Same-sex sexual behavior and psychiatric disorders: findings from the Netherlands Mental Health Survey and Incidence Study (NEMESIS).
BACKGROUND
It has been suggested that homosexuality is associated with psychiatric morbidity. This study examined differences between heterosexually and homosexually active subjects in 12-month and lifetime prevalence of DSM-III-R mood, anxiety, and substance use disorders in a representative sample of the Dutch population (N = 7076; aged 18-64 years).


METHODS
Data were collected in face-to-face interviews, using the Composite International Diagnostic Interview. Classification as heterosexual or homosexual was based on reported sexual behavior in the preceding year. Five thousand nine hundred ninety-eight (84.8%) of the total sample could be classified: 2.8% of 2878 men and 1.4% of 3120 women had had same-sex partners. Differences in prevalence rates were tested by logistic regression analyses, controlling for demographics.


RESULTS
Psychiatric disorders were more prevalent among homosexually active people compared with heterosexually active people. Homosexual men had a higher 12-month prevalence of mood disorders (odds ratio [OR] = 2.93; 95% confidence interval [CI] = 1.54-5.57) and anxiety disorders (OR = 2.61; 95% CI = 1.44-4.74) than heterosexual men. Homosexual women had a higher 12-month prevalence of substance use disorders (OR = 4.05; 95% CI = 1.56-10.47) than heterosexual women. Lifetime prevalence rates reflect identical differences, except for mood disorders, which were more frequently observed in homosexual than in heterosexual women (OR = 2.41; 95% CI = 1.26-4.63). The proportion of persons with 1 or more diagnoses differed only between homosexual and heterosexual women (lifetime OR = 2.61; 95% CI = 1. 31-5.19). More homosexual than heterosexual persons had 2 or more disorders during their lifetimes (homosexual men: OR = 2.70; 95% CI = 1.66-4.41; homosexual women: OR = 2.09; 95% CI = 1.07-4.09).


CONCLUSIONS
The findings support the assumption that people with same-sex sexual behavior are at greater risk for psychiatric disorders.
Sandfort
T G
TG
Department of Clinical Psychology, Utrecht University, PO Box 80140, 3508 TC Utrecht, the Netherlands. t.sandfort@fss.uu.nl
de Graaf
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R
Bijl
R V
RV
Schnabel
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D000293:Adolescent; D000328:Adult; D005260:Female; D006306:Health Surveys; D020010:Heterosexuality / Q000523:psychology / Q000706:statistics & numerical data; D006716:Homosexuality / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D012107:Research Design / Q000592:standards; D012737:Sex Factors