Increased risks for mental disorders among LGB individuals: cross-national evidence from the World Mental Health Surveys
Authors: Gmelin Jan-Ole H. , De Vries Ymkje Anna , Baams Laura , Aguilar-Gaxiola Sergio , Alonso Jordi , Borges Guilherme , Bunting Brendan , Cardoso Graca , Florescu Silvia , Gureje Oye , Karam Elie G. , Kawakami Norito , Lee Sing , Mneimneh Zeina , Navarro-Mateu Fernando , Posada-Villa José , Rapsey Charlene , Slade Tim , Stagnaro Juan Carlos , Torres Yolanda , Kessler Ronald C. , de Jonge Peter ,   The WHO World Mental Health Survey collaborators, Aguilar-Gaxiola Sergio , Al-Hamzawi Ali , Alonso Jordi , Andrade Laura Helena , Atwoli Lukoye , Benjet Corina , Borges Guilherme , Bromet Evelyn J. , Bruffaerts Ronny , Bunting Brendan , Caldas-de-Almeida Jose Miguel , Cardoso Graça , Chatterji Somnath , Cia Alfredo H. , Degenhardt Louisa , Demyttenaere Koen , Florescu Silvia , de Girolamo Giovanni , Gureje Oye , Haro Josep Maria , Harris Meredith , Hinkov Hristo , Hu Chi-yi , de Jonge Peter , Karam Aimee Nasser , Karam Elie G. , Kawakami Norito , Kessler Ronald C. , Kiejna Andrzej , Kovess-Masfety Viviane , Lee Sing , Lepine Jean-Pierre , McGrath John , Medina-Mora Maria Elena , Mneimneh Zeina , Moskalewicz Jacek , Navarro-Mateu Fernando , Piazza Marina , Posada-Villa Jose , Scott Kate M. , Slade Tim , Stagnaro Juan Carlos , Stein Dan J. , Have Margreet ten , Torres Yolanda , Viana Maria Carmen , Vigo Daniel V. , Whiteford Harvey , Williams David R. , Wojtyniak Bogdan 
Published: July 2022

Abstract
Purpose
Lesbian,
gay, and bisexual (LGB) individuals, and LB women specifically, have an
increased risk for psychiatric morbidity, theorized to result from stigma-based
discrimination. To date, no study has investigated the mental health
disparities between LGB and heterosexual AQ1individuals in a large
cross-national population-based comparison. The current study addresses this
gap by examining differences between LGB and heterosexual participants in 13
cross-national surveys, and by exploring whether these disparities were
associated with country-level LGBT acceptance. Since lower social support has
been suggested as a mediator of sexual orientation-based differences in
psychiatric morbidity, our secondary aim was to examine whether mental health
disparities were partially explained by general social support from family and
friends.

Methods
Twelve-month
prevalence of DSM-IV anxiety, mood, eating, disruptive behavior, and substance
disorders was assessed with the WHO Composite International Diagnostic
Interview in a general population sample across 13 countries as part of the
World Mental Health Surveys. Participants were 46,889 adults (19,887 males; 807
LGB-identified).

Results
Male
and female LGB participants were more likely to report any 12-month disorder (OR
2.2, p < 0.001 and OR 2.7, p < 0.001, respectively) and most individual
disorders than heterosexual participants. We found no evidence for an
association between country-level LGBT acceptance and rates of psychiatric
morbidity between LGB and heterosexualAQ2 participants. However, among LB
women, the increased risk for mental disorders was partially explained by lower
general openness with family, although most of the increased risk remained
unexplained.

Conclusion
These results provide cross-national evidence for an association between sexual minority status and psychiatric morbidity, and highlight that for women, but not men, this association was partially mediated by perceived openness with family. Future research into individual-level and cross-national sexual minority stressors is needed.