Sexual Orientation, Substance Use and Mental Health

描述(由申请人提供)：针对PA-06-329《药物滥用流行病学》，这一探索性项目建议使用现有的具有全国代表性的数据集来评估性取向、可感知的歧视、药物滥用、心理健康和美国治疗利用之间的关系。过去的研究通常发现，女同性恋者、男同性恋者和双性恋者(LGB)患药物使用和精神健康障碍的风险更高，但这些研究一直受到方法学限制的困扰，包括小的、没有代表性的样本和缺乏异性恋比较组。到目前为止，还没有大规模的具有全国代表性的研究对自我确认的LGB个人的药物使用和精神健康障碍的流行病学进行审查，而且几乎没有关于性少数群体使用治疗的数据。因此，我们建议对2004-2005年全国酒精及相关疾病流行病学调查(NESARC)进行二次分析，这是一个具有全国代表性的样本，调查对象为在美国18岁及以上的34,653名美国成年人。具体目标是：(1)评估基于性取向的药物使用行为、DSM-IV药物使用、情绪和焦虑症的患病率和共生率；(2)评估有和没有DSM-IV诊断的受访者基于性取向的药物滥用和精神健康治疗的使用情况；以及(3)检验性少数群体中感觉到的歧视与药物使用和精神健康结果之间的关系。拟议的项目将利用2004-2005年《东北大西洋公约》提供的独特机会：提供大量种族多样化的样本，包括大量的性少数群体男女；包括性取向的多种衡量标准；以及关于DSM-IV药物使用、情绪和焦虑症以及治疗利用的大量数据。该项目的结果将增进对美国异性恋者和性少数群体中药物使用和精神健康障碍的流行病学的了解，并将为改进对这些疾病的评估、预防和治疗提供信息。7.项目叙述性取向了解药物滥用和精神健康障碍在各个分组中的模式和分布情况，对于设计有效的公共卫生预防、干预和治疗方案至关重要。该项目将审查与性取向、这些群体中的治疗利用以及感知到的歧视对性少数群体的物质使用行为和心理健康的影响等方面的药物使用和精神健康障碍的流行病学有关的几个未探索的研究问题。

DESCRIPTION (provided by applicant): In response to PA-06-329, Epidemiology of Drug Abuse, this exploratory project proposes to use an existing nationally representative dataset to assess the relationships among sexual orientation, perceived discrimination, substance abuse, mental health, and treatment utilization in the United States. Past research has generally found lesbian, gay and bisexual (LGB) individuals are at heightened risk for substance use and mental health disorders but these studies have been plagued by methodological limitations, including small, non-representative samples and lack of heterosexual comparison groups. To date, no large-scale nationally representative studies have examined the epidemiology of substance use and mental health disorders among self-identified LGB individuals and almost no data on treatment utilization among sexual minorities exists. Thus, we propose to conduct a secondary analysis of the 2004-2005 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a nationally representative sample of 34,653 U.S. adults 18 years and older in the United States. The specific aims are to: (1) assess the prevalence and co-occurrence of substance use behaviors, DSM-IV substance use, mood and anxiety disorders based on sexual orientation; (2) estimate substance abuse and mental health treatment utilization based on sexual orientation among respondents with and without DSM-IV diagnoses; and (3) examine the association between perceived discrimination and substance use and mental health outcomes among sexual minorities. The proposed project will take advantage of the unique opportunities afforded by the 2004-2005 NESARC: the availability of an ample and ethnically diverse sample with large numbers of sexual minority women and men; the inclusion of multiple measures of sexual orientation; and the wealth of data on DSM-IV substance use, mood and anxiety disorders, and treatment utilization. Findings from this project will enhance understanding of the epidemiology of substance use and mental health disorders among both heterosexuals and sexual minorities in the United States, and will provide information to improve the assessment, prevention and treatment of these disorders. 7. PROJECT NARRATIVE Understanding patterns and distributions of substance abuse and mental health disorders across sub-groups based on dimensions of sexual orientation is critical for designing effective public health prevention, intervention and treatment programs. This project will examine several unexplored research questions related to the epidemiology of substance use and mental health disorders across dimensions of sexual orientation, treatment utilization among those groups and the impact of perceived discrimination on the substance use behaviors and mental health of sexual minority groups.