title: A Comparison of the Mental Health and Well-Being of Sexual Minority and Heterosexual First-Year Medical Students: A Report From the Medical Student CHANGE Study.
abstract: OBJECTIVE
  Research is lacking on psychological distress and disorder among sexual minority medical students (students who identify as nonheterosexual). If left unaddressed, distress may result in academic and professional difficulties and undermine workforce diversity goals. The authors compared depression, anxiety, and self-rated health among sexual minority and heterosexual medical students.
  
  
  METHODS
  This study included 4,673 first-year students who self-reported sexual orientation in the fall 2010 baseline survey of the Medical Student Cognitive Habits and Growth Evaluation Study, a national longitudinal cohort study. The authors used items from published scales to measure depression, anxiety, self-rated health, and social stressors. They conducted bivariate and multivariate analyses to estimate the association between sexual identity and depression, anxiety, and self-rated health.
  
  
  RESULTS
  Of 4,673 students, 232 (5.0%) identified as a sexual minority. Compared with heterosexual students, after adjusting for relevant covariates, sexual minority students had greater risk of depressive symptoms (adjusted relative risk [ARR] = 1.59 [95% confidence interval, 1.24-2.04]), anxiety symptoms (ARR = 1.64 [1.08-2.49]), and low self-rated health (ARR = 1.77 [1.15-2.60]). Sexual minority students were more likely to report social stressors, including harassment (22.7% versus 12.7%, P < .001) and isolation (53.7% versus 42.8%, P = .001). Exposure to social stressors attenuated but did not eliminate the observed associations between minority sexual identity and mental and self-reported health measures.
  
  
  CONCLUSIONS
  First-year sexual minority students experience significantly greater risk of depression, anxiety, and low self-rated health than heterosexual students. Targeted interventions are needed to improve mental health and well-being.
authors: J.M. Przedworski is a doctoral student and National Cancer Institute predoctoral fellow, Division of Health Policy and Management, University of Minnesota, Minneapolis, Minnesota. J.F. Dovidio is Carl Iver Hovland Professor, Department of Psychology, Yale School of Public Health, and Center for Interdisciplinary Research on AIDS, Yale University, New Haven, Connecticut. R.R. Hardeman is an associated health postdoctoral fellow, Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota. S.M. Phelan is assistant professor, Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota. S.E. Burke is a doctoral candidate, Department of Psychology, Yale University, New Haven, Connecticut. M.A. Ruben is a postdoctoral research fellow, Center for Healthcare Organization and Implementation Research, Department of Veterans Affairs, Boston, Massachusetts. S.P. Perry is assistant professor, Department of Psychological Science, University of Vermont, Burlington, Vermont. D.J. Burgess is associate professor, Department of Medicine, University of Minnesota, and core investigator, Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota. D.B. Nelson is core investigator and senior statistician, Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Medical Center, and associate professor, Department of Medicine, University of Minnesota, Minneapolis, Minnesota. M.W. Yeazel is associate professor, Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota. J.M. Knudsen is director, Office of Health Equity and Inclusion, and assistant professor, Radiology Department, Mayo Clinic, Rochester, Minnesota. M. van Ryn is professor, Health Services Research, Mayo Clinic College of Medicine, and director, Research Program on Equity and Quality of Patient-Provider Encounters, Division of Health Care Polic
authors: Julia M
authors: JM
authors: Przedworski
authors: John F
authors: JF
authors: Dovidio
authors: Rachel R
authors: RR
authors: Hardeman
authors: Sean M
authors: SM
authors: Phelan
authors: Sara E
authors: SE
authors: Burke
authors: Mollie A
authors: MA
authors: Ruben
authors: Sylvia P
authors: SP
authors: Perry
authors: Diana J
authors: DJ
authors: Burgess
authors: David B
authors: DB
authors: Nelson
authors: Mark W
authors: MW
authors: Yeazel
authors: John M
authors: JM
authors: Knudsen
authors: Michelle
authors: M
authors: van Ryn
mesh_terms: D000328:Adult; D004501:Education, Medical; D005260:Female; D020010:Heterosexuality / Q000523:psychology*; D006801:Humans; D015994:Incidence; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology; D008603:Mental Health; D008913:Minority Groups / Q000523:psychology*; D010549:Personal Satisfaction; D012189:Retrospective Studies; D012725:Sexual Behavior / Q000523:psychology*; D013337:Students, Medical / Q000523:psychology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult