title: Sexual orientation and treatment-seeking for depression in a multilingual worldwide sample.
abstract: Prior research has found higher rates of mental health problems among sexual minority individuals. We examine treatment-seeking for depression, as well as its relationship with sexual orientation, in a large, multilingual, international sample.
  
  
  
  Participants in an automated, quintilingual internet-based depression screening tool were screened for depression, and completed several background measures, including sexual orientation (with an option to decline to state) and past and current depression treatment seeking.
  
  
  
  3695 participants screened positive for current or past depression and responded to the sexual orientation question. Those who declined to state their sexual orientation were far less likely to seek any treatment than individuals endorsing any orientation; they were especially unlikely to seek psychotherapy. Individuals identifying as bisexual sought both psychotherapy and alternative treatments at a higher rate than other groups. An interaction was observed between sexual orientation and gender, such that lesbian women were especially likely to have used psychotherapy. Other variables that emerged as significant predictors of treatment-seeking for depression included age and participant's language.
  
  
  
  Limitations include possible misinterpretation of translated terms due to regional differences, and possible limits to generalizability due to this study being conducted on the internet.
  
  
  
  Our results suggest that individuals who decline to state their sexual orientation may be more likely to forgo effective treatments for depression. Further studies of depression service utilization should focus on developing treatment modalities that could better engage sexual minority individuals, especially those who are reluctant to disclose their orientation.
authors.affiliation: University of California, San Francisco, USA.
authors.forename: Tara M
authors.initials: TM
authors.lastname: Rutter
authors.affiliation: University of California, San Francisco, USA.
authors.forename: Annesa
authors.initials: A
authors.lastname: Flentje
authors.affiliation: University of California, San Francisco, USA; San Francisco General Hospital, USA.
authors.forename: James W
authors.initials: JW
authors.lastname: Dilley
authors.affiliation: University of California, San Francisco, USA.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Barakat
authors.affiliation: University of California, Berkeley, USA.
authors.forename: Nancy H
authors.initials: NH
authors.lastname: Liu
authors.affiliation: University of California, San Francisco, USA.
authors.forename: Margaret S
authors.initials: MS
authors.lastname: Gross
authors.affiliation: University of California, San Francisco, USA; San Francisco General Hospital, USA; Palo Alto University, USA.
authors.forename: Ricardo F
authors.initials: RF
authors.lastname: Muñoz
authors.affiliation: University of California, San Francisco, USA; Palo Alto University, USA. Electronic address: yleykin@paloaltou.edu.
authors.forename: Yan
authors.initials: Y
authors.lastname: Leykin
mesh_terms: D000328:Adult; D001727:Bisexuality; D003863:Depression / Q000175:diagnosis / Q000628:therapy*; D003866:Depressive Disorder / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D020010:Heterosexuality; D006716:Homosexuality; D006801:Humans; D020407:Internet; D008297:Male; D008403:Mass Screening; D010342:Patient Acceptance of Health Care; D057240:Patient Preference; D011613:Psychotherapy; D012737:Sex Factors; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Antidepressant; Depression; LGBT; Psychotherapy; Service use; Sexual minority