Abstract
OBJECTIVES: Depression is a global concern and it is well known that certain segments of the population are at greater risk. Sexual minorities are recognized as being more likely to suffer from depression due to social stigma and prejudice. The aim of this study was to describe the relationship between sexual orientation and depression in the Canadian population.
METHODS: The study used the 2012 Canadian Community Health Survey — Mental Health data. The sample comprised 24,788 Canadians living in the ten provinces. Logistic regression analyses were used to examine the relationship of depression and sexual orientation.
RESULTS: After adjusting for known risk factors for depression, there was no difference in prevalence of past 12-month or lifetime major depressive episode between sexual minorities and heterosexuals. Bisexuals did have a near significant trend towards higher prevalence of both past 12-month and lifetime depression as a combined group, but there were not clear differences when stratified by sex.
CONCLUSION: This study supports important emerging trends in the relationship between sexual orientation and depression. Research on the mental health of sexual minority people must take into account differences between sexual minority groups and avoid aggregating mental health disorders into broad categories. These findings have implications for public health planning and clinical recommendations.
Key Words: Homosexuality, bisexuality, depression, mental health, quantitative evaluation
Résumé
OBJECTIFS: La dépression est un problème mondial, et l’on sait que certains segments de la population y sont plus vulnérables. Les minorités sexuelles sont reconnues comme étant plus susceptibles de souffrir de dépression en raison de la stigmatisation sociale et des préjugés à leur endroit. Notre étude visait à décrire le lien entre l’orientation sexuelle et la dépression dans la population canadienne.
MÉTHODE: L’étude a fait appel aux données sur la santé mentale de l’Enquête sur la santé dans les collectivités canadiennes de 2012.
L’échantillon comprenait 24 788 Canadiens vivant dans les 10 provinces. Des analyses de régression logistique ont servi à examiner la relation entre la dépression et l’orientation sexuelle.
RÉSULTATS: Après avoir tenu compte des facteurs de risque connus de la dépression, il n’y avait aucune différence dans la prévalence des accès dépressifs majeurs au cours des 12 mois antérieurs ou au cours de la vie entre les minorités sexuelles et la population hétérosexuelle. Les personnes bisexuelles, en tant que groupe combiné, présentaient bien une tendance quasi significative de prévalence accrue de dépression au cours des 12 mois antérieurs et au cours de la vie, mais il n’y avait pas de différence claire lorsque les données étaient stratifiées selon le sexe.
CONCLUSION: Notre étude appuie d’importantes tendances émergentes en ce qui a trait au lien entre l’orientation sexuelle et la dépression. La recherche sur la santé mentale des minorités sexuelles doit tenir compte des différences entre les minorités sexuelles et éviter de regrouper les troubles de santé mentale en grandes catégories. Ces constatations ont des conséquences pour la planification en santé publique et pour les recommandations cliniques.
Mots Clés: homosexualité, bisexualité, dépression, santé mentale, évaluation quantitative
Footnotes
Acknowledgements: The authors acknowledge Statistics Canada Research Data Centre, University of Alberta, for their assistance with data access and vetting results for release.
Conflict of Interest: None to declare.
