Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-28T22:28:45.881Z Has data issue: false hasContentIssue false

Do shared etiological factors contribute to the relationship between sexual orientation and depression?

Published online by Cambridge University Press:  26 August 2011

B. P. Zietsch*
Affiliation:
School of Psychology, University of Queensland, Brisbane, Queensland, Australia Genetic Epidemiology, Queensland Institute of Medical Research, Brisbane, Queensland, Australia
K. J. H. Verweij
Affiliation:
School of Psychology, University of Queensland, Brisbane, Queensland, Australia Genetic Epidemiology, Queensland Institute of Medical Research, Brisbane, Queensland, Australia
A. C. Heath
Affiliation:
Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
P. A. F. Madden
Affiliation:
Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
N. G. Martin
Affiliation:
Genetic Epidemiology, Queensland Institute of Medical Research, Brisbane, Queensland, Australia
E. C. Nelson
Affiliation:
Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
M. T. Lynskey
Affiliation:
Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
*
*Address for correspondence: Dr B. P. Zietsch, School of Psychology, University of Queensland, St Lucia, Brisbane, 4072 Australia. (Email: [email protected])

Abstract

Background

Gays, lesbians and bisexuals (i.e. non-heterosexuals) have been found to be at much greater risk for many psychiatric symptoms and disorders, including depression. This may be due in part to prejudice and discrimination experienced by non-heterosexuals, but studies controlling for minority stress, or performed in very socially liberal countries, suggest that other mechanisms must also play a role. Here we test the viability of common cause (shared genetic or environmental etiology) explanations of elevated depression rates in non-heterosexuals.

Method

A community-based sample of adult twins (n=9884 individuals) completed surveys investigating the genetics of psychiatric disorder, and were also asked about their sexual orientation. Large subsets of the sample were asked about adverse childhood experiences such as sexual abuse, physical abuse and risky family environment, and also about number of older brothers, paternal and maternal age, and number of close friends. Data were analyzed using the classical twin design.

Results

Non-heterosexual males and females had higher rates of lifetime depression than their heterosexual counterparts. Genetic factors accounted for 31% and 44% of variation in sexual orientation and depression respectively. Bivariate analysis revealed that genetic factors accounted for a majority (60%) of the correlation between sexual orientation and depression. In addition, childhood sexual abuse and risky family environment were significant predictors of both sexual orientation and depression, further contributing to their correlation.

Conclusions

Non-heterosexual men and women had elevated rates of lifetime depression, partly due to shared etiological factors, although causality cannot be definitively resolved.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

