Same-sex sexual behavior and psychiatric disorders - Findings from the Netherlands Mental Health Survey and Incidence Study (NEMESIS)

Background: It has been suggested that homosexuality is associated with psy chiatric morbidity. This study examined differences between heterosexually and homosexually active subjects in 12-month and lifetime prevalence of DSM -III-R mood, anxiety, and substance use disorders in a representative sampl e of the Dutch population (N=7076; aged 18-64 years). Methods: Data were collected in face-to-face interviews, using the Composit e International Diagnostic Interview. Classification as heterosexual or hom osexual was based on reported sexual behavior in the preceding year. Five t housand nine hundred ninety-eight (84.8%) of the total sample could be clas sified: 2.8% of 2878 men and 1.4% of 3120 women had had same-sex partners. Differences in prevalence rates were tested by logistic regression analyses , controlling for demographics. Results: Psychiatric disorders were more prevalent among homosexually activ e people compared with heterosexually active people. Homosexual men had a h igher 12-month prevalence of mood disorders (odds ratio [OR]=2.93; 95% conf idence interval [CI]=1.54-5.57) and anxiety disorders (OR=2.61; 95% CI= 1.4 4-4.74) than heterosexual men. Homosexual women had a higher 12-month preva lence of substance use disorders (OR=4.05; 95% CI=1.56-10.47) than heterose xual women. Lifetime prevalence rates reflect identical differences, except for mood disorders, which were more frequently observed in homosexual than in heterosexual women (OR=2.41; 95% CI=1.26-4.63). The proportion of perso ns with 1 or more diagnoses differed only between homosexual and heterosexu al women (lifetime OR=2.61; 95% CI=1.31-5.19). More homosexual than heteros exual persons had 2 or more disorders during their lifetimes (homosexual me n: OR=2.70; 95% CI=1.66-4.41; homosexual women: OR=2.09; 95% CI=1.07-4.09). Conclusion: The findings support the assumption that people with same-sex s exual behavior are at greater risk for psychiatric disorders.