Sexual orientation and suicidal behaviour in adolescents and young adults: systematic review and meta-analysis

Miranda-Mendizábal, Andrea; Castellví, Pere; Parés‐Badell, Oleguer; Almenara, José; Alonso, Iciar; Blasco, María Jesús; Cebrià, Ana Isabel; Gabilondo, Andrea; Gili, Margalida; Lagares‐Franco, Carolina; Rodríguez, José Antonio Piqueras; Roca, Miquel; Marín, Jesús Rodríguez; Rodríguez-Jiménez, Tiscar; Soto‐Sanz, Victoria; Vilagut, Gemma; Alonso, Jordi

doi:10.1192/bjp.bp.116.196345

Cited by 146 publications

(106 citation statements)

References 58 publications

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“…38 Family discord and feelings of guilt, shame, fear, isolation and rejection are also reported and are associated with mental health problems. 39 We found that depressive symptoms began to decline from age 18 in the sample overall and more so in sexual minorities. This could be due to social and psychological changes such as increased independence or changes in peer groups that result from moving away perhaps.…”

Section: Sexual Orientation Was Measured With a Single Question Aboutmentioning

confidence: 58%

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

Irish

Solmi

Mars

et al. 2019

The Lancet Child & Adolescent Health

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Background: There are few population-based cohort studies of the emergence, development, and persistence of mental health problems in sexual minorities compared to heterosexuals.We compared trajectories of depressive symptoms from 10 to 21 years of age in sexual minority and heterosexual adolescents, and examined self-harm at ages 16 and 21. Methods:The study included 4828 adolescents from the ALSPAC birth cohort (Bristol, UK) who reported their sexual orientation at age 16. Depressive symptoms were assessed with the short Mood and Feelings Questionnaire (sMFQ) at seven time-points between ages 10 and 21. A self-harm questionnaire was completed at ages 16 and 21. Analyses were linear multilevel models with growth curves (depressive symptoms), logistic multilevel models (self-harm in the past year at ages 16 and 21) and multinomial regression (lifetime self-harm with and without suicidal intent at age 21). Findings:In sexual minorities, depressive symptoms were higher at age 10 and increased to a larger extent compared to heterosexuals. In heterosexuals, depressive symptoms increased by 0.31 sMFQ points at each time-point (95% CI 0.27 to 0.34) and in sexual minorities by 0.49 sMFQ points (95% CI 0.40 to 0.59). Sexual minority adolescents were more likely to report self-harm in the past year at ages 16 and 21 (adjusted odds ratio 4.23, 95% CI 2.90 to 6.16), with no evidence that this estimate reduced with age (p=0.798). At 21, sexual minorities were 4.53 (95% CI 3.02 to 6.78) times more likely to report previous self-harm with suicidal intent.

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Section: Sexual Orientation Was Measured With a Single Question Aboutmentioning

confidence: 58%

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

Irish

Solmi

Mars

et al. 2019

The Lancet Child & Adolescent Health

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“…Fifth, analyses according to sexual orientation were not performed and transsexual individuals were excluded. We are aware there are important suicidal risk differences among sexual minorities and we have reported some of them in a recent systematic review of the literature (Miranda‐Mendizábal et al, ). To assess these issues, a specific paper based on the UNIVERSAL project survey will be performed.…”

Section: Discussionmentioning

confidence: 99%

Gender commonalities and differences in risk and protective factors of suicidal thoughts and behaviors: A cross‐sectional study of Spanish university students

et al. 2019

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Aim: To assess gender differences in the association between risk/protective factors and suicidal thoughts and behaviors (STB); and whether there is any genderinteraction with those factors and STB; among Spanish university students.Methods: Data from baseline online survey of UNIVERSAL project, a multicenter, observational study of first-year Spanish university students (18-24 years). We assessed STB; lifetime and 12-month negative life-events and family adversities; mental disorders; personal and community factors. Gender-specific regression models and gender-interactions were also analyzed. Results:We included 2,105 students, 55.4% women. Twelve-month prevalence of suicidal ideation (SI) was 10%, plans 5.7%, attempts 0.6%. Statistically significant 05728; Generalitat de Catalunya, Grant/ Award Number: 20172017 gender-interactions were found for lifetime anxiety disorder, hopelessness, violence between parents, chronic health conditions and family support. Lifetime mood disorder was a common risk factor of SI for both genders (Females: OR= 5.5; 95%CI 3.3-9.3; Males: OR= 4.4; 95%CI 2.0-9.7). For females, exposure to violence between parents (OR= 3.5; 95%CI 1.7-7.2), anxiety disorder (OR= 2.7; 95%CI 1.6-4.6), and alcohol/substance disorder (OR= 2.1; 95%CI 1.1-4.3); and for males, physical childhood maltreatment (OR= 3.6; 95%CI 1.4-9.2), deceased parents (OR= 4.6; 95% CI 1.2-17.7), and hopelessness (OR= 7.7; 95%CI 2.8-21.2), increased SI risk. Family support (OR= 0.5; 95%CI 0.2-0.9) and peers/others support (OR= 0.4; 95%CI 0.2-0.8) were associated to a lower SI risk only among females.Conclusions: Only mood disorder was a common risk factor of SI for both genders, whereas important gender-differences were observed regarding the other factors assessed. The protective effect from family and peers/others support was observed only among females. Further research assessing underlying mechanisms and pathways of gender-differences is needed. K E Y W O R D Sanxiety/anxiety disorders, depression, gender, mood disorders, suicide/self-harm

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“…Results evidenced from 2.26 15 to 2.92 16 times higher rates of suicidality (ideation, intent, plans, attempts and serious attempts) in sexual minority individuals, a figure that became bigger with the increasing severity of suicidal behaviour.…”

Section: Introductionmentioning

confidence: 94%

Suicidal behaviour among sexual-minority youth: a review of the role of acceptance and support

Poštuvan

Podlogar

Šedivy

et al. 2019

The Lancet Child & Adolescent Health

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Sexual minority youths have two-to threefold higher risk for suicidal behaviour compared to their peers. They also face increased levels of different mental health risk factors, such as depression and substance abuse, and are often victims of homophobia and discrimination. However, available data are unable to provide a clear understanding of the psychosocial factors contributing to these unfavourable mental health indicators. Therefore, this study reviews current knowledge about the impact of factors such as acceptance and support as possible risk or protective factors for the development of suicidal behaviour among sexual minority youth. Thirty four articles were eventually included in the review process; their content was contextualised at three different levels (society, social network and individual) and then integrated into a model. This study shows how negative social environments, such as non-acceptant school climate, lack of support within closest social network, and absence of LGBT support movements in communities, contribute to the development of suicidality in young persons. Unsupportive reactions are internalised and played out at the individual's level as internalised homo-/bi-/transphobic patterns. In order to prevent suicidal behaviour, all these aspects need to be taken into consideration.

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Sexual orientation and suicidal behaviour in adolescents and young adults: systematic review and meta-analysis

Cited by 146 publications

References 58 publications

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

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

Gender commonalities and differences in risk and protective factors of suicidal thoughts and behaviors: A cross‐sectional study of Spanish university students

Suicidal behaviour among sexual-minority youth: a review of the role of acceptance and support

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