APA (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn, text revision. American Psychiatric Association: Washington, DC.Google Scholar
Arreola, S, Neilands, T, Pollack, L, Paul, J, Catania, J (2008). Childhood sexual experiences and adult health sequelae among gay and bisexual men: defining childhood sexual abuse. Journal of Sex Research 45, 246252.Google Scholar
Bailey, JM (1999). Homosexuality and mental illness. Archives of General Psychiatry 56, 883884.CrossRefGoogle ScholarPubMed
Balsam, KF, Rothblum, ED, Beauchaine, TP (2005). Victimization over the life span: a comparison of lesbian, gay, bisexual, and heterosexual siblings. Journal of Consulting and Clinical Psychology 73, 477487.CrossRefGoogle ScholarPubMed
Baumeister, RF, Leary, MR (1995). The need to belong: desire for interpersonal attachments as a fundamental human motivation. Psychological Bulletin 117, 497529.Google Scholar
Blanchard, R (2004). Quantitative and theoretical analyses of the relation between older brothers and homosexuality in men. Journal of Theoretical Biology 230, 173187.CrossRefGoogle ScholarPubMed
Bogaert, AF (2010). Physical development and sexual orientation in men and women: an analysis of NATSAL-2000. Archives of Sexual Behavior 39, 110116.Google Scholar
Bolton, S, Sareen, J (2011). Sexual orientation and its relation to mental disorder and suicide attempts: findings from a nationally representative sample. Canadian Journal of Psychiatry 11, 3543.CrossRefGoogle Scholar
Cameron, P, Cameron, K (1995). Does incest cause homosexuality? Psychological Reports 76, 611621.CrossRefGoogle ScholarPubMed
Chakraborty, A, McManus, S, Brugha, TS, Bebbington, P, King, M (2011). Mental health of the non-heterosexual population of England. British Journal of Psychiatry 198, 143148.CrossRefGoogle ScholarPubMed
Cochran, SD, Mays, VM (2000). Relation between psychiatric syndromes and behaviorally defined sexual orientation in a sample of the US population. American Journal of Epidemiology 151, 516523.CrossRefGoogle Scholar
DeLisi, LE, Svetina, C, Razi, K, Shields, G, Wellman, N, Crow, TJ (2002). Hand preference and hand skill in families with schizophrenia. Laterality 7, 321332.Google Scholar
Dube, SR, Williamson, DF, Thompson, T, Felitti, VJ, Anda, RF (2004). Assessing the reliability of retrospective reports of adverse childhood experiences among adult HMO members attending a primary care clinic. Child Abuse and Neglect 28, 729737.CrossRefGoogle ScholarPubMed
Duffy, DL, Martin, NG (1994). Inferring the direction of causation in cross-sectional twin data: theoretical and empirical considerations. Genetic Epidemiology 11, 483502.CrossRefGoogle ScholarPubMed
Elias, LJ, Saucier, DM, Guylee, MJ (2001). Handedness and depression in university students: a sex by handedness interaction. Brain and Cognition 46, 125129.CrossRefGoogle Scholar
Evans, DM, Gillespie, NA, Martin, NG (2002). Biometrical genetics. Biological Psychology 61, 3351.CrossRefGoogle ScholarPubMed
Felitti, VJ, Anda, RF, Nordenberg, D, Williamson, DF, Spitz, AM, Edwards, V, Koss, MP, Marks, JS (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine 14, 245258.CrossRefGoogle ScholarPubMed
Fergusson, DM, Boden, JM, Horwood, LJ (2008). Exposure to childhood sexual and physical abuse and adjustment in early adulthood. Child Abuse and Neglect 32, 607619.Google 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, 876880.CrossRefGoogle ScholarPubMed
Frisell, T, Lichtenstein, P, Rahman, Q, Langstrom, N (2010). Psychiatric morbidity associated with same-sex sexual behaviour: influence of minority stress and familial factors. Psychological Medicine 40, 315324.CrossRefGoogle ScholarPubMed
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, 933939.Google ScholarPubMed
Grulich, AE, de Visser, RO, Smith, AMA, Rissel, CE, Richters, J (2003). Sex in Australia: homosexual experience and recent homosexual encounters. Australian and New Zealand Journal of Public Health 27, 155163.CrossRefGoogle ScholarPubMed
Hare, EH, Moran, PAP (1979). Parental age and birth-order in homosexual patients: replication of Slater's study. British Journal of Psychiatry 134, 178182.Google Scholar
Hatzenbuehler, ML (2009). How does sexual minority stigma ‘get under the skin’? A psychological mediation framework. Psychological Bulletin 135, 707730.CrossRefGoogle ScholarPubMed
Heim, C, Newport, DJ, Mletzko, T, Miller, AH, Hemeroff, CB (2008). The link between childhood trauma and depression: insights from HPA axis studies in humans. Psychoneuroendocrinology 33, 693710.CrossRefGoogle ScholarPubMed
