A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people.
A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people.
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DOI：
10.1186/1471-244x-8-70
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发表时间：
2008-08-18
期刊：
影响因子：
4.4
通讯作者：
Nazareth I
中科院分区：
文献类型：
--
作者：
King M;Semlyen J;Tai SS;Killaspy H;Osborn D;Popelyuk D;Nazareth I
女同性恋、男同性恋和双性恋（LGB）的人可能比异性恋的人有更高的精神障碍风险。我们对LGB人群中精神障碍、物质滥用、自杀、自杀意念和故意自我伤害的患病率进行了系统回顾和荟萃分析。我们检索了Medline、Embase、PsycInfo、Cinahl、科克伦图书馆数据库、Web of Knowledge、应用社会科学索引和摘要、国际社会科学文献目录、社会学摘要、坎贝尔协作和灰色文献数据库中1966年1月至2005年4月发表的文章。我们还使用谷歌和谷歌学术，并在必要时联系作者。我们搜索了所有与同性恋、女同性恋和双性恋相关的术语，以及所有与精神障碍、自杀和故意自残相关的术语。我们纳入了基于人口的研究论文，其中包含同时异性恋比较组和性取向和心理健康结果的有效定义。在识别的13706篇论文中，最初选择了476篇，28篇（25项研究）符合纳入标准。只有一项研究符合我们所有的四项质量标准，七项符合其中三项标准。数据来自214,344名异性恋者和11,971名非异性恋者。荟萃分析显示，女同性恋、男同性恋和双性恋者的自杀企图增加了两倍[终生风险的合并风险比为2.47（CI 1.87，3.28）]。在荟萃分析中，女同性恋、男同性恋和双性恋者患抑郁症和焦虑症的风险（12个月或一生）至少高出1.5倍（RR范围1.54-2.58），酒精和其他物质依赖超过12个月的风险也高出1.5倍（RR范围1.51-4.00）。结果在两种性别中相似，但Meta分析显示，女同性恋和双性恋妇女特别容易产生物质依赖（酒精12个月：RR 4.00，CI 2.85，5.61;药物依赖：RR 3.50，CI 1.87，6.53;任何物质使用障碍RR 3.42，CI 1.97-5.92），而自杀企图的终生患病率在同性恋和双性恋男性中尤其高（RR 4.28，CI 2.32，7.88）。LGB人群比异性恋人群更容易出现精神障碍、自杀意念、药物滥用和故意自残。
Lesbian, gay and bisexual (LGB) people may be at higher risk of mental disorders than heterosexual people. We conducted a systematic review and meta-analysis of the prevalence of mental disorder, substance misuse, suicide, suicidal ideation and deliberate self harm in LGB people. We searched Medline, Embase, PsycInfo, Cinahl, the Cochrane Library Database, the Web of Knowledge, the Applied Social Sciences Index and Abstracts, the International Bibliography of the Social Sciences, Sociological Abstracts, the Campbell Collaboration and grey literature databases for articles published January 1966 to April 2005. We also used Google and Google Scholar and contacted authors where necessary. We searched all terms related to homosexual, lesbian and bisexual people and all terms related to mental disorders, suicide, and deliberate self harm. We included papers on population based studies which contained concurrent heterosexual comparison groups and valid definition of sexual orientation and mental health outcomes. Of 13706 papers identified, 476 were initially selected and 28 (25 studies) met inclusion criteria. Only one study met all our four quality criteria and seven met three of these criteria. Data was extracted on 214,344 heterosexual and 11,971 non heterosexual people. Meta-analyses revealed a two fold excess in suicide attempts in lesbian, gay and bisexual people [pooled risk ratio for lifetime risk 2.47 (CI 1.87, 3.28)]. The risk for depression and anxiety disorders (over a period of 12 months or a lifetime) on meta-analyses were at least 1.5 times higher in lesbian, gay and bisexual people (RR range 1.54–2.58) and alcohol and other substance dependence over 12 months was also 1.5 times higher (RR range 1.51–4.00). Results were similar in both sexes but meta analyses revealed that lesbian and bisexual women were particularly at risk of substance dependence (alcohol 12 months: RR 4.00, CI 2.85, 5.61; drug dependence: RR 3.50, CI 1.87, 6.53; any substance use disorder RR 3.42, CI 1.97–5.92), while lifetime prevalence of suicide attempt was especially high in gay and bisexual men (RR 4.28, CI 2.32, 7.88). LGB people are at higher risk of mental disorder, suicidal ideation, substance misuse, and deliberate self harm than heterosexual people.