Sexual minority youth and depressive symptoms or depressive disorder: A systematic review and meta-analysis of population-based studies

Abstract

Objective: Research has suggested that sexual minority young people are more likely to have depressive symptoms or depressive disorder, but to date most studies in the field have relied on convenience-based samples. This study overcomes this limitation by systematically reviewing the literature from population-based studies and conducting a meta-analysis to identify whether depressive disorder and depressive symptoms are elevated in sexual minority youth. Method:A systematic review and meta-analysis were conducted and informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement to determine if rates of depressive symptoms or depressive disorder differ for sexual minority youth, relative to heterosexual adolescents. MEDLINE, PsycINFO, EMBASE and ERIC databases were searched. Studies reporting depressive symptom data or the prevalence of depressive disorder in population-based samples of adolescents, that included sexual minority youth and heterosexual young people, were included in the review. A meta-analysis was conducted to examine differences between groups.Results: Twenty-three articles met the inclusion criteria. The proportion of sexual minority youth in the studies ranged from 2.3% to 12%. Sexual minority youth reported higher rates of depressive symptoms and depressive disorder (odds ratio = Sexual minority youth and depression 4 2.94, p<0.001 and standardized mean difference, d = 0.39, p<0.001) in comparison to heterosexual young people. Female sexual minority youth were more likely to report depressive symptoms when compared to male sexual minority youth (standardized mean difference, d = 0.34, p<0.001). Limitations included variations in how sexuality was operationalized and how depressive symptoms or depressive disorder was measured. Conclusions:There is robust evidence that rates of depressive disorder and depressive symptoms are elevated in sexual minority youth in comparison to heterosexual young people. Despite the elevated risk of depressive symptoms or depressive disorder for sexual minority youth, the treatment for this group of young people has received little attention.

Depression and self-harm from adolescence to young adulthood in sexual minorities compared with heterosexuals in the UK: a population-based cohort study

“…Sexual minorities (for example people identifying as lesbian, gay or bisexual, not exclusively heterosexual or not sure of their sexual orientation 1,2 ) are more likely to experience depression, self-harm and suicide attempts than heterosexuals. 2,3 These associations have been reported in cross-sectional surveys across the world, in adults 2,3 and adolescents.…”

“…2,3 These associations have been reported in cross-sectional surveys across the world, in adults 2,3 and adolescents. 4,5 However, there is little longitudinal research on when increased risk for these mental health problems emerges and how it develops over time.…”

Sexual Orientation–Based Depression and Suicidality Health Disparities: The Protective Role of School‐Based Health Centers

“…A wealth of research has demonstrated mental health disparities among SMY relative to their heterosexual counterparts (Lucassen et al., ) and that SMY report greater unmet health care needs (Ramos et al., ). The current study aimed to examine whether sexual orientation–based differences in mental health indicators were smaller in schools with SBHCs than those without SBHCs among a representative sample of Oregon adolescents.…”

“…Research examining sexual and reproductive health have shown that SBHCs activities support adolescents’ self‐efficacy toward health practices (Mesheriakova & Tebb, ; Weeks et al., ). Alternatively, it may be that SBHC presence may be especially impactful for SMY given increased need based on disproportionate rates of mental health problems (Lucassen et al., ). Indeed, the current study did not find that SBHC presence was associated with non‐SMY mental health indicators.…”

“…However, research on SBHCs has yet to examine whether and to what extent the benefits of SBHC use and access extend to sexual minority youth (SMY), a particularly marginalized adolescent population. This is despite research suggesting that SMY report higher rates of victimization, depression and anxiety, suicidality, and other high‐risk behaviors compared to their heterosexual peers (Coker, Austin, & Schuster, ; King et al., ; Lucassen, Stasiak, Samra, Frampton, & Merry, ). For example, findings from a nationally representative sample of adolescents suggest that SMY have significantly higher prevalence of suicide attempts and suicidal ideation compared to heterosexual youth, controlling for age, race, and ethnicity (Silenzio, Pena, Duberstein, Cerel, & Knox, ).…”