Hughes, TL, Johnson, T, Wilsnack, SC (2001). Sexual assault and alcohol abuse: a comparison of lesbians and heterosexual women. Journal of Substance Abuse 13, 515532.CrossRefGoogle ScholarPubMed
Kendler, KS, Gardner, CO, Neale, MC, Prescott, CA (2001). Genetic risk factors for major depression in men and women: similar or different heritabilities and same or partly distinct genes? Psychological Medicine 31, 605616.CrossRefGoogle ScholarPubMed
Kendler, KS, Gardner, CO, Prescott, CA (2002). Toward a comprehensive developmental model for major depression in women. American Journal of Psychiatry 159, 11331145.CrossRefGoogle Scholar
Kendler, KS, Gardner, CO, Prescott, CA (2006). Toward a comprehensive developmental model for major depression in men. American Journal of Psychiatry 163, 115124.Google Scholar
Kendler, KS, Kuhn, JW, Prescott, CA (2004). Childhood sexual abuse, stressful life events and risk for major depression in women. Psychological Medicine 34, 14751482.CrossRefGoogle ScholarPubMed
Kendler, KS, Neale, MC, Kessler, RC, Heath, AC, Eaves, LJ (1993 a). The lifetime history of major depression in women: reliability of diagnosis and heritability. Archives of General Psychiatry 50, 863870.Google Scholar
Kendler, KS, Neale, MC, Kessler, RC, Heath, AC, Eaves, LJ (1993 b). A longitudinal twin study of personality and major depression in women. Archives of General Psychiatry 50, 853862.CrossRefGoogle ScholarPubMed
Kendler, KS, Neale, MC, Kessler, RC, Heath, AC, Eaves, LJ (1993 c). A test of the equal-environment assumption in twin studies of psychiatric illness. Behavior Genetics 23, 2127.CrossRefGoogle ScholarPubMed
Kendler, KS, Thornton, LM, Gilman, SE, Kessler, RC (2000). Sexual orientation in a US national sample of twin and nontwin sibling pairs. American Journal of Psychiatry 157, 18431846.CrossRefGoogle Scholar
King, M, Semlyen, J, Tai, SS, 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 8, 70.CrossRefGoogle ScholarPubMed
Kinsey, AC, Pomeroy, WB, Martin, CE (1948). Sexual Behavior in the Human Male. W. B. Saunders: Philadelphia, PA.Google Scholar
Knopik, VS, Heath, AC, Madden, PAF, Bucholz, KK, Slutske, WS, Nelson, EC, Statham, D, Whitfield, JB, Martin, NG (2004). Genetic effects on alcohol dependence risk: re-evaluating the importance of psychiatric and other heritable risk factors. Psychological Medicine 34, 15191530.CrossRefGoogle ScholarPubMed
Langstrom, N, Rahman, Q, Carlstrom, E, Lichtenstein, P (2010). Genetic and environmental effects on same-sex sexual behavior: a population study of twins in Sweden. Archives of Sexual Behavior 39, 7580.Google Scholar
Levinson, DF (2006). The genetics of depression: a review. Biological Psychiatry 60, 8492.CrossRefGoogle ScholarPubMed
Lewis, NM (2009). Mental health in sexual minorities: recent indicators, trends, and their relationships to place in North America and Europe. Health and Place 15, 10291045.CrossRefGoogle Scholar
Loehlin, JC (1996). The Cholesky approach: a cautionary note. Behavior Genetics 26, 6569.CrossRefGoogle Scholar
Lupien, SJ, McEwen, BS, Gunnar, MR, Heim, C (2009). Effects of stress throughout the lifespan on the brain, behaviour and cognition. Nature Reviews Neuroscience 10, 434445.Google Scholar
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, 18691876.CrossRefGoogle ScholarPubMed
Meyer, IH (1995). Minority stress and mental health in gay men. Journal of Health and Social Behavior 36, 3856.Google Scholar
Meyer, IH (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychological Bulletin 129, 674697.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, 278285.Google Scholar
Neale, MC, Boker, SM, Xie, G, Maes, HH (2006). Mx: Statistical Modeling. Department of Psychiatry, VCU Box 900126: Richmond, VA 23298.Google Scholar
Neale, MC, Cardon, LR (1992). Methodology for Genetic Studies of Twins and Families. Kluwer: Boston.CrossRefGoogle Scholar
Nelson, EC, Heath, AC, Madden, PAF, Cooper, ML, Dinwiddie, SH, Bucholz, KK, Glowinski, A, McLaughlin, T, Dunne, MP, Statham, DJ, Martin, NG (2002). Association between self-reported childhood sexual abuse and adverse psychosocial outcomes: results from a twin study. Archives of General Psychiatry 59, 139145.Google Scholar
Ooki, S, Yamada, K, Asaka, A, Hayakawa, K (1990). Zygosity diagnosis of twins by questionnaire. Acta Geneticae Medicae et Gemellologiae 39, 109115.Google Scholar
