title: Sexual orientation and symptoms of common mental disorder or low wellbeing: combined meta-analysis of 12 UK population health surveys.
abstract: BACKGROUND
  Previous studies have indicated increased risk of mental disorder symptoms, suicide and substance misuse in lesbian, gay and bisexual (LGB) adults, compared to heterosexual adults. Our aims were to determine an estimate of the association between sexual orientation identity and poor mental health and wellbeing among adults from 12 population surveys in the UK, and to consider whether effects differed for specific subgroups of the population.
  
  
  METHODS
  Individual data were pooled from the British Cohort Study 2012, Health Survey for England 2011, 2012 and 2013, Scottish Health Survey 2008 to 2013, Longitudinal Study of Young People in England 2009/10 and Understanding Society 2011/12. Individual participant meta-analysis was used to pool estimates from each study, allowing for between-study variation.
  
  
  RESULTS
  Of 94,818 participants, 1.1 % identified as lesbian/gay, 0.9 % as bisexual, 0.8 % as 'other' and 97.2 % as heterosexual. Adjusting for a range of covariates, adults who identified as lesbian/gay had higher prevalence of common mental disorder when compared to heterosexuals, but the association was different in different age groups: apparent for those under 35 (OR = 1.78, 95 % CI 1.40, 2.26), weaker at age 35-54.9 (OR = 1.42, 95 % CI 1.10, 1.84), but strongest at age 55+ (OR = 2.06, 95 % CI 1.29, 3.31). These effects were stronger for bisexual adults, similar for those identifying as 'other', and similar for 'low wellbeing'.
  
  
  CONCLUSIONS
  In the UK, LGB adults have higher prevalence of poor mental health and low wellbeing when compared to heterosexuals, particularly younger and older LGB adults. Sexual orientation identity should be measured routinely in all health studies and in administrative data in the UK in order to influence national and local policy development and service delivery. These results reiterate the need for local government, NHS providers and public health policy makers to consider how to address inequalities in mental health among these minority groups.
authors.affiliation: Department of Psychology, London Metropolitan University, London, UK.
authors.forename: Joanna
authors.initials: J
authors.lastname: Semlyen
authors.affiliation: Division of Psychiatry, UCL, London, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: King
authors.affiliation: Public Health England, London, UK.
authors.forename: Justin
authors.initials: J
authors.lastname: Varney
authors.affiliation: Administrative Data Research Centre for England (ADRC-E), Farr Institute, UCL, London, NW1 2DA, UK. G.Hagger-Johnson@ucl.ac.uk.
authors.forename: Gareth
authors.initials: G
authors.lastname: Hagger-Johnson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006306:Health Surveys / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology*; D008875:Middle Aged; D015995:Prevalence; D012725:Sexual Behavior / Q000523:psychology / Q000706:statistics & numerical data*; D019529:Sexuality / Q000523:psychology* / Q000706:statistics & numerical data*; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
keywords: Anxiety disorders; Depression; Health surveys; Homosexuality; Mental disorders; Meta-analysis; Mood disorders; Neurotic disorders; Sexual orientation; Sexuality