Mental Health in Sexual and Gender Minority Populations: A Systematic Review of Systematic Reviews With Narrative Synthesis and a Network Meta-Analysis of Suicide Attempts.
Mattia Marchi, Giulia Ferrazzi, Giulia Pollice, Luca Pingani, Silvia Ferrari, Antonio Ventriglio, Gian M Galeazzi
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引用次数: 0
Abstract
Background: Sexual and gender minorities, collectively known as LGBTQIA+ individuals, experience disproportionate mental health disparities compared to their heterosexual/cisgender peers.
Aims: The aim of this systematic review was to synthesize high-quality evidence from previously published systematic reviews on mental health in the LGBTQIA+ population.
Method: PubMed was searched for systematic reviews on LGBTQIA+ mental health, published by September 1st, 2024. For each mental health outcome, a narrative synthesis of the findings was performed. Additionally, when included reviews reported case-control data suitable for pooled analysis, network meta-analyses with random-effects models were conducted to estimate the Odds Ratios (ORs) and 95% confidence intervals (95% CIs) for mental disorders across sexual and gender groups.
Results: Twenty systematic reviews were included, accounting for 5,164,641 LGBTQIA+ individuals. These focused on the following mental health outcomes: major depressive disorder (MDD, n = 7), eating disorders (ED, n = 5), anxiety disorders (AD, n = 5), substance use disorder (SUD, n = 4), alcohol use disorder (AUD, n = 1), post-traumatic stress disorder (PTSD, n = 1), and suicidality (n = 11), all resulting more prevalent among LGBTQIA+ individuals compared to the general population. Network meta-analysis was possible only for suicide attempts (SA), finding the highest risk among bisexual individuals (OR = 6.43, 95% CI [4.43; 9.34]), followed by lesbian and gay individuals (OR = 4.54, 95% CI [3.42, 6.03]), sexual and gender minorities analyzed together (OR = 4.32, 95% CI [3.52, 5.30]), and transgender individuals (OR = 3.61, 95% CI [2.78, 4.67]). Geographical differences were also found, with transgender individuals being the group with the highest SA risk in Europe (OR = 7.22, 95% CI [4.83, 10.81]) and the lowest SA risk in Asia (OR = 1.84, 95% CI [0.68, 5.03]), suggesting potential socio-cultural influences or differences in participant selection.
Conclusions: LGBTQIA+ individuals experience significant mental health challenges compared to the general population. To reduce these disparities, more inclusive policies, supportive social environments, affirmative mental health care, and ongoing research into minority stressors and protective factors are essential.
期刊介绍：
The International Journal of Social Psychiatry, established in 1954, is a leading publication dedicated to the field of social psychiatry. It serves as a platform for the exchange of research findings and discussions on the influence of social, environmental, and cultural factors on mental health and well-being. The journal is particularly relevant to psychiatrists and multidisciplinary professionals globally who are interested in understanding the broader context of psychiatric disorders and their impact on individuals and communities.
Social psychiatry, as a discipline, focuses on the origins and outcomes of mental health issues within a social framework, recognizing the interplay between societal structures and individual mental health. The journal draws connections with related fields such as social anthropology, cultural psychiatry, and sociology, and is influenced by the latest developments in these areas.
The journal also places a special emphasis on fast-track publication for brief communications, ensuring that timely and significant research can be disseminated quickly. Additionally, it strives to reflect its international readership by publishing state-of-the-art reviews from various regions around the world, showcasing the diverse practices and perspectives within the psychiatric disciplines. This approach not only contributes to the scientific understanding of social psychiatry but also supports the global exchange of knowledge and best practices in mental health care.
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