Differences in suicidality and psychological symptoms between sexual and gender minority patients compared to heterosexual and cisgender patients in a psychiatric hospital

Ugueto, Ana M. and Lucassen, Mathijs (2022). Differences in suicidality and psychological symptoms between sexual and gender minority patients compared to heterosexual and cisgender patients in a psychiatric hospital. Children and Youth Services Review, 138, article no. 106504.

DOI: https://doi.org/10.1016/j.childyouth.2022.106504

Abstract

Introduction
We aimed to examine differences in depression, hopelessness, anxiety, traumatic stress, emotion regulation, suicidality, non-suicidal self-injury (NSSI), and drug use between sexual and gender minority youth (SGMY) and heterosexual, cisgender youth (HCY) admitted to an acute, psychiatric inpatient unit in Texas. We also sought to predict participants’ suicide risk level at hospitalization using psychological and demographic variables.

Methods
Adolescent inpatients completed: a demographic questionnaire; the Center for Epidemiological Studies Scale for Children; the Hopelessness Scale for Children; the Screen for Child Anxiety Related Disorders; the Difficulties in Emotion Regulation Scale–16; the Deliberate Self-Harm Inventory; and the Child Posttraumatic Stress Disorder Symptom Scale–5. The Columbia Suicide Severity Rating Scale–Screener Version, and history of suicide attempts and drug use were extracted from medical records. Data were analyzed using independent t-tests and chi-square tests to determine differences in symptoms between SGMY and HCY. A logistic regression was utilized to predict the likelihood of ‘high’ versus ‘low’ suicide risk.

Results
This study included 348 adolescents, mean age 15.31 years, who identified as primarily female (63.22%) and heterosexual, cisgender (61.30%), with many being Hispanic/Latino (40.23%). Nearly 38% of patients identified as SGMY; 3% identified as transgender. SGMY reported significantly more symptoms of depression, hopelessness, anxiety, and emotional dysregulation, reported significantly more suicide attempts, and were more likely to engage in NSSI than HCY. No differences were found for traumatic stress or drug use. SGMY had double the odds of high suicide risk (OR=2.08, 95% CI,1.14–3.71), even after controlling for depression and suicide attempts.

Conclusions
SGMY, compared to HCY inpatients, were particularly vulnerable to developing psychological symptoms, engaging in self-harm, and attempting suicide.

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