Depression Risk and Self-Harm Increased in Adolescent Sexual Minorities

Investigators compared trajectories of depressive symptoms in sexual-minority adolescents and heterosexual adolescents from age 10 to 21.

Disparities in mental health between heterosexuals and sexual minorities exist early in adolescence, increase throughout adolescence, and continue into young adulthood, with an increased risk for depression and self-harm, according to study results published in The Lancet Child &Adolescent Health.

Investigators note that sexual minorities, including individuals who identify as lesbian, gay, bisexual, not exclusively heterosexual, or not sure of their orientation, are more likely to develop depression, to self-harm, and to attempt suicide. However, there is a need for research on when and how the risk for mental health problems develops in this population.

Madeleine Irish, MSc, of the department of psychological medicine, King’s College, London, United Kingdom, and colleagues used data from the ongoing British Avon Longitudinal Study of Parents and Children (ALSPAC) to determine whether the increase in depressive symptoms that occurs during adolescence is greater in sexual-minority adolescents than in heterosexual adolescents. They asked participants about their sexual orientation at age 16 and assessed depressive symptoms with the short Mood and Feelings Questionnaire (sMFQ) at 7 time points between age 10 and 21. They administered a self-harm questionnaire to participants at age 16 and 21.

The investigators found that depressive symptoms were higher in sexual minorities (sMFQ 4.58) than in heterosexuals (sMFQ 3.79) at age 10 and continued to increase with age. At each time point, depressive symptoms increased in heterosexuals by 0.31 sMFQ points compared with 0.49 sMFQ points in sexual minorities.  The adjusted odds ratio for self-harm for sexual-minority adolescents was 4.23 compared with heterosexual adolescents. Furthermore, this increased risk did not appear to decrease with age: at age 21, sexual minorities were 4.53 times more likely than heterosexuals to report lifetime self-harm with suicidal intent.

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The investigators suggested that clinicians and individuals working in public mental health should be conscious of the increased risk for both depression and self-harm in adolescents and young adults who do not identify as exclusively heterosexual.


Irish M, Solmi F, Mars B, et al. Depression and self-harm from adolescence to young adulthood in sexual minorities compared with heterosexuals in the UK: a population-based cohort study [published online December 11, 2018]. Lancet Child Adolesc Health. doi:10.1016/S2352-4642(18)30343-2