Beorn
01-11-2009, 10:25 PM
Is Sexual Orientation Related to Mental Health Problems and Suicidality in Young People?
(http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#ACK)
David M. Fergusson, PhD; L. John Horwood, MSc; Annette L. Beautrais, PhD (http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#ACK)
Arch Gen Psychiatry. 1999;56:876-880.
Background This study examines the extent to which gay, lesbian, and bisexual young people are at increased risk of psychiatric disorder and suicidal behaviors using data gathered on a New Zealand birth cohort studied to age 21 years.
Methods Data were gathered during the course of the Christchurch Health and Development Study, a 21-year longitudinal study of a birth cohort of 1265 children born in Christchurch, New Zealand. At 21 years of age, 1007 sample members were questioned about their sexual orientation and relationships with same-sex partners since the age of 16 years. Twenty-eight subjects (2.8%) were classified as being of gay, lesbian, or bisexual sexual orientation. Over the period from age 14 to 21 years, data were gathered on a range of psychiatric disorders that included major depression, generalized anxiety disorder, conduct disorder, and substance use disorders. Data were also gathered on suicidal ideation and suicide attempts.
Results Gay, lesbian, and bisexual young people were at increased risks of major depression (odds ratio [OR], 4.0; 95% confidence interval [CI], 1.8-9.3), generalized anxiety disorder (OR, 2.8; 95% CI, 1.2-6.5), conduct disorder (OR, 3.8; 95% CI, 1.7-8.7), nicotine dependence (OR, 5.0; 95% CI, 2.3-10.9), other substance abuse and/or dependence (OR, 1.9; 95% CI, 0.9-4.2), multiple disorders (OR, 5.9; 95% CI, 2.4-14.8), suicidal ideation (OR, 5.4; 95% CI, 2.4-12.2), and suicide attempts (OR, 6.2; 95% CI, 2.7-14.3).
Conclusions Findings support recent evidence suggesting that gay, lesbian, and bisexual young people are at increased risk of mental health problems, with these associations being particularly evident for measures of suicidal behavior and multiple disorder.
INTRODUCTION
IN RECENT years, there has been growing concern and debate about the extent to which young people of gay, lesbian, or bisexual (GLB) sexual orientation are at increased risk of mental health problems.1 (http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#REF-YOA9081-1)-5 (http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#REF-YOA9081-5) These issues have emerged in clear relief in the context of debates about whether GLB young people are at increased risk of suicide and suicidal behaviors. Specifically, it has been argued that because of a series of social processes that center on homophobic attitudes, GLB youth are exposed to serious personal stresses that increase their likelihood of suicidal behavior.6 (http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#REF-YOA9081-6)-8 (http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#REF-YOA9081-8) However, a reappraisal of these claims showed them not to be well founded in evidence, and reviews of this issue concluded that problems in existing research were such that no clear conclusions about the role of sexual orientation in suicidal behavior could be drawn.7 (http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#REF-YOA9081-7)-8 (http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#REF-YOA9081-8) Nonetheless, in the last 2 years there have been an increasing number of studies that have compared representative samples of GLB youth with heterosexual controls, with these studies all suggesting increased rates of suicide attempts among GLB youth. Bagley and Tremblay1 (http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#REF-YOA9081-1) in a study of 82 homosexual or bisexual men aged 18 to 27 years and 668 heterosexual men found that rates of suicidal behaviors were nearly 14 times higher among the gay or bisexual subjects. Garofalo et al2 (http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#REF-YOA9081-2) compared 104 GLB high school students with 4055 high school students identifying themselves as heterosexual. They found rates of suicide attempt among the GLB subjects that were more than 3.5 times higher than among the control subjects. Similarly, Remafedi et al3 (http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#REF-YOA9081-3) compared 394 GLB high school students with 336 heterosexual controls. Their findings showed that the GLB subjects had odds of suicide attempt that were 7.1 times higher than heterosexual controls and odds of suicidal intent that were 3.6 times higher. The weight of evidence from these studies clearly supports the view that GLB sexual orientation acts as a risk factor for suicidal behaviors.
In contrast to the growing body of literature on sexual orientation and suicide, there is less systematic evidence on the extent to which GLB youth are at greater risk of mental health problems, although there is a widespread belief that GLB youth are at greater risk of these problems.2 (http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#REF-YOA9081-2), 9 (http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#REF-YOA9081-9) In addition, Hartstein5 (http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#REF-YOA9081-5) has emphasized the importance of gathering data on the mental health of contemporary cohorts of young people since, because of changing political, social, and health factors, cohort specificity will limit the applicability of research done in previous decades.
In this article we report the results of a 21-year longitudinal study of a birth cohort of more than 1000 New Zealand young people. The aims of this study were (1) to estimate the proportion of young people in the cohort who by age 21 years reported being of GLB sexual orientation, and (2) to examine the relationships between GLB sexual orientation and estimates of lifetime prevalence of suicidal behaviors (suicidal ideation and suicide attempt) and common psychiatric disorders (major depression, generalized anxiety disorder, substance use disorders, and conduct disorder). The study is characterized by a number of features that include the use of a relatively large and representative population sample, the measurement of psychiatric disorder throughout adolescence and young adulthood using standardized (DSM-III-R10 (http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#REF-YOA9081-10) and DSM-IV11 (http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#REF-YOA9081-11)) diagnostic criteria, and the collection of prospective social, family, and childhood information...
