Mental health among UK inner city non-heterosexuals: the role of risk factors, protective factors and place.
Mental health among UK inner city non-heterosexuals: the role of risk factors, protective factors and place.
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英国内城区非异性恋者的心理健康：风险因素、保护因素和地点的作用。
DOI：
10.1017/s2045796015000645
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发表时间：
2016
影响因子：
8.1
通讯作者：
Woodhead C
中科院分区：
文献类型：
--
作者：
Woodhead C
性少数群体在全球范围内经历了过多的心理健康问题，但英国缺乏探索性少数群体心理健康状况不佳原因的数据。本研究比较了内城非异性恋者和异性恋者的幸福感、常见精神障碍（CMD）症状、终生自杀意念、有害酒精和药物使用的患病率。这是英国第一项研究，旨在量化有多少主要的，日常的和预期的歧视;一生和童年的创伤;以及应对不公平待遇的应对策略，预测非异性恋者的过度精神疾病。此外，内城和国家的结果进行了比较。方法自我报告的调查数据来自南东伦敦社区卫生研究（N = 1052）和成人精神病发病率调查（N = 7403）。结果调整更大的暴露于测量的经验，歧视和一生和童年创伤有一个小到中度的影响，效果大小的不利健康结果，虽然在充分调整的模型，非异性恋取向仍然与CMD、终生自杀意念、有害酒精和药物使用密切相关。有有限的支持的假设，衡量应对策略可能会调解这些协会。内城的样本有较差的心理健康整体相比，全国样本和非异性恋者比异性恋者的差异更大。ConclusionsChildhood和成人逆境的影响，但不占性取向相关的心理健康的差距。为了进一步了解这些关联，需要采取生命过程方法，采取更具体的歧视和应对措施。在设计和提供保健和社会服务时，应优先考虑性少数群体。
BackgroundSexual minorities experience excess psychological ill health globally, yet the UK data exploring reasons for poor mental health among sexual minorities is lacking. This study compares the prevalence of a measure of well-being, symptoms of common mental disorder (CMD), lifetime suicidal ideation, harmful alcohol and drug use among inner city non-heterosexual and heterosexual individuals. It is the first UK study which aims to quantify how much major, everyday and anticipated discrimination; lifetime and childhood trauma; and coping strategies for dealing with unfair treatment, predict excess mental ill health among non-heterosexuals. Further, inner city and national outcomes are compared.MethodsSelf-report survey data came from the South East London Community Health study (N = 1052) and the Adult Psychiatric Morbidity Survey (N = 7403).ResultsAdjustments for greater exposure to measured experiences of discrimination and lifetime and childhood trauma had a small to moderate impact on effect sizes for adverse health outcomes though in fully adjusted models, non-heterosexual orientation remained strongly associated with CMD, lifetime suicidal ideation, harmful alcohol and drug use. There was limited support for the hypothesis that measured coping strategies might mediate some of these associations. The inner city sample had poorer mental health overall compared with the national sample and the discrepancy was larger for non-heterosexuals than heterosexuals.ConclusionsChildhood and adult adversity substantially influence but do not account for sexual orientation-related mental health disparities. Longitudinal work taking a life course approach with more specific measures of discrimination and coping is required to further understand these associations. Sexual minorities should be considered as a priority in the design and delivery of health and social services.