Sexual orientation as a risk factor for depressive symptoms in a population-based sample of California males : analysis of the 2009 California Health Interview Survey

Includes bibliographical references (p. 54-68)The purpose of this study was to estimate the prevalence and correlates of depressive symptoms (DS) in a population-based sample of men (including a subpopulation of gay and bisexual men, GBM). Historically, researchers have not examined mental health in GBM to the same extent as the heterosexual population. This lack of research exists in part because sexual orientation is generally not captured in large-scale surveys. The California Health Interview Survey (CHIS) is the nation's largest health survey (N = 47,236, unweighted), and one of the few cross-sectional population-based surveys that collects sexual orientation. This secondary analysis of CHIS data had the following hypothesis: GBM (analyzed separately) will show higher rates of DS prevalence when compared to heterosexual men. Sexual orientation, general and mental health variables as well as standard demographics were included in analysis. The outcome variable DS is based on the K6 scale, with scores of 13 or higher defining DS. The 30-day DS prevalence for bisexual males was 6.52%, and 1.41% for gay males (vs. 3.1% heterosexual males). The final multivariate model indicated that age and race had significant interactions with sexual orientation and DS. Males in the 18- 24 age group had a 8.05 (95% CI: 1.917, 33.801) times higher odds of reporting DS than heterosexual males, after adjusting for covariates. Bisexual males in the 40-64+ age group had 6.96 (95% CI: 2.223, 21.774) times higher odds of reporting DS than heterosexual males after adjusting for covariates. Significant risk of DS was found for White bisexual males (OR 7.51, 95% CI: 1.9166, 33.8011); had higher risk for DS than White heterosexual males after adjusting for covariates. This research has important practical implications in psychiatric public health, planning and public policy in California and the United States. Future research should routinely collect sexual orientation variables on health surveys so that researchers can quantify mental health disparities in sexual minority populations