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Cited by 292LGBTQ Health, Identity, and PolicyChild and Adolescent Psychosocial and Emotional DevelopmentMental Health Treatment and Access

Sexual minority youth and depressive symptoms or depressive disorder: A systematic review and meta-analysis of population-based studies

Open access
Lucassen, Mathijs FG, Stasiak, Karolina, Samra, Rajvinder, Frampton, Christopher MA, Merry, Sally N·2017·Australian & New Zealand Journal of Psychiatry
DOI 10.1177/0004867417713664
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Abstract

Objective: Research has suggested that sexual minority young people are more likely to have depressive symptoms or depressive disorder, but to date most studies in the field have relied on convenience-based samples. This study overcomes this limitation by systematically reviewing the literature from population-based studies and conducting a meta-analysis to identify whether depressive disorder and depressive symptoms are elevated in sexual minority youth. Method: A systematic review and meta-analysis were conducted and informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement to determine if rates of depressive symptoms or depressive disorder differ for sexual minority youth, relative to heterosexual adolescents. MEDLINE, PsycINFO, EMBASE and ERIC databases were searched. Studies reporting depressive symptom data or the prevalence of depressive disorder in population-based samples of adolescents, which included sexual minority youth and heterosexual young people, were included in the review. A meta-analysis was conducted to examine differences between groups. Results: Twenty-three articles met the inclusion criteria. The proportion of sexual minority youth in the studies ranged from 2.3% to 12%. Sexual minority youth reported higher rates of depressive symptoms and depressive disorder (odds ratio = 2.94, p < 0.001 and standardized mean difference, d = 0.39, p < 0.001) in comparison to heterosexual young people. Female sexual minority youth were more likely to report depressive symptoms when compared to male sexual minority youth (standardized mean difference, d = 0.34, p < 0.001). Limitations included variations in how sexuality was operationalized and how depressive symptoms or depressive disorder was measured. Conclusions: There is robust evidence that rates of depressive disorder and depressive symptoms are elevated in sexual minority youth in comparison to heterosexual young people. Despite the elevated risk of depressive symptoms or depressive disorder for sexual minority youth, the treatment for this group of young people has received little attention.

AI snapshot

Written from the paper’s full text.

TL;DR

This systematic review and meta-analysis of population-based studies found that sexual minority youth have substantially higher odds of depressive symptoms or depressive disorder than heterosexual youth. The authors report robust evidence of elevated risk, with female sexual minority youth appearing at particular risk.

Key findings

  • Across 23 included articles, sexual minority youth had higher odds of depressive disorder/depressive symptoms compared with heterosexual youth: odds ratio = 2.94, 95% CI [2.27, 3.80], p < 0.001.
  • For continuous depressive symptom measures, the standardized mean difference was d = 0.39, 95% CI [0.33, 0.45], p < 0.001.
  • Female sexual minority youth were more likely to report depressive symptoms than male sexual minority youth: d = 0.34, 95% CI [0.16, 0.51], p < 0.001.
  • The proportion of sexual minority youth in the studies ranged from 2.3% to 12%; the review included 165,380 individuals, of whom an estimated 14,352 were sexual minority youth.

Methods

  • Systematic review and meta-analysis informed by PRISMA, including population-based studies of adolescents that compared sexual minority youth with heterosexual young people on depressive symptoms or depressive disorder.
  • Searched PsycINFO, Medline, ERIC, and EMBASE through October 2015; 23 articles met inclusion criteria, and study quality was appraised with the Joanna Briggs Institute Prevalence Critical Appraisal Tool.
  • Meta-analysis used a random effects model because of anticipated heterogeneity, summarized heterogeneity with I², used standardized mean differences for continuous symptom scales, and conducted subgroup analyses comparing male vs. female sexual minority youth and LGB vs. questioning youth.

Limitations

  • The paper states limitations including variation in how sexuality was operationalized and how depressive symptoms or depressive disorder was measured, and high heterogeneity for the dichotomous meta-analysis (I² = 93%).
  • The authors note that secondary school samples likely underestimate depression for both sexual minority and heterosexual youth, and that the review focused on sexual minority youth rather than transgender or intersex adolescents because of insufficient probability studies.
  • The text also makes evident further measurement limitations: only one study included a diagnostic interview, many studies used single-item questions, and only seven of 21 probability samples explicitly stated that analyses were weighted.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1177/0004867417713664

Cites

63 of 63 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 38 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    For continuous data comparing sexual minority youth with heterosexual young people, the overall standardized mean difference for depressive symptoms was 0.39 (95% CI 0.33-0.45, p < 0.001).

    “Where studies reported continuous data on depressive symptoms comparing sexual minority youth with heterosexual young people, the overall standardized mean difference was d = 0.39 (95% CI = [0.33,0.45], p < 0.001), with a range of 0.17-0.81across studies (see Figure 3).”
    Quote in the paperSubstantial claim
  • Findingreasoning

    The review's estimate of the proportion of sexual minority youth includes adolescents who reported same-sex attractions, rather than only sexual identity or same-sex sexual behaviour.

    “Our estimate of the proportion of sexual minority youth is inclusive of adolescents who reported same-sex attractions, rather than the more limited constructs of sexual identity or same-sex sexual behaviour.”
    Quote in the paperSubstantial claim
  • Findingown data

    Twenty-three studies met the inclusion criteria.

    “Twenty-three studies met the inclusion criteria (see Table 1).”
    Quote in the paperSubstantial claim
  • Findingown data

    The estimated study-level odds ratios ranged from 1.78 to 4.04.

