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Psychiatric morbidity associated with same-sex sexual behaviour: influence of minority stress and familial factors

Published online by Cambridge University Press:  22 May 2009

T. Frisell ,
P. Lichtenstein ,
Q. Rahman  and
N. Långström
T. Frisell
Affiliation:
Centre for Violence Prevention, Karolinska Institutet, Stockholm, Sweden Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
P. Lichtenstein
Affiliation:
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
Q. Rahman
Affiliation:
Biological and Experimental Psychology Group, School of Biological Sciences, Queen Mary, University of London, UK King's College, University of London, UK
N. Långström*
Affiliation:
Centre for Violence Prevention, Karolinska Institutet, Stockholm, Sweden
*
*Address for correspondence: Dr N. Långström, Centre for Violence Prevention, Karolinska Institutet, PO Box 23000, 104 35 Stockholm, Sweden. (Email: [email protected])
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Abstract

Background

Increased psychiatric morbidity has been widely reported among non-heterosexual individuals (defined as reporting a homosexual/bisexual identity and/or same-sex sexual partners). However, the causes of this psychiatric ill-health are mostly unknown.

Method

We attempted to estimate the influence of minority stress and familial factors on psychiatric disorder among adults with same-sex sexual partners. Self-report data from a 2005 survey of adults (age 20–47 years, n=17 379) in the population-based Swedish Twin Registry were analysed with regression modelling and co-twin control methodology.

Results

Rates of depression, generalized anxiety disorder (GAD), eating disorders, alcohol dependence and attention deficit hyperactivity disorder (ADHD) were increased among men and women with same-sex sexual experiences. Adjusting for perceived discrimination and hate crime victimization lowered this risk whereas controlling for familial (genetic or environmental) factors in within-twin pair comparisons further reduced or eliminated it.

Conclusions

Components of minority stress influence the risk of psychiatric ill-health among individuals with any same-sex sexual partner. However, substantial confounding by familial factors suggests a common genetic and/or environmental liability for same-sex sexual behaviour and psychiatric morbidity.

Keywords

Environmentgeneticsminority stresspsychiatric symptomssexual behaviour
Type
Original Articles
Information
Psychological Medicine , Volume 40 , Issue 2 , February 2010 , pp. 315 - 324
Copyright
Copyright © Cambridge University Press 2009