References
- 1.American Psychiatric Association APA. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: American Psychiatric Press Inc.; 2013. p. 991. [Google Scholar]
- 2.World Health Organization. Mental Health: A State of Weil-Being. 2014. [Google Scholar]
- 3.Kessler RC, Aguilar-Gaxiola S, Alonso S, Chatterji S, Lee S, Ormel J, et al. The global burden of mental disorders: An update from the WHO World Mental Health (WMH) surveys. Epidemiol Psychiatr Soc. 2009;18(1):22–33. doi: 10.1017/S1121189X00001421. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.Pearson C, Janz T, Ali J. Mental Health and Substance Use Disorders in Canada. Ottawa, ON: Statistics Canada; 2013. [Google Scholar]
- 5.De Marco RR. The epidemiology of major depression: Implications of occurrence, recurrence and stress in a Canadian community sample. Can J Psychiatry. 2000;45:67–74. doi: 10.1177/070674370004500110. [DOI] [PubMed] [Google Scholar]
- 6.Evans D, Charney DS, Golden RN, Gorman JM, Krishnan KR, Nemeroff CB, et al. Mood disorders in the medically ill: Scientific review and recommendations. Biol Psych. 2005;58(3):178–89. doi: 10.1016/j.biopsych.2005.05.001. [DOI] [PubMed] [Google Scholar]
- 7.Kessler RC. Epidemiology of women and depression. J Affect Disord. 2003;74:5–13. doi: 10.1016/S0165-0327(02)00426-3. [DOI] [PubMed] [Google Scholar]
- 8.Kirmayer LJ, Gill K, Fletcher C, Ternar Y, Boothroyd L, Quesney C, et al. Emerging Trends in Research on Mental Health among Canadian Aboriginal Peoples. A Report Prepared for the Royal Commission on Aboriginal Peoples. Montreal, QC: Culture & Mental Health Research Unit, Jewish General Hospital; 1994. [Google Scholar]
- 9.Government of Canada. The Human Face of Mental Health and Mental Illness in Canada. Ottawa, ON: Minister of Public Works and Government Services; 2006. [Google Scholar]
- 10.King M, Semlyen J, Tai SS, Killaspy H, Osborn D, Popelyuk D, et al. A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people. BMC Psychiatry. 2008;8:70. doi: 10.1186/1471-244X-8-70. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 11.Meyer IH. Prejudice and discrimination as social stressors. In: Meyer IH, Northridge ME, editors. The Health of Sexual Minorities: Public Health Perspectives on Lesbian, Gay, Bisexual, and Transgender Populations. New York, NY: Springer; 2007. pp. 242–67. [Google Scholar]
- 12.Steel LS, Ross LE, Dobinson C, Veldhuizen S, Tinmouth JM. Women’s sexual orientation and health: Results from a Canadian population-based survey. Women & Health. 2009;49(5):353–67. doi: 10.1080/03630240903238685. [DOI] [PubMed] [Google Scholar]
- 13.Brennan DJ, Ross LE, Dobinson C, Veldhuizen S, Steele LS. Men’s sexual orientation and health in Canada. Can J Public Health. 2010;101(3):255–58. doi: 10.1007/BF03404385. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 14.Juster RP, Smith NG, Ouellet E, Sindi S, Lupien SJ. Sexual orientation and disclosure in relation to psychiatric symptoms, diurnal Cortisol, and allostatic load. Psychosom Med. 2013;75(2):103–16. doi: 10.1097/PSY.0b013e3182826881. [DOI] [PubMed] [Google Scholar]
- 15.Canadian Community Health Survey CCHS - Mental Health. User Guide Microdata Files. Ottawa, ON: Statistics Canada; 2013. p. 300. [Google Scholar]
- 16.Canadian Community Health Survey CCHS - Mental Health. Derived Variable Specifications. Ottawa, ON: Statistics Canada; 2013. p. 164. [Google Scholar]
- 17.Kessler RC, Abelson J, Dernier O, Escobar JI, Gibbon M, Guyer M C c o D-I d i t W M H W v o t W H O W C I D I W-CIDI, et al. Int J Methods Psychiatr Res. 2004;13(2):122–39. doi: 10.1002/mpr.169. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 18.Cutrona CE, Russell DW. The provisions of social support and adaptation to stress. In: Jones WH, Perlman D, editors. Advances in Personal Relationships. Greenwich, CT: JAI Press; 1987. pp. 37–67. [Google Scholar]
- 19.Krause N. Negative interaction and satisfaction with social support among older adults. J Gerontol B Psychol Sci Soc Sci. 1995;50(2):P59–73. doi: 10.1093/geronb/50B.2.P59. [DOI] [PubMed] [Google Scholar]
- 20.Scott RL, Lasiuk G, Norris C. The relationship between sexual orientation and depression in a national population sample. J Clin Nurs. 2016;25(23-24):3522–32. doi: 10.1111/jocn.13286. [DOI] [PubMed] [Google Scholar]
- 21.Cochran SD, Mays VM. Burden of psychiatric morbidity among lesbian, gay, and bisexual individuals in the California Quality of Life Survey. J Abnorm Psychol. 2009;118:647–58. doi: 10.1037/a0016501. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 22.Bostwick WB, Boyd CJ, Hughes TL, McCabe SE. Dimensions of sexual orientation and the prevalence of mood and anxiety disorders in the United States. Am J Public Health. 2010;100:468–75. doi: 10.2105/AJPH.2008.152942. [DOI] [PMC free article] [PubMed] [Google Scholar]
