Mental health in gay, lesbian and bisexual medical students

TL;DR

Gay, lesbian, and bisexual medical students experience high rates of depression, with bisexual students and women being most affected, linked to lower quality of life and higher internalized stigma.

Contribution

This study provides empirical evidence on mental health disparities among sexual minority medical students in Brazil.

Findings

63.4% of students showed depression symptoms, with higher rates among women and bisexual students.

Higher internalized stigma and lower resilience were associated with more severe depression symptoms.

Quality of life scores were significantly lower for students with moderate to severe depression.

Abstract

Our study aimed to assess depression symptoms among lesbian, gay and bisexual medical students and the associations between these data and sociodemographic characteristics, quality of life, resilience and internalized stigma scores. A multicenter cross-sectional study was conducted using an online questionnaire. We used Beck Depression Inventory, Trait-State Anxiety Inventory, Internalized Homophobia Inventory and Brief Resilience Inventory to assess depression and anxiety symptoms, internalized stigma and resilience, respectively. We used the snowballing technique. The initial sample comprised five individuals known to the research group who, in turn, were asked to recommend an additional five participants from any medical school in the state of São Paulo, Brazil. Among the medical students recruited through a snowball strategy, 404 (55.6%) responded to the survey. We used multinomial logistic regression models, both crude and adjusted for gender and sexual orientation, to examine the associations between depression symptoms and other data. Among the students surveyed, 62.3% identified themselves as men, and 35.8% of men identified themselves as bisexual; 63.4% of the students presented symptoms of depression, including 70.2% of the women, 58.6% of the men (P = .015), 70.6% of the bisexual students and 58.8% of the lesbian or gay students (P = .032). Medical students with moderate to severe depression symptoms had lower mean quality of life scores than those with mild symptoms and those without symptoms (P < .001). Similar patterns during medical school were observed for quality of life and resilience scores (P < .001 for all comparisons). The internalized stigma scores followed a similar trend, with higher scores associated with more severe depression symptoms than with mild symptoms or no symptoms (P = .004). The percentage of gay, lesbian and bisexual medical students with depression and anxiety symptoms is high, especially among bisexual students and women. Increased internalized stigma, lower resilience, and poorer quality of life are associated with higher depression scores.

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