Pariante, CM, Lightman, SL (2008). The HPA axis in major depression: classical theories and new developments. Trends in Neurosciences 31, 464468.Google Scholar
Paul, JP, Catania, J, Pollack, L, Stall, R (2001). Understanding childhood sexual abuse as a predictor of sexual risk-taking among men who have sex with men: the Urban Men's Health Study. Child Abuse and Neglect 25, 557584.CrossRefGoogle ScholarPubMed
Pillard, RC, Bailey, JM (1998). Human sexual orientation has a heritable component. Human Biology 70, 347365.Google Scholar
Posthuma, D, Beem, AL, de Geus, EJC, van Baal, GCM, von Hjelmborg, JB, Lachine, I, Boomsma, DI (2003). Theory and practice in quantitative genetics. Twin Research 6, 361376.CrossRefGoogle ScholarPubMed
Rahman, Q (2005 ). The neurodevelopment of human sexual orientation. Neuroscience and Biobehavioral Reviews 29, 10571066.Google Scholar
Repetti, RL, Taylor, SE, Seeman, TE (2002). Risky families: family social environments and the mental and physical health of offspring. Psychological Bulletin 128, 330366.Google Scholar
Romeo, RD (2010). Pubertal maturation and programming of hypothalamic-pituitary-adrenal reactivity. Frontiers in Neuroendocrinology 31, 232240.CrossRefGoogle ScholarPubMed
Rothman, EF, Exner, D, Baughman, AL (2011). The prevalence of sexual assault against people who identify as gay, lesbian, or bisexual in the United States: a systematic review. Trauma Violence and Abuse 12, 5566.CrossRefGoogle ScholarPubMed
Sandfort, TGM, 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, 8591.CrossRefGoogle ScholarPubMed
Santtila, P, Sandnabba, NK, Harlaar, N, Varjonen, M, Alanko, K, von der Pahlen, B (2008). Potential for homosexual response is prevalent and genetic. Biological Psychology 77, 102105.Google Scholar
Sell, RL, Wells, JA, Wypij, D (1995). The prevalence of homosexual behavior and attraction in the United States, the United Kingdom and France: results of national population-based samples. Archives of Sexual Behavior 24, 235248.Google Scholar
Sullivan, PF, de Geus, EJC, Willemsen, G, James, MR, Smit, JH, Zandbelt, T, Arolt, V, Baune, BT, Blackwood, D, Cichon, S, Coventry, WL, Domschke, K, Farmer, A, Fava, M, Gordon, SD, He, Q, Heath, AC, Heutink, P, Holsboer, F, Hoogendijk, WJ, Hottenga, JJ, Hu, Y, Kohli, M, Lin, D, Lucae, S, MacIntyre, DJ, Maier, W, McGhee, KA, McGuffin, P, Montgomery, GW, Muir, WJ, Nolen, WA, Nothen, MM, Perlis, RH, Pirlo, K, Posthuma, D, Rietschel, M, Rizzu, P, Schosser, A, Smit, AB, Smoller, JW, Tzeng, JY, van Dyck, R, Verhage, M, Zitman, FG, Martin, NG, Wray, NR, Boomsma, DI, Penninx, B (2009). Genome-wide association for major depressive disorder: a possible role for the presynaptic protein piccolo. Molecular Psychiatry 14, 359375.CrossRefGoogle ScholarPubMed
Sullivan, PF, Neale, MC, Kendler, KS (2000). Genetic epidemiology of major depression: review and meta-analysis. American Journal of Psychiatry 157, 15521562.CrossRefGoogle ScholarPubMed
Swaab, DF, Garcia-Falgueras, A (2009). Sexual differentiation of the human brain in relation to gender identity and sexual orientation. Functional Neurology 24, 1728.Google ScholarPubMed
Tomeo, ME, Templer, DI, Anderson, S, Kotler, D (2001). Comparative data of childhood and adolescence molestation in heterosexual and homosexual persons. Archives of Sexual Behavior 30, 535541.CrossRefGoogle ScholarPubMed
Yancura, LA, Aldwin, CM (2009). Stability and change in retrospective reports of childhood experiences over a 5-year period: findings from the Davis Longitudinal Study. Psychology and Aging 24, 715721.CrossRefGoogle Scholar
Young, E, Korszun, A (2010). Sex, trauma, stress hormones and depression. Molecular Psychiatry 15, 2328.Google Scholar
Zietsch, BP (in press). Explanations for elevated psychiatric vulnerability in nonheterosexuals: environmental stressors, genetics, and the HPA and HPG axes. In Psychiatric Disorders (ed. Uehara, T.). InTech: Rijeka.Google Scholar
Zietsch, BP, Morley, KI, Shekar, SN, Verweij, KJH, Keller, MC, Macgregor, S, Wright, MJ, Bailey, JM, Martin, NG (2008). Genetic factors predisposing to homosexuality may increase mating success in heterosexuals. Evolution and Human Behavior 29, 424433.Google Scholar
Zietsch, BP, Verweij, KJH, Bailey, JM, Wright, MJ, Martin, NG (2011). Sexual orientation and psychiatric vulnerability: a twin study of Neuroticism and Psychoticism. Archives of Sexual Behavior 40, 133142.CrossRefGoogle ScholarPubMed