Burden of Psychiatric Morbidity Among Lesbian, Gay, and Bisexual Individuals in the California Quality of Life Survey

In recent population-based surveys, minority sexual orientation has been identified as a potential risk indicator for psychiatric morbidity. However, methodological limitations in the studies to date have led to concerns that current estimates are biased due to inadequate measurement of sexual orientation and uncontrolled confounding from prevalent HIV infection. In the present study, the authors investigate associations between sexual orientation and mental health/substance use morbidity using information obtained from 2,272 individuals, including 652 sexual orientation minorities, age 18 to 72 years, interviewed in the California Quality of Life Survey. Results confirm that minority sexual orientation is a risk indicator for psychiatric morbidity. However, levels of increased risk vary within this subpopulation by both gender and patterns of sexual orientation expression. Among gay/bisexual men, much of this greater burden is related to concurrent HIV infection. Reducing excess mental health morbidity risk among sexual orientation minorities could result in possibly a 5% to 11% reduction in the burden of the disorders assessed here among the adult population. Sexual orientation represents an important, but relatively understudied, individual characteristic shaping risk for psychiatric morbidity.