Suicidality and Sexual Orientation: Differences Between Men and Women in a General Population-Based Sample From The Netherlands
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Homosexuality has been shown to be associated with suicidality and mental disorders. It is unclear whether homosexuality is related to suicidality, independently of mental disorders. This study assessed differences in lifetime symptoms of suicidality (death ideation, death wishes, suicide contemplation, and deliberate self-harm) between homosexual and heterosexual men and women, controlling for lifetime psychiatric morbidity. Interaction effects of age and the role of perceived discrimination were also examined. Data were collected on a representative sample of the Dutch population aged 18–64 years. Classification as heterosexual or homosexual was based upon reported sexual behavior in the preceding year. Of those sexually active, 2.8% of 2,878 men and 1.4% of 3,120 women had had same-sex partners. Homosexual men differed from their heterosexual counterparts on all four suicide symptoms (OR ranging from 2.58 to 10.23, with higher ORs for more severe symptoms), and on the sum total of the four symptoms; homosexual women only differed from heterosexual women on suicide contemplation (OR=2.12). Controlling for psychiatric morbidity decreased the ORs, but among men all associations were still significant; the significance for suicide contemplation among women disappeared. Younger homosexuals were not at lower risk for suicidality than older homosexuals in comparison with their heterosexual counterparts. Among homosexual men, perceived discrimination was associated with suicidality. This study suggests that even in a country with a comparatively tolerant climate regarding homosexuality, homosexual men were at much higher risk for suicidality than heterosexual men. This relationship could not only be attributed to their higher psychiatric morbidity. In women, there was no such clear relationship.
KEY WORDS:homosexuality suicidality epidemiology mental disorders general population study.
NEMESIS is conducted by the Netherlands Institute of Mental Health and Addiction (Trimbos Institute) in Utrecht. Financial support was provided by the Netherlands Ministry of Health, Welfare and Sports (VWS). The authors thank Jeffrey Weiss for his feedback on earlier versions of this manuscript.
- American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., rev.). Washington, DC: American Psychiatric Association.Google Scholar
- Diplacido, J. (1998). Minority stress among lesbians, gay men, and bisexuals: A consequence of heterosexism, homophobia and stigmatization. In G. M. Herek (Ed.), Stigma and sexual orientation: Understanding prejudice against lesbians, gay men, and bisexuals (pp. 138–159). Thousand Oaks, CA: Sage.Google Scholar
- Doll, L. S., Petersen, L. R., White, C. R., Johnson, E. S., & Ward, J. W. (1992). Homosexually and nonhomosexually identified men who have sex with men: A behavioral comparison. Journal of Sex Research, 29, 1–14.Google Scholar
- Kessler, R. C., Wittchen, H.-U., Abelson, J. M., McGonagle, K. A., Schwarz, N., Kendler, K. S., et al. (1998). Methodological studies of the Composite International Diagnostic Interview (CIDI) in the US National Comorbidity Survey (NCS). International Journal of Methods in Psychiatric Research, 7, 33–55.CrossRefGoogle Scholar
- Kite, M. E., & Whitley, B. E. (1998). Do heterosexual women and men differ in their attitudes toward homosexuality? In G. M. Herek (Ed.), Stigma and sexual orientation: Understanding prejudice against lesbians, gay men, and bisexuals (pp. 39–61). Thousand Oaks, CA: Sage.Google Scholar
- Laumann, E. O., Gagnon, J. H., Michael, R. T., & Michaels, S. (1994). The social organization of sexuality: Sexual practices in the United States. Chicago: University of Chicago Press.Google Scholar
- Robins, L. N., Wing, J., Wittchen, H.-U., Helzer, J. E., Babor, T. F., Burke, J., et al. (1988). The Composite International Diagnostic Interview: An epidemiologic instrument suitable for use in conjunction with different diagnostic systems and in different cultures. Archives of General Psychiatry, 45, 1069–1077.PubMedGoogle Scholar
- Sandfort, T. G. M. (1998). Homosexual and bisexual behaviour in European countries. In M. C. Hubert, N. Bajor, & T. G. M. Sandfort (Eds.), Sexual behaviour and HIV/AIDS in Europe (pp. 68–105). London: UCL Press.Google Scholar
- Sandfort, T. G. M., Bos, H., & Vet, R. (2005). Lesbians and gay men at work: Consequences of being out. In A. M. Omoto & H. S. Kurtzman (Eds.), Sexual orientation and mental health: Examining identity and development in lesbian, gay, and bisexual people (pp. 225–244). Washington DC: American Psychological Association.Google Scholar
- Semler, G., Von Cranach, M., & Wittchen, H.-U. (Eds.). (1987). Comparison between the Composite International Diagnostic Interview and the Present State Examination. Report to the WHO/ADAMHA Task Force on Instrument Development. Geneva: World Health Organization.Google Scholar
- Social and Cultural Planning Office. (1996). Sociaal Cultureel Rapport [Social and Cultural Report]. The Hague, the Netherlands: SCP/Vuga.Google Scholar
- Social and Cultural Planning Office. (2000). Sociaal en Cultureel Rapport 2000: Nederland in Europe [Social and Cultural Report 2000: Netherlands in Europe]. Rijswijk, the Netherlands: SCP.Google Scholar
- Van den Akker, P., Halman, L., & De Moor, R. (1994). Primary relations in Western societies. In P. Ester, L. Halman, & R. De Moor (Eds.), The individualizing society: Value change in Europe and North America (pp. 97–127). Tilburg, The Netherlands: Tilburg University Press.Google Scholar
- Van Zessen, G., & Sandfort, T. (Eds.). (1991). Seksualiteit in Nederland: Seksueel gedrag, risico en preventie van AIDS [Sexuality in the Netherlands: Sexual behaviour, risks and prevention of AIDS]. Amsterdam: Swets & Zeitlinger.Google Scholar
- Wittchen, H.-U., Burke, J. D., Semler, G., Pfister, H., von Cranach, M., & Zaudig, M. (1989). Recall and dating reliability of psychiatric symptoms: Test-retest reliability of time related symptom questions in a standardized psychiatric interview (CIDI/DIS). Archives of General Psychiatry, 46, 437–443.PubMedGoogle Scholar
- World Health Organization. (1990). Composite International Diagnostic Interview (CIDI). Version 1.0. Geneva: World Health Organization.Google Scholar