Abstract

BackgroundPrevious studies have indicated increased risk of mental disorder symptoms, suicide and substance misuse in lesbian, gay and bisexual (LGB) adults, compared to heterosexual adults. Our aims were to determine an estimate of the association between sexual orientation identity and poor mental health and wellbeing among adults from 12 population surveys in the UK, and to consider whether effects differed for specific subgroups of the population.MethodsIndividual data were pooled from the British Cohort Study 2012, Health Survey for England 2011, 2012 and 2013, Scottish Health Survey 2008 to 2013, Longitudinal Study of Young People in England 2009/10 and Understanding Society 2011/12. Individual participant meta-analysis was used to pool estimates from each study, allowing for between-study variation.ResultsOf 94,818 participants, 1.1 % identified as lesbian/gay, 0.9 % as bisexual, 0.8 % as ‘other’ and 97.2 % as heterosexual. Adjusting for a range of covariates, adults who identified as lesbian/gay had higher prevalence of common mental disorder when compared to heterosexuals, but the association was different in different age groups: apparent for those under 35 (OR = 1.78, 95 % CI 1.40, 2.26), weaker at age 35–54.9 (OR = 1.42, 95 % CI 1.10, 1.84), but strongest at age 55+ (OR = 2.06, 95 % CI 1.29, 3.31). These effects were stronger for bisexual adults, similar for those identifying as ‘other’, and similar for 'low wellbeing'.ConclusionsIn the UK, LGB adults have higher prevalence of poor mental health and low wellbeing when compared to heterosexuals, particularly younger and older LGB adults. Sexual orientation identity should be measured routinely in all health studies and in administrative data in the UK in order to influence national and local policy development and service delivery. These results reiterate the need for local government, NHS providers and public health policy makers to consider how to address inequalities in mental health among these minority groups.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-016-0767-z) contains supplementary material, which is available to authorized users.

Highlights

  • Previous studies have indicated increased risk of mental disorder symptoms, suicide and substance misuse in lesbian, gay and bisexual (LGB) adults, compared to heterosexual adults

  • Meta-analysis following this review found that LGB people were around twice as likely to have attempted suicide in their lifetime and have around 1.5 times higher prevalence of depression and anxiety disorders in the preceding 12 months

  • We examined whether sex, age and educational attainment significantly modified the association between sexual orientation identity groups and mental health, to identity population subgroups with higher relative risks of poor mental health

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Summary

Introduction

Previous studies have indicated increased risk of mental disorder symptoms, suicide and substance misuse in lesbian, gay and bisexual (LGB) adults, compared to heterosexual adults. We know that sexual minority populations experience poorer physical heath [4] and engage in riskier health behaviours such as smoking and hazardous drinking [5]. These inequalities may emerge in adolescence and early adulthood, persist throughout the lifecourse [6]. Associations between minority sexual orientation and poorer mental health have persisted over time with recent studies showing the same effects as older studies [9] Such disparities are thought to emerge early in adolescence and persist into adulthood [10]

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