wang Angel Y, Wiers Reinout W, Wong Samuel Y S, Benjet Corina
Department of Psychology, University of Massachusetts Boston, Boston, MA, USA.
Department of Criminology, Malmö University, Malmö, Sweden; Department of Psychology, Uppsala University, Uppsala, Sweden.
J Psychiatr Res. 2025 Jun;186:331-340. doi: 10.1016/j.jpsychires.2025.04.021. Epub 2025 Apr 18.
Mental health disparities have been reported among sexual minority individuals; minority stress theory posits that such disparities are a result of stigma and discrimination. We estimated the prevalence of mental disorders across sexual orientation groups among first-year college students and whether differences across sexual orientation groups varied by gender and country-level LGBTQ+ (lesbian, gay, bisexual, transgender, queer) social acceptance. Using data (N = 53,175; 13 countries) from the World Mental Health Surveys International College Surveys, we performed multilevel logistic regressions to estimate the associations between sexual orientation (i.e., heterosexual, heterosexual with same-gender attraction [SGA], gay/lesbian, bisexual, asexual, questioning, and other) and five twelve-month DSM-5 disorders (major depressive disorder, generalized anxiety disorder, panic disorder, alcohol use disorder, drug use disorder). Heterosexual students with SGA (AORs 1.30-2.15), gay/lesbian (AORs 1.49-2.70), bisexual (AORs 2.26-3.49), questioning (AORs 1.38-2.04), and "other" (AORs 1.76-2.94) students had higher odds of all disorders compared to heterosexual students with no SGA; asexual students did not. Significant interactions with gender show that the gender difference in prevalence was greater among bisexual individuals for most disorders and among all sexual minorities (except "other") for drug use disorder. Significant interactions with country level LGBT+ social acceptance showed some sexual minority groups had lower odds (AORs 0.83-0.95) of disorder as country-level acceptance increased. These findings provide further evidence of mental disorder disparities across a wide range of sexual orientations and how these disparities vary by gender and societal LGBTQ+ acceptance in students from diverse countries.
性少数群体中存在心理健康差异的报道；少数群体压力理论认为，这种差异是耻辱感和歧视的结果。我们估计了一年级大学生中性取向群体中心理障碍的患病率，以及性取向群体之间的差异是否因性别和国家层面的 LGBTQ+（女同性恋、男同性恋、双性恋、跨性别者、酷儿）社会接受度而有所不同。利用世界心理健康调查国际大学生调查的数据（N = 53175；13 个国家），我们进行了多水平逻辑回归，以估计性取向（即异性恋、有同性吸引的异性恋 [SGA]、男同性恋/女同性恋、双性恋、无性恋、性取向存疑者和其他）与五种 DSM-5 十二个月内的障碍（重度抑郁症、广泛性焦虑症、恐慌症、酒精使用障碍、药物使用障碍）之间的关联。与没有 SGA 的异性恋学生相比，有 SGA 的异性恋学生（调整后比值比为 1.30 - 2.15）、男同性恋/女同性恋学生（调整后比值比为 1.49 - 2.70）、双性恋学生（调整后比值比为 2.26 - 3.49）、性取向存疑者（调整后比值比为 1.38 - 2.04）和“其他”学生（调整后比值比为 1.76 - 2.94）患所有障碍的几率更高；无性恋学生则不然。与性别的显著交互作用表明，对于大多数障碍，双性恋个体中的患病率性别差异更大，而对于药物使用障碍，所有性少数群体（“其他”除外）中的患病率性别差异更大。与国家层面 LGBT+ 社会接受度的显著交互作用表明，随着国家层面接受度的提高，一些性少数群体患障碍的几率较低（调整后比值比为 0.83 - 0.95）。这些发现进一步证明了广泛的性取向中心理障碍差异，以及这些差异如何因性别和不同国家学生的社会对 LGBTQ+ 的接受度而有所不同。
