Sexual orientation and treatment-seeking for depression in a multilingual worldwide sample

Abstract

Background Prior research has found higher rates of mental health problems among sexual minority individuals. We examine treatment-seeking for depression, as well as its relationship with sexual orientation, in a large, multilingual, international sample. Method Participants in an automated, quintilingual internet-based depression screening tool were screened for depression, and completed several background measures, including sexual orientation (with an option to decline to state) and past and current depression treatment seeking. Results 3,695 participants screened positive for current or past depression and responded to the sexual orientation question. Those who declined to state their sexual orientation were far less likely to seek any treatment than individuals endorsing any orientation; they were especially unlikely to seek psychotherapy. Individuals identifying as bisexual sought both psychotherapy and alternative treatments at a higher rate than other groups. An interaction was observed between sexual orientation and gender, such that lesbian women were especially likely to have used psychotherapy. Other variables that emerged as significant predictors of treatment-seeking for depression included age and participant's language. Limitations Limitations include possible misinterpretation of translated terms due to regional differences, and possible limits to generalizability due to this study being conducted on the internet. Conclusions Our results suggest that individuals who decline to state their sexual orientation may be more likely to forgo effective treatments for depression. Further studies of depression service utilization should focus on developing treatment modalities that could better engage sexual minority individuals, especially those who are reluctant to disclose their orientation.

Longitudinal associations of cannabis, depression, and anxiety in heterosexual and LGB adolescents.

“…Indeed, factors that have been linked to substance use among sexual minorities, such as lower self-efficacy (Tucker et al, 2008), as well as lower life satisfaction and higher stress levels, especially related to the coming out process (Padilla et al, 2010; Rosario et al, 2009; Schauer et al, 2013), may explain why sexual minority youth would be less likely to possess alternative coping resources such as accessing therapy, or engaging in activities like arts or sports. Accordingly, and relatedly to the hypothesized relationship between cannabis use and depression symptoms as a reflection of internalized homophobia posited above, one study found that participants who declined to disclose their sexual orientation were more likely not to seek treatment for their depression (Rutter et al, 2016). This is detrimental in light of the current findings identifying depression symptoms as an important precursor of cannabis use in this group.…”

Help-seeking for depression as a stigmatized threat to masculinity.

“…Although we view our sample of men who screened positive for depression as a strength to our study, we also recognize the limitations of our mostly white, mostly heterosexual sample, who tended to have some college education, and all had Internet access. Research shows help-seeking for depression differs as a function of many variables including race, ethnicity, and education (Magaard et al, 2017), as well as sexual orientation and language use (Rutter et al, 2016). Even the relationship between stigma and help-seeking differs between racial groups with internalized stigma reported to mediate the relationship between public stigma and attitudes toward mental health treatment for white persons but not Black persons (Brown et al, 2010).…”

Prevalence of depressive symptoms among dental students is influenced by sex, academic performance, smoking exposure, and sexual orientation

“…The literature indicates that young people who belong to sexual minorities are significantly more likely to present depressive symptoms and face the double stigma of belonging to this marginalized group and experiencing mental health problems 30,31 . This disparity in the prevalence of depressive symptoms among non-heterosexual individuals has been associated with stressors such as discrimination, structural prejudices, concealment of sexual orientation, and isolation among heterosexual individuals 32,33 .…”