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Sexual minority status and psychotic symptoms: findings from the Netherlands Mental Health Survey and Incidence Studies (NEMESIS)

Published online by Cambridge University Press:  28 May 2013

M. J. Gevonden ,
J. P. Selten ,
I. Myin-Germeys ,
R. de Graaf ,
M. ten Have ,
S. van Dorsselaer ,
J. van Os  and
W. Veling
M. J. Gevonden*
Affiliation:
Maastricht University Medical Centre, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht, The Netherlands Rivierduinen Psychiatric Institute, Leiden, The Netherlands Academic Medical Centre, Department of Nuclear Medicine, University of Amsterdam, Amsterdam, The Netherlands
J. P. Selten
Affiliation:
Maastricht University Medical Centre, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht, The Netherlands Rivierduinen Psychiatric Institute, Leiden, The Netherlands
I. Myin-Germeys
Affiliation:
Maastricht University Medical Centre, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht, The Netherlands
R. de Graaf
Affiliation:
Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
M. ten Have
Affiliation:
Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
S. van Dorsselaer
Affiliation:
Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
J. van Os
Affiliation:
Maastricht University Medical Centre, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht, The Netherlands King's College London, King's Health Partners, Department of Psychosis Studies, Institute of Psychiatry, London, UK
W. Veling
Affiliation:
Maastricht University Medical Centre, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht, The Netherlands Parnassia Psychiatric Institute, The Hague, The Netherlands
*
* Address for correspondence: M. J. Gevonden, PO Box 22660 (F2–233), 1100 DD Amsterdam; The Netherlands. (Email: m.gevonden@maastrichtuniversity.nl)
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Abstract

Background

Ethnic minority position is associated with increased risk for psychotic outcomes, which may be mediated by experiences of social exclusion, defeat and discrimination. Sexual minorities are subject to similar stressors. The aim of this study is to examine whether sexual minorities are at increased risk for psychotic symptoms and to explore mediating pathways.

Method

A cross-sectional survey was performed assessing cumulative incidence of psychotic symptoms with the Composite International Diagnostic Interview in two separate random general population samples (NEMESIS-1 and NEMESIS-2). Participants were sexually active and aged 18–64 years (n = 5927, n = 5308). Being lesbian, gay or bisexual (LGB) was defined as having sexual relations with at least one same-sex partner during the past year. Lifetime experience of any psychotic symptom was analysed using logistic regression, adjusted for gender, educational level, urbanicity, foreign-born parents, living without a partner, cannabis use and other drug use.

Results

The rate of any psychotic symptom was elevated in the LGB population as compared with the heterosexual population both in NEMESIS-1 [odds ratio (OR) 2.56, 95% confidence interval (CI) 1.71–3.84] and NEMESIS-2 (OR 2.30, 95% CI 1.42–3.71). Childhood trauma, bullying and experience of discrimination partly mediated the association.

Conclusions

The finding that LGB orientation is associated with psychotic symptoms adds to the growing body of literature linking minority status with psychosis and other mental health problems, and suggests that exposure to minority stress represents an important mechanism.

Keywords

Discriminationepidemiologyhomosexualityminority stresspsychosis
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 2 , January 2014 , pp. 421 - 433
Copyright
Copyright © Cambridge University Press 2013 

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