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References

APA (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn, text revision (DSM-IV-TR). American Psychiatric Association: Washington, DC.Google Scholar
Bailey, JM (1999). Homosexuality and mental illness. Archives of General Psychiatry 56, 883–884.CrossRefGoogle ScholarPubMed
Balsam, KF, Beauchaine, TP, Mickey, RM, Rothblum, ED (2005 b). Mental health of lesbian, gay, bisexual, and heterosexual siblings: effects of gender, sexual orientation, and family. Journal of Abnormal Psychology 114, 471–476.CrossRefGoogle ScholarPubMed
Balsam, KF, Rothblum, ED, Beauchaine, TP (2005 a). Victimization over the life span: a comparison of lesbian, gay, bisexual, and heterosexual siblings. Journal of Consulting and Clinical Psychology 73, 477–487.CrossRefGoogle ScholarPubMed
Carlin, JB, Gurrin, LC, Sterne, JA, Morley, R, Dwyer, T (2005). Regression models for twin studies: a critical review. International Journal of Epidemiology 34, 1089–1099.CrossRefGoogle ScholarPubMed
Carpenter, JS, Andrykowski, MA, Wilson, J, Hall, LA, Rayens, MK, Sachs, B, Cunningham, LL (1998). Psychometrics for two short forms of the Center for Epidemiologic Studies-Depression Scale. Issues in Mental Health Nursing 19, 481–494.CrossRefGoogle ScholarPubMed
Cochran, SD, Mays, VM (2000 a). Lifetime prevalence of suicide symptoms and affective disorders among men reporting same-sex sexual partners: results from NHANES III. American Journal of Public Health 90, 573–578.Google ScholarPubMed
Cochran, SD, Mays, VM (2000 b). Relation between psychiatric syndromes and behaviorally defined sexual orientation in a sample of the US population. American Journal of Epidemiology 151, 516–523.CrossRefGoogle Scholar
Cochran, SD, Mays, VM, Alegria, M, Ortega, AN, Takeuchi, D (2007). Mental health and substance use disorders among Latino and Asian American lesbian, gay, and bisexual adults. Journal of Consulting and Clinical Psychology 75, 785–794.CrossRefGoogle ScholarPubMed
Cochran, SD, Mays, VM, Sullivan, JG (2003). Prevalence of mental disorders, psychological distress, and mental health services use among lesbian, gay, and bisexual adults in the United States. Journal of Consulting and Clinical Psychology 71, 53–61.CrossRefGoogle ScholarPubMed
Conner, M, Johnson, C, Grogan, S (2004). Gender, sexuality, body image and eating behaviours. Journal of Health Psychology 9, 505–515.CrossRefGoogle ScholarPubMed
de Graaf, R, Sandfort, TG, ten Have, M (2006). Suicidality and sexual orientation: differences between men and women in a general population-based sample from the Netherlands. Archives of Sexual Behavior 35, 253–262.CrossRefGoogle Scholar
Fergusson, DM, Horwood, LJ, Beautrais, AL (1999). Is sexual orientation related to mental health problems and suicidality in young people? Archives of General Psychiatry 56, 876–880.CrossRefGoogle ScholarPubMed
Fergusson, DM, Horwood, LJ, Ridder, EM, Beautrais, AL (2005). Sexual orientation and mental health in a birth cohort of young adults. Psychological Medicine 35, 971–981.CrossRefGoogle Scholar
First, MB, Spitzer, RL, Gibbon, M, Williams, JB (2002). Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Non-Patient Edition (SCID-I/NP). Biometrics Research Department, New York State Psychiatric Institute: New York.Google Scholar
Friedman, RC, Downey, JI (1998). Psychoanalysis and the model of homosexuality as psychopathology: a historical overview. American Journal of Psychoanalysis 58, 249–270.CrossRefGoogle ScholarPubMed
Furberg, H, Lichtenstein, P, Pedersen, NL, Thornton, L, Bulik, CM, Lerman, C, Sullivan, PF (2008). The STAGE cohort: a prospective study of tobacco use among Swedish twins. Nicotine and Tobacco Research 12, 1727–1735.CrossRefGoogle Scholar
Gilman, SE, Cochran, SD, Mays, VM, Hughes, M, Ostrow, D, Kessler, RC (2001). Risk of psychiatric disorders among individuals reporting same-sex sexual partners in the National Comorbidity Survey. American Journal of Public Health 91, 933–939.Google ScholarPubMed
Heinrup, M (2005). The HIV Epidemic in Sweden [in Swedish]. Smittskyddsinstitutet: Stockholm, Sweden.Google Scholar
Herek, GM, Garnets, LD (2007). Sexual orientation and mental health. Annual Review of Clinical Psychology 3, 353–375.CrossRefGoogle ScholarPubMed
Herrell, R, Goldberg, J, True, WR, Ramakrishnan, V, Lyons, M, Eisen, S, Tsuang, MT (1999). Sexual orientation and suicidality: a co-twin control study in adult men. Archives of General Psychiatry 56, 867–874.CrossRefGoogle ScholarPubMed
Hospers, HJ, Jansen, A (2005). Why homosexuality is a risk factor for eating disorders in males. Journal of Social and Clinical Psychology 24, 1188–1201.CrossRefGoogle Scholar
Kessler, RC, Berglund, P, Demler, O, Jin, R, Merikangas, KR, Walters, EE (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry 62, 593–602.CrossRefGoogle ScholarPubMed
King, M, McKeown, E, Warner, J, Ramsay, A, Johnson, K, Cort, C, Wright, L, Blizard, R, Davidson, O (2003). Mental health and quality of life of gay men and lesbians in England and Wales: controlled, cross-sectional study. British Journal of Psychiatry 183, 552–558.Google ScholarPubMed
King, M, Semlyen, J, See Tai, S, Killaspy, H, Osborn, D, Popelyuk, D, Nazareth, I (2008). A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people. BMC Psychiatry 2008, 8, 70.CrossRefGoogle ScholarPubMed
Långström, N, Rahman, Q, Carlström, E, Lichtenstein, P (2008). Genetic and environmental effects on same-sex sexual behavior: a population study of twins in Sweden. Archives of Sexual Behavior. Published online: 7 June 2008. doi:10.1007/s10508-008-9386-1.Google ScholarPubMed
Lichtenstein, P, De Faire, U, Floderus, B, Svartengren, M, Svedberg, P, Pedersen, NL (2002). The Swedish Twin Registry: a unique resource for clinical, epidemiological and genetic studies. Journal of Internal Medicine 252, 184–205.CrossRefGoogle ScholarPubMed
Lichtenstein, P, Sullivan, PF, Cnattingius, S, Gatz, M, Johansson, S, Carlström, E, Björk, C, Svartengren, M, Wolk, A, Klareskog, L, de Faire, U, Schalling, M, Palmgren, J, Pedersen, NL (2006). The Swedish Twin Registry in the third millennium: an update. Twin Research and Human Genetics 9, 875–882.CrossRefGoogle ScholarPubMed
Mays, VM, Cochran, SD (2001). Mental health correlates of perceived discrimination among lesbian, gay, and bisexual adults in the United States. American Journal of Public Health 91, 1869–1876.CrossRefGoogle ScholarPubMed
Meyer, IH (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychological Bulletin 129, 674–697.CrossRefGoogle ScholarPubMed
Mills, TC, Paul, J, Stall, R, Pollack, L, Canchola, J, Chang, YJ, Moskowitz, JT, Catania, JA (2004). Distress and depression in men who have sex with men: the Urban Men's Health Study. American Journal of Psychiatry 161, 278–285.CrossRefGoogle ScholarPubMed
Murphy, P, Schachar, R (2000). Use of self-ratings in the assessment of symptoms of attention deficit hyperactivity disorder in adults. American Journal of Psychiatry 157, 1156–1159.CrossRefGoogle ScholarPubMed
Sandfort, TG, de Graaf, R, Bijl, RV, Schnabel, P (2001). Same-sex sexual behavior and psychiatric disorders: findings from the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Archives of General Psychiatry 58, 85–91.CrossRefGoogle ScholarPubMed
Sandfort, TG, de Graaf, R, Bijl, RV (2003). Same-sex sexuality and quality of life: findings from the Netherlands Mental Health Survey and Incidence Study. Archives of Sexual Behavior 32, 15–22.CrossRefGoogle ScholarPubMed
Silenzio, VM, Pena, JB, Duberstein, PR, Cerel, J, Knox, KL (2007). Sexual orientation and risk factors for suicidal ideation and suicide attempts among adolescents and young adults. American Journal of Public Health 97, 2017–2019.CrossRefGoogle ScholarPubMed
Wamala, S, Boström, G, Nyqvist, K (2007). Perceived discrimination and psychological distress in Sweden. British Journal of Psychiatry 190, 75–76.CrossRefGoogle ScholarPubMed
Wichstrøm, L, Hegna, K (2003). Sexual orientation and suicide attempt: a longitudinal study of the general Norwegian adolescent population. Journal of Abnormal Psychology 112, 144–151.CrossRefGoogle ScholarPubMed
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