The mental health of lesbian, gay and bisexual adults compared with heterosexual adults: results of two nationally representative English household probability samples

Pitman, Alexandra, Marston, Louise, Lewis, Gemma, Semlyen, Joanna, McManus, Sally and King, Michael (2021) The mental health of lesbian, gay and bisexual adults compared with heterosexual adults: results of two nationally representative English household probability samples. Psychological Medicine. pp. 1-10. ISSN 0033-2917

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Abstract

Background Evidence on inequalities in mental health in lesbian, gay, and bisexual people arises primarily from non-random samples. Aims To use a probability sample to study change in mental health inequalities between two survey points, 7 years apart; the contribution of minority stress; and whether associations vary by age, gender, childhood sexual abuse, and religious identification. Methods We analysed data from 10 443 people, in two English population-based surveys (2007 and 2014), on common mental disorder (CMD), hazardous alcohol use, and illicit drug use. Multivariable models were adjusted for age, gender, and economic factors, adding interaction terms for survey year, age, gender, childhood sexual abuse, and religious identification. We explored bullying and discrimination as mediators. Results Inequalities in risks of CMD or substance misuse were unchanged between 2007 and 2014. Compared to heterosexuals, bisexual, and lesbian/gay people were more likely to have CMD, particularly bisexual people [adjusted odds ratio (AOR) = 2.86; 95% CI 1.83-4.46], and to report alcohol misuse and illicit drug use. When adjusted for bullying, odds of CMD remained elevated only for bisexual people (AOR = 3.21; 95% CI 1.64-6.30), whilst odds of alcohol and drug misuse were unchanged. When adjusted for discrimination, odds of CMD and alcohol misuse remained elevated only for bisexual people (AOR = 2.91; 95% CI 1.80-4.72; and AOR = 1.63; 95% CI 1.03-2.57 respectively), whilst odds of illicit drug use remained unchanged. There were no interactions with age, gender, childhood sexual abuse, or religious identification. Conclusions Mental health inequalities in non-heterosexuals have not narrowed, despite increasing societal acceptance. Bullying and discrimination may help explain the elevated rate of CMD in lesbian women and gay men but not in bisexual people.

Item Type: Article
Uncontrolled Keywords: discrimination,lgb,inequalities,mental health,minority stress,sexual minorities,applied psychology,psychiatry and mental health ,/dk/atira/pure/subjectarea/asjc/3200/3202
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: LivePure Connector
Date Deposited: 19 Jan 2021 00:57
Last Modified: 11 Apr 2021 23:48
URI: https://ueaeprints.uea.ac.uk/id/eprint/78211
DOI: 10.1017/S0033291721000052

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