Post-traumatic stress disorder among LGBTQ people: a systematic review and meta-analysis.

IF 5.9 2区医学 Q1 PSYCHIATRY

Epidemiology and Psychiatric Sciences Pub Date : 2023-07-11 DOI:10.1017/S2045796023000586

Mattia Marchi, Antonio Travascio, Daniele Uberti, Edoardo De Micheli, Pietro Grenzi, Elisa Arcolin, Luca Pingani, Silvia Ferrari, Gian M Galeazzi

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Abstract

Aims: Lesbian, gay, bisexual, transgender and queer people (LGBTQ) are at increased risk of traumatization. This systematic review aimed to summarize data regarding the risk of post-traumatic stress disorder (PTSD) for LGBTQ people and their subgroups.

Methods: Medline, Scopus, PsycINFO and EMBASE were searched until September 2022. Studies reporting a comparative estimation of PTSD among LGBTQ population and the general population (i.e., heterosexual/cisgender), without restrictions on participants' age and setting for the enrolment, were identified. Meta-analyses were based on odds ratio (OR and 95% confidence intervals [CI]), estimated through inverse variance models with random effects.

Results: The review process led to the selection of 27 studies, involving a total of 31,903 LGBTQ people and 273,842 controls, which were included in the quantitative synthesis. Overall, LGBTQ people showed an increased risk of PTSD (OR: 2.20 [95% CI: 1.85; 2.60]), although there was evidence of marked heterogeneity in the estimate (I² = 91%). Among LGBTQ subgroups, transgender people showed the highest risk of PTSD (OR: 2.52 [95% CI: 2.22; 2.87]) followed by bisexual people (OR: 2.44 [95% CI: 1.05; 5.66]), although these comparisons are limited by the lack of data for other sexual and gender minorities, such as intersex people. Interestingly, the risk of PTSD for bisexual people was confirmed also considering lesbian and gay as control group (OR: 1.44 [95% CI: 1.07; 1.93]). The quality of the evidence was low.

Conclusions: LGBTQ people are at higher risk of PTSD compared with their cisgender/heterosexual peers. This evidence may contribute to the public awareness on LGBTQ mental health needs and suggest supportive strategies as well as preventive interventions (e.g., supportive programs, counselling, and destigmatizing efforts) as parts of a tailored health-care planning aimed to reduce psychiatric morbidity in this at-risk population.

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LGBTQ人群的创伤后应激障碍:系统回顾和荟萃分析。

目的:女同性恋、男同性恋、双性恋、变性人和酷儿人群(LGBTQ)受到创伤的风险越来越大。本系统综述旨在总结关于LGBTQ人群及其亚群体创伤后应激障碍(PTSD)风险的数据。方法:截至2022年9月，检索Medline、Scopus、PsycINFO和EMBASE。研究报告了LGBTQ人群和一般人群(即异性恋/顺性)的创伤后应激障碍的比较估计，没有限制参与者的年龄和入组环境。meta分析基于优势比(OR和95%置信区间[CI])，通过随机效应的逆方差模型估计。结果:审查过程中选择了27项研究，共涉及31,903名LGBTQ人群和273,842名对照，纳入定量综合。总体而言，LGBTQ人群患PTSD的风险增加(OR: 2.20 [95% CI: 1.85;2.60])，尽管有证据表明在估计中存在明显的异质性(I2 = 91%)。在LGBTQ亚群中，跨性别者患PTSD的风险最高(OR: 2.52 [95% CI: 2.22;2.87])，其次是双性恋者(OR: 2.44 [95% CI: 1.05;5.66])，尽管这些比较由于缺乏其他性和性别少数群体(如双性人)的数据而受到限制。有趣的是，双性恋者患创伤后应激障碍的风险也被确认为将女同性恋和男同性恋作为对照组(OR: 1.44 [95% CI: 1.07;1.93])。证据的质量很低。结论:LGBTQ人群患PTSD的风险高于顺性/异性恋人群。这一证据可能有助于提高公众对LGBTQ心理健康需求的认识，并建议采取支持性策略和预防性干预措施(例如，支持性项目、咨询和去污名化努力)，作为量身定制的医疗保健计划的一部分，旨在减少这一高危人群的精神病发病率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Epidemiology and Psychiatric Sciences PSYCHIATRY-

CiteScore

7.80

自引率

1.20%

发文量

121

审稿时长

>12 weeks

期刊介绍： Epidemiology and Psychiatric Sciences is a prestigious international, peer-reviewed journal that has been publishing in Open Access format since 2020. Formerly known as Epidemiologia e Psichiatria Sociale and established in 1992 by Michele Tansella, the journal prioritizes highly relevant and innovative research articles and systematic reviews in the areas of public mental health and policy, mental health services and system research, as well as epidemiological and social psychiatry. Join us in advancing knowledge and understanding in these critical fields.