Depression and suicidal behavior in LGB and heterosexual populations in Serbia and their differences: Cross-sectional study

Interaction between nutrition-related parameters and sexual orientation on depression

OBJECTIVES

Sexual minorities may be more vulnerable to mental disorders. Previous studies have found associations between diet and depression, but no studies have focused on the interaction between nutrition-related parameters and sexual orientation regarding depression. This study aims to explore the interaction between nutrition-related parameters and sexual orientation regarding depression.

STUDY DESIGN

Cross-sectional analysis using NHANES 2007-2016 data.

METHODS

This study utilized data from NHANES 2007-2016, with 11,065 participants involved. Nutrition-related parameters were evaluated using the healthy eating index-2015 (HEI-2015) and the dietary inflammation index (DII), while depression was obtained through Patient Health Questionnaire (PHQ-9). Logistic regression and stratified analysis of subgroups were used in this study.

RESULTS

Compared to those who consumed healthy and anti-inflammatory diets, the ORs for depression in groups consuming unhealthy and pro-inflammatory diets were 1.366 (95%CI:1.073,1.738) and 1.652 (95%CI:1.345,2.028), respectively. Sexual minorities have a higher risk of depression than heterosexuals. There is an interaction effect (P = 0.037) between HEI-2015 and sexual orientation on depression, while it was not found in DII. Subgroup analysis indicated that the interaction between sexual orientation and HEI-2015 persisted in males (P = 0.024), but not in females.

CONCLUSION

Both diet and sexual orientation had impacts on depression. There was an interaction between HEI-2015 and sexual orientation on depression, and this association was different by gender. Sexual minorities who are Gay/lesbian, Bisexual, and Something else are at higher risk for depression, and adopting healthy eating patterns and anti-inflammatory diets that are consistent with the recommendations of the USDA may appropriately reduce the risk of depression.

Mental health and suicide risk among homosexual males in Bangladesh

BACKGROUND

Homosexual individuals are at high risk of suicide, but there is a shortage of data from developing countries to confirm this. Estimates on mental health and suicide risk among male homosexuals in Bangladesh are needed to generate awareness and to plan services accordingly.

METHOD

We assessed mental health and suicidal behavior of 102 self-identified homosexual males from a community-based organization that works with the sexual minority population.

RESULTS

One-third of the participants (32.4%) had experienced attempted suicide, and almost half (47.1%) had a history of suicidal ideation and self-harm (40.2%). Compared to a heterosexual sample, homosexual males had poorer mental health as they scored higher on Beck Hopelessness Scale (Cohen's d = 0.29) and General Health Questionnaire (GHQ) (Cohen's d = 0.57). The results revealed positive correlations between self-harm, suicidal ideation and suicide attempt scores. Participants with history of suicide attempt, suicide ideation and self-harm reported worse general health, more social dysfunction, and severe depression than those without such history.

CONCLUSION

Suicidality and mental health conditions among homosexual males in Bangladesh have appeared to be alarming. Given the concerns, we offer some recommendations for practitioners and social workers who are serving this population in Bangladesh.

Examining Health Disparities and Severity of Depression among Sexual Minorites in a National Population Sample

Background: Health disparities and mental health issues have not been fully explored among sexual minorities. This study aims to examine health disparities and severity of depression among sexual minorities using a nationally representative sample of the US population. Methods: The National Health and Nutrition Examination Survey (NHANES) data from 2011 to 2016 were analyzed. The Patient Health Questionnaire (PHQ-9) was used to examine the severity of depression among sexual minorities compared to heterosexuals. Data were analyzed for descriptive statistics and associations using the Chi-squared test. A multivariate logistic regression analysis was used to quantify the magnitude of association between severity of depression and demographic characteristics. A p-value of <0.05 was considered statistically significant. Results: Among 7826 participants included, 426 (5.4%) were identified as a sexual minority. Moderately severe to severe depression was observed among 9.3% of sexual minorities with women having higher rates (64.2%) than men. Similarly, sexual minorities were two times more likely to have moderately severe to severe depression, two and half times more likely to see a mental health professional, and one and half times more likely to have genital herpes and be a user of illicit drugs than heterosexuals. In addition, they were less likely to be married and more likely to have been born in the United States, be a U.S. citizen, and earn less than USD 25,000 (p < 0.05). Conclusions: Sexual minorities are affected by a range of social, structural, and behavioral issues impacting their health. The screening of individuals with depression who are sexual minorities (especially females), illicit drug users, poor, or aged over 39 years may benefit from early intervention efforts.

