title: Suicidal ideation, suicide attempts and non-suicidal self-injury among lesbian, gay, bisexual and heterosexual adults: Findings from an Australian national study.
abstract: OBJECTIVE
  This study investigated associations between sexual orientation and measures of suicidality and non-suicidal self-injury in Australian adults. Previous studies of sexual orientation and suicidality have been limited by unclear conceptualisations of suicidal intent, failure to differentiate between homosexuality and bisexuality, inattention to gender differences and use of convenience-based samples.
  
  
  METHODS
  A large (N = 10,531) representative national sample of Australian adults was used to investigate associations between sexual orientation (heterosexual, homosexual, bisexual) and (1) suicidal ideation, (2) attempted suicide and (3) non-suicidal self-injury, for males and females separately, in a series of sequentially adjusted logistic regression models.
  
  
  RESULTS
  Sexual minority participants were at greater risk of suicidality and self-injury than heterosexuals, after adjusting for age and other covariates, with patterns of risk differing by sexual orientation and gender. Compared with their heterosexual counterparts, gay men, but not bisexual men, were more likely to report suicidal ideation (odds ratio = 3.05, 95% confidence interval = [1.65, 5.60]) and suicide attempts (odds ratio = 4.16, confidence interval = [2.18, 7.93]). Bisexual women, but not lesbian women, were more likely to report suicidal ideation (odds ratio = 4.40, confidence interval = [3.00, 6.37]) and suicide attempts (odds ratio = 4.46, confidence interval = [2.41, 8.24]). Neither bisexual nor gay men were more likely than heterosexual men to report self-injury. However, bisexual women, but not lesbian women, were more likely than heterosexual women to report self-injury (odds ratio = 19.59, confidence interval = [9.05, 42.40]). Overall, bisexual females were at greatest risk of suicidality and self-injury.
  
  
  CONCLUSIONS
  Clinicians working with sexual minority populations are encouraged to openly discuss suicidal and self-injurious thoughts and behaviours with their clients and may consider using therapeutic strategies to reduce internalised stigma and enhance personal and social resources.
authors.affiliation: Discipline of Psychiatry, School of Medicine, The University of Queensland, Herston, QLD, Australia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Swannell
authors.affiliation: Discipline of Psychiatry, School of Medicine, The University of Queensland, Herston, QLD, Australia.
authors.forename: Graham
authors.initials: G
authors.lastname: Martin
authors.affiliation: Centre for Health Research, School of Medicine, Western Sydney University, Campbelltown, NSW, Australia a.page@westernsydney.edu.au.
authors.forename: Andrew
authors.initials: A
authors.lastname: Page
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D001727:Bisexuality / Q000523:psychology*; D005260:Female; D020010:Heterosexuality / Q000523:psychology*; D006716:Homosexuality / Q000523:psychology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000453:epidemiology* / Q000523:psychology; D012737:Sex Factors; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Homosexuality; bisexuality; non-suicidal self-injury; sexual orientation; suicidal ideation