Mattia Marchi, Giulia Ferrazzi, Giulia Pollice, Luca Pingani, Silvia Ferrari, Antonio Ventriglio, Gian M Galeazzi
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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.</p><p><strong>Results: </strong>Twenty systematic reviews were included, accounting for 5,164,641 LGBTQIA+ individuals. These focused on the following mental health outcomes: major depressive disorder (MDD, <i>n</i> = 7), eating disorders (ED, <i>n</i> = 5), anxiety disorders (AD, <i>n</i> = 5), substance use disorder (SUD, <i>n</i> = 4), alcohol use disorder (AUD, <i>n</i> = 1), post-traumatic stress disorder (PTSD, <i>n</i> = 1), and suicidality (<i>n</i> = 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.</p><p><strong>Conclusions: </strong>LGBTQIA+ individuals experience significant mental health challenges compared to the general population. 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引用次数: 0
摘要
背景：性和性别少数群体，统称为LGBTQIA+个体，与异性恋/顺性同龄人相比，经历了不成比例的心理健康差异。目的：本系统综述的目的是综合以前发表的关于LGBTQIA+人群心理健康的系统综述的高质量证据。方法：检索PubMed截至2024年9月1日发表的关于LGBTQIA+心理健康的系统综述。对于每一项心理健康结果，对调查结果进行了叙述综合。此外，当纳入的综述报告了适合合并分析的病例对照数据时，使用随机效应模型进行网络荟萃分析，以估计不同性别和性别群体的精神障碍的优势比（ORs）和95%置信区间（95% ci）。结果：共纳入20篇系统评价，共计5164641名LGBTQIA+个体。这些研究集中在以下心理健康结果：重度抑郁症（MDD, n = 7）、饮食失调（ED, n = 5）、焦虑症（AD, n = 5）、物质使用障碍（SUD, n = 4）、酒精使用障碍（AUD, n = 1）、创伤后应激障碍（PTSD, n = 1）和自杀（n = 11），与一般人群相比，LGBTQIA+个体中所有这些结果都更为普遍。网络荟萃分析仅适用于自杀企图（SA），发现双性恋者的风险最高（OR = 6.43, 95% CI[4.43; 9.34]），其次是女同性恋和男同性恋者（OR = 4.54, 95% CI[3.42, 6.03]），性少数群体和性别少数群体（OR = 4.32, 95% CI[3.52, 5.30]）和变性者（OR = 3.61, 95% CI[2.78, 4.67]）。地域差异也被发现，变性人是欧洲SA风险最高的群体（OR = 7.22, 95% CI[4.83, 10.81]），而亚洲SA风险最低的群体（OR = 1.84, 95% CI[0.68, 5.03]），提示潜在的社会文化影响或参与者选择的差异。结论：与普通人群相比，LGBTQIA+个体经历了显著的心理健康挑战。为了减少这些差异，更包容的政策、支持性的社会环境、积极的精神卫生保健以及对少数群体压力源和保护因素的持续研究至关重要。
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.
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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