Continued@ Source (http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#ACK)
(http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#ACK)
David M. Fergusson, PhD; L. John Horwood, MSc; Annette L. Beautrais, PhD (http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#ACK)
Arch Gen Psychiatry. 1999;56:876-880.
Background This study examines the extent to which gay, lesbian, and bisexual young people are at increased risk of psychiatric disorder and suicidal behaviors using data gathered on a New Zealand birth cohort studied to age 21 years.
Methods Data were gathered during the course of the Christchurch Health and Development Study, a 21-year longitudinal study of a birth cohort of 1265 children born in Christchurch, New Zealand. At 21 years of age, 1007 sample members were questioned about their sexual orientation and relationships with same-sex partners since the age of 16 years. Twenty-eight subjects (2.8%) were classified as being of gay, lesbian, or bisexual sexual orientation. Over the period from age 14 to 21 years, data were gathered on a range of psychiatric disorders that included major depression, generalized anxiety disorder, conduct disorder, and substance use disorders. Data were also gathered on suicidal ideation and suicide attempts.
Results Gay, lesbian, and bisexual young people were at increased risks of major depression (odds ratio [OR], 4.0; 95% confidence interval [CI], 1.8-9.3), generalized anxiety disorder (OR, 2.8; 95% CI, 1.2-6.5), conduct disorder (OR, 3.8; 95% CI, 1.7-8.7), nicotine dependence (OR, 5.0; 95% CI, 2.3-10.9), other substance abuse and/or dependence (OR, 1.9; 95% CI, 0.9-4.2), multiple disorders (OR, 5.9; 95% CI, 2.4-14.8), suicidal ideation (OR, 5.4; 95% CI, 2.4-12.2), and suicide attempts (OR, 6.2; 95% CI, 2.7-14.3).
Conclusions Findings support recent evidence suggesting that gay, lesbian, and bisexual young people are at increased risk of mental health problems, with these associations being particularly evident for measures of suicidal behavior and multiple disorder.
INTRODUCTION
IN RECENT years, there has been growing concern and debate about the extent to which young people of gay, lesbian, or bisexual (GLB) sexual orientation are at increased risk of mental health problems.1 (http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#REF-YOA9081-1)-5 (http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#REF-YOA9081-5) These issues have emerged in clear relief in the context of debates about whether GLB young people are at increased risk of suicide and suicidal behaviors. Specifically, it has been argued that because of a series of social processes that center on homophobic attitudes, GLB youth are exposed to serious personal stresses that increase their likelihood of suicidal behavior.6 (http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#REF-YOA9081-6)-8 (http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#REF-YOA9081-8) However, a reappraisal of these claims showed them not to be well founded in evidence, and reviews of this issue concluded that problems in existing research were such that no clear conclusions about the role of sexual orientation in suicidal behavior could be drawn.7 (http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#REF-YOA9081-7)-8 (http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#REF-YOA9081-8) Nonetheless, in the last 2 years there have been an increasing number of studies that have compared representative samples of GLB youth with heterosexual controls, with these studies all suggesting increased rates of suicide attempts among GLB youth. Bagley and Tremblay1 (http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#REF-YOA9081-1) in a study of 82 homosexual or bisexual men aged 18 to 27 years and 668 heterosexual men found that rates of suicidal behaviors were nearly 14 times higher among the gay or bisexual subjects. Garofalo et al2 (http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#REF-YOA9081-2) compared 104 GLB high school students with 4055 high school students identifying themselves as heterosexual. They found rates of suicide attempt among the GLB subjects that were more than 3.5 times higher than among the control subjects. Similarly, Remafedi et al3 (http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#REF-YOA9081-3) compared 394 GLB high school students with 336 heterosexual controls. Their findings showed that the GLB subjects had odds of suicide attempt that were 7.1 times higher than heterosexual controls and odds of suicidal intent that were 3.6 times higher. The weight of evidence from these studies clearly supports the view that GLB sexual orientation acts as a risk factor for suicidal behaviors.
In contrast to the growing body of literature on sexual orientation and suicide, there is less systematic evidence on the extent to which GLB youth are at greater risk of mental health problems, although there is a widespread belief that GLB youth are at greater risk of these problems.2 (http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#REF-YOA9081-2), 9 (http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#REF-YOA9081-9) In addition, Hartstein5 (http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#REF-YOA9081-5) has emphasized the importance of gathering data on the mental health of contemporary cohorts of young people since, because of changing political, social, and health factors, cohort specificity will limit the applicability of research done in previous decades.
In this article we report the results of a 21-year longitudinal study of a birth cohort of more than 1000 New Zealand young people. The aims of this study were (1) to estimate the proportion of young people in the cohort who by age 21 years reported being of GLB sexual orientation, and (2) to examine the relationships between GLB sexual orientation and estimates of lifetime prevalence of suicidal behaviors (suicidal ideation and suicide attempt) and common psychiatric disorders (major depression, generalized anxiety disorder, substance use disorders, and conduct disorder). The study is characterized by a number of features that include the use of a relatively large and representative population sample, the measurement of psychiatric disorder throughout adolescence and young adulthood using standardized (DSM-III-R10 (http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#REF-YOA9081-10) and DSM-IV11 (http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#REF-YOA9081-11)) diagnostic criteria, and the collection of prospective social, family, and childhood information...
Continued@ Source (http://archpsyc.ama-assn.org/cgi/content/full/56/10/876#ACK)