Sexual orientation differences in psychological treatment outcomes for depression and anxiety: National cohort study

TY - JOUR

T1 - Sexual orientation differences in psychological treatment outcomes for depression and anxiety

T2 - National cohort study

AU - Rimes, Katharine Amber

AU - Ion, Denisa

AU - Wingrove, Janet

AU - Carter, Benjamin Richard

PY - 2019

Y1 - 2019

N2 - This study investigates whether sexual minority patients have poorer treatment outcomes than heterosexual patients in England's Improving Access to Psychological Therapies (IAPT) services. These services provide evidence-based psychological interventions for people with depression or anxiety. Method: National routinely collected data were analyzed for a cohort who had attended at least 2 treatment sessions and were discharged between April 2013-March, 2015. Depression, anxiety and functional impairment were compared for 85,831 women (83,482 [97.2%] heterosexual; 1,285 [1.5%] lesbian; 1,064 [1.2%] bisexual) and 47,092 men (44,969 [95.5%] heterosexual; 1,734 [3.7%] gay; 389 [0.8%] bisexual). Linear and logistic models were fitted adjusting for baseline scores, and sociodemographic and treatment characteristics. Results: Compared to heterosexual women, lesbian and bisexual women had higher final-session severity for depression, anxiety, and functional impairment and increased risk of not attaining reliable recovery in depression/ anxiety or functioning (aORs 1.3-1.4) and reliable improvement in depression/anxiety or functioning (aORs 1.2-1.3). Compared to heterosexual and gay men, bisexual men had higher final-session severity for depression, anxiety, and functioning and increased risk of not attaining reliable recovery for depression/ anxiety or functioning (aORs 1.5-1.7) and reliable improvement in depression/anxiety or functioning (aORs 1.3-1.4). Gay and heterosexual men did not differ on treatment outcomes. Racial minority lesbian/gay or bisexual patients did not have significantly different outcomes to their White lesbian/gay or bisexual counterparts. Conclusions: The reasons for treatment outcome inequities for bisexual patients and lesbian women (e.g., 30-70% increased risk of not recovering) need investigation. Health services should address these inequalities.

AB - This study investigates whether sexual minority patients have poorer treatment outcomes than heterosexual patients in England's Improving Access to Psychological Therapies (IAPT) services. These services provide evidence-based psychological interventions for people with depression or anxiety. Method: National routinely collected data were analyzed for a cohort who had attended at least 2 treatment sessions and were discharged between April 2013-March, 2015. Depression, anxiety and functional impairment were compared for 85,831 women (83,482 [97.2%] heterosexual; 1,285 [1.5%] lesbian; 1,064 [1.2%] bisexual) and 47,092 men (44,969 [95.5%] heterosexual; 1,734 [3.7%] gay; 389 [0.8%] bisexual). Linear and logistic models were fitted adjusting for baseline scores, and sociodemographic and treatment characteristics. Results: Compared to heterosexual women, lesbian and bisexual women had higher final-session severity for depression, anxiety, and functional impairment and increased risk of not attaining reliable recovery in depression/ anxiety or functioning (aORs 1.3-1.4) and reliable improvement in depression/anxiety or functioning (aORs 1.2-1.3). Compared to heterosexual and gay men, bisexual men had higher final-session severity for depression, anxiety, and functioning and increased risk of not attaining reliable recovery for depression/ anxiety or functioning (aORs 1.5-1.7) and reliable improvement in depression/anxiety or functioning (aORs 1.3-1.4). Gay and heterosexual men did not differ on treatment outcomes. Racial minority lesbian/gay or bisexual patients did not have significantly different outcomes to their White lesbian/gay or bisexual counterparts. Conclusions: The reasons for treatment outcome inequities for bisexual patients and lesbian women (e.g., 30-70% increased risk of not recovering) need investigation. Health services should address these inequalities.

KW - disparities

KW - health care inequalities

KW - sexual orientation

KW - therapy

KW - treatment

UR - https://www.scopus.com/pages/publications/85067549797

U2 - 10.1037/ccp0000416

DO - 10.1037/ccp0000416

M3 - Article

SN - 0022-006X

VL - 87

SP - 577

EP - 589

JO - Journal of Consulting and Clinical Psychology

JF - Journal of Consulting and Clinical Psychology

IS - 7

ER -