title: Depression and anxiety in patients with and without same-sex attraction: differences in clinical expression, lifestyle factors, and vulnerability indicators.
abstract: BACKGROUND
  The aim of this study was to compare clinical expressions (severity and loneliness), lifestyle factors (substance use), and vulnerability indicators (stressful childhood experiences) in patients with any same-sex attraction versus heterosexual patients diagnosed with depression and/or anxiety disorder. Little is known about this, even though it is now well documented that depression and anxiety are more prevalent among persons with same-sex attraction.
  
  
  METHODS
  Data, derived from the Netherlands Study of Depression and Anxiety (NESDA), allowed us to compare patients with a same-sex (n = 122) and an exclusively opposite-sex (n = 1658) attraction. Persons with same-sex attraction included persons who were attracted to both sexes. Data were collected by means of the Composite International Diagnostic Interview and paper-and pencil questionnaires.
  
  
  RESULTS
  Seven percent of the patients reported any same-sex orientation. Clinical expression of depression and anxiety did not differ in relation to sexual attraction. Regarding substance use, same-sex attracted women reported more drug use than heterosexual women (drug use: 16.2% vs. 6.6%, P = 0.003). Regarding stressful childhood experiences, men with any same-sex attraction reported more sexual abuse during childhood than men with a heterosexual orientation (20.4% vs. 8.5%, P = 0.005).
  
  
  CONCLUSIONS
  For women with same-sex attraction substance use (especially illicit drug use) might be a coping mechanism to deal with existing symptoms or with the minority stressors they have to deal with; for same-sex attracted men stressful childhood experiences might reflect an aspect of etiology.
authors.affiliation: Faculty of Social and Behavioral Sciences, Research Institute of Child Development and Education Nieuwe Prinsengracht 130, 1018 VZ, Amsterdam, the Netherlands.
authors.forename: Henny M W
authors.initials: HM
authors.lastname: Bos
authors.affiliation: Faculty of Medical Sciences, Academic Centre of Psychiatry, University of Groningen Hanzeplein 1, 9713 GZ, Groningen, the Netherlands.
authors.forename: Lynn
authors.initials: L
authors.lastname: Boschloo
authors.affiliation: Faculty of Medical Sciences, Academic Centre of Psychiatry, University of Groningen Hanzeplein 1, 9713 GZ, Groningen, the Netherlands.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Schoevers
authors.affiliation: Division of Gender, Sexuality and Health, New York Psychiatric Institute and Department of Psychiatry, Columbia University 1051 Riverside Drive, Unit 15, New York, New York, 10032.
authors.forename: Theo G M
authors.initials: TG
authors.lastname: Sandfort
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology*; D001008:Anxiety Disorders; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D003866:Depressive Disorder; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012725:Sexual Behavior / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Anxiety disorders; clinical expression; depressive disorders; risk factors; same-sex attraction