Integrating HIV and mental health interventions to address a global syndemic among men who have sex with men

In this Series paper, we review evidence on the co-occurring and synergistic epidemics (syndemic) of HIV and mental health problems worldwide among men who have sex with men (MSM). The multilevel determinants of this global syndemic include structural factors that enable stigma, systematic bias, and violence towards MSM across geographical and cultural contexts. Cumulative exposure to these factors over time results in population-level inequities in the burden of HIV infections and mental health problems among MSM. Evidence for this syndemic among MSM is strongest in the USA, Canada, western Europe, and parts of Asia and Latin America, with emerging evidence from sub-Saharan Africa. Integrated interventions are needed to address syndemics of HIV and mental health problems that challenge the wellbeing of MSM populations worldwide, and such interventions should consider various mental health conditions (eg, depression, anxiety, trauma, and suicidality) and their unique expressions and relationships with HIV outcomes depending on cultural contexts. In addition, interventions should identify and intervene with locally relevant structural factors that result in HIV and mental health vulnerabilities among MSM.

Examining differences in suicidality between and within mental health disorders and sexual identity among adults in the United States

BACKGROUND

Suicide is a leading but preventable cause of death and is preceded by domains of thoughts, plans, and attempts. We assessed the prevalence of suicidality domains and determined the association of suicidality domains with sexual identity, mental health disorder symptoms, and sociodemographic characteristics.

METHODS

We used the 2019 National Survey on Drug Use and Health (NSDUH) data to perform weighted multivariable logistic regression and margins analyses to examine between and within-group differences in suicidality by sexual identity among adults aged ≥ 18 years.

RESULTS

About 4.89%, 1.37%, and 0.56% of the population experienced suicidal thoughts, plans, and attempts, respectively. Those aged 18-25 years old had a higher odds of suicidality compared to those aged 26 years or older. Compared to those who reported having no alcohol use dependence, illicit drug use dependence, and major depressive episodes (MDEs), those who reported alcohol use dependence, illicit drug use dependence, and MDE had higher odds of suicidal thoughts, plans, and attempts. Between all sexual identity groups, bisexuals who experienced MDEs had the highest probability of having suicidal thoughts while lesbians and gays who experienced MDE showed a higher probability of suicidal plans and attempts compared to heterosexuals. Within each sexual identity group, the probability of having suicidal thoughts, suicidal plans, and suicidal attempts was higher for those who had experienced MDEs compared to those who had not experienced MDEs.

CONCLUSION

Substance use disorder and MDE symptoms were associated with increased suicidality, especially among young adults and sexual minority people. This disparity underscores the need for tailored interventions and policies to enhance the provision of prompt mental health screening, diagnosis, and linkage to care for mental health services, particularly among the most vulnerable in the population.

A descriptive mapping review of suicide in vulnerable populations in low and middle countries

INTRODUCTION

In 2016, low-and-middle income countries (LMICs) accounted for 79% of the global suicide deaths. In LMICs, vulnerable groups-women, sexual minorities and refugees, and internally displaced persons (IDPs)-are at high risk of suicidal ideation, attempts and deaths by suicide, but information for designing targeted interventions for them is fragmented and missing, making it difficult to address gaps in the existing system. This review highlights these gaps by mapping: (a) risk factors associated with suicides and suicidal behavior including challenges in implementing targeted programmes for vulnerable groups; and (b) recommendations for effective suicide prevention interventions and strategies in LMICs as documented in the literature.

METHODS

A descriptive mapping review of literature was conducted. Three electronic databases-PubMed, Google Scholar, and Refworld-were searched for specific keywords. The researchers mapped and reviewed 34 studies on suicide and suicide prevention across three main vulnerable groups.

RESULTS

This review highlighted the need for gender-specific interventions for women and sexual minorities, addressing gender-based discrimination, access to healthcare, abuse and violence, while for refugees and IDPs, critical concerns are monitoring and understanding suicidal behaviors and to address psychological and emotional responses to resettlement.

CONCLUSION

In LMICs, specific and unique socio-cultural and environmental factors may increase the risk of vulnerable groups to suicidal behaviors. In order to develop effective and comprehensive suicide prevention strategies, it is crucial to evaluate these differential risk factors and develop culturally appropriate and sensitive interventions and strategies.