    “The estimated study level ORs ranged from 1.78 to 4.04 (see Figure 2).”
    Quote in the paperNot a substantial claim
  • Findingreasoning

    The proportion of sexual minority young people is between 2.3% and 12%.

    “By excluding convenience-based studies, we have been able to report the proportion of sexual minority young people more confidently at between 2.3% and 12%.”
    • Also stated in: § Conclusion · plain
      “Sexual minority youth make up a relatively small but important sub-group of the overall population (i.e.2.3-12% of adolescents)”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Questions on sexuality are affected by social desirability bias because they are sensitive.
  • May combine two claims. 29
  • Classified as probably not a substantial claim. 23

  • May combine two claims.

    Findingown data

    The proportion of sexual minority youth in the studies ranged from 2.3% to 12% (13.3% for same-sex attracted females in one study), and between 2.8% and 10.5% identified as lesbian, gay or bisexual.

    “The proportion of sexual minority youth in the studies ranged from 2.3% to 12% (with this being 13.3% for same-sex attracted females in one study) and between 2.8% and 10.5% identifying as lesbian, gay or bisexual.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    There was no consistent method for determining participants' sexuality across the studies, and many studies measured more than one dimension of sexuality.

    “There were reliability issues in determining participants' sexuality, specifically there was no consistent method for determining sexuality for participants in the studies, and many measured more than one dimension of sexuality.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Sexual minority youth are at elevated rate of depressive symptoms and depressive disorder compared with heterosexual youth.

    “there is now robust evidence to suggest that this group of young people are at elevated rate of depressive symptoms and depressive disorder (although there are ongoing reliability issues in terms of how sexuality is defined and depressive symptoms or depressive disorder are assessed in this area of research).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Four studies compared male and female sexual minority youth, and sexual minority males were less likely to report depressive symptoms than female sexual minority youth (standardized mean difference d = 0.34, 95% CI 0.16-0.51, p < 0.001).

    “Only four studies reported data that allowed for comparisons to be made between male sexual minority and female sexual minority youth.The results indicated that sexual minority males are less likely to report depressive symptoms, relative to female sexuality minority youth (standardized mean difference d = 0.34, 95% CI = [0.16,0.51], p < 0.001, see Figure 4).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Heterogeneity was high for the meta-analysis of dichotomous results (I2 = 93%), but the same direction of effect was evident across studies, and the findings were supported by continuous data.

    “Heterogeneity was high for the metaanalysis of dichotomous results (i.e.I 2 93%), yet the same direction of effect was evident across these studies, and the findings were further supported by the results from studies reporting continuous data.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In total, the reviewed studies included 165,380 individuals, of which an estimated 14,352 were sexual minority youth.

    “In total, the studies in the review included 165,380 individuals, of which an estimated 14,352 were sexual minority youth.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    There was no consistent method for establishing depressive symptomatology across studies, and only one study included a diagnostic interview.

    “There were issues in terms of reliability, as there was no consistent method for establishing depressive symptomatology (Table 2) and only one study included a diagnostic interview (i.e.Fergusson et al., 1999).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Fergusson et al., 1999

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Poteat et al. (2009) found that only white LGB females reported higher levels of depressive symptoms, and Van Griensven et al. (2004) found that only sexual minority males were more likely to have depressive symptoms; both studies assessed depressive symptoms using a single-item.

    “Poteat et al. (2009) found that only white LGB females reported higher levels of depressive symptoms, and Van Griensven et al. (2004) found that only sexual minority males were more likely to have depressive symptoms; however, both studies assessed depressive symptoms using a single-item.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Poteat et al. (2009)

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    • cites Van Griensven et al. (2004)

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  • May combine two claims.

    Findingcitation

    In one study (Birkett et al., 2009), only those questioning their sexuality reported higher levels of depressive symptoms, but this study relied only on a single-item question to determine depressive symptoms.

    “In one study (Birkett et al., 2009), only those questioning their sexuality reported higher levels of depressive symptoms, but this study relied only on a single-item question to determine depressive symptoms.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Birkett et al., 2009

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    Five studies compared LGB and questioning young people on depressive symptoms, and the pooled standardized mean difference was 0.21 (95% CI −0.04-0.46, p = 0.1, I2 = 94%), which did not reach statistical significance.

    “Five studies provided data comparing LGB (i.e.LGB young people or youth who were same-sex attracted) and questioning young people (i.e.youth questioning or unsure of their sexuality) and depressive symptoms.But the results for these comparisons did not reach statistical significance (standardized mean difference d = 0.21, 95% CI = [-0.04,0.46], p = 0.1, I 2 = 94%).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Rivers and Noret (2008) found no significant differences between sexual minority youth and heterosexual young people, but this was based on a small sample of 106 participants.

    “One other study (Rivers and Noret, 2008) found no significant differences between sexual minority youth and heterosexual young people; however, this was based on a small sample of 106 participants.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Rivers and Noret, 2008

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    The true proportion of sexual minority youth in the overall adolescent population and the risk of depressive disorder and depressive symptoms in sexual minority youth have been unclear.

    “As a result, the true proportion of sexual minority youth in the overall adolescent population and the risk of depressive disorder and depressive symptoms in sexual minority youth have been unclear.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Sexual minority youth are thought to be at increased risk of depressive symptoms.

    “As a group of young people, sexual minority youth (i.e.lesbian, gay and bisexual [LGB] individuals, those that are not exclusively heterosexual, and people not sure of their sexual attractions) are thought to be at an increased risk of depressive symptoms (Marshal et al., 2011).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Marshal et al., 2011

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Sexual minority individuals involved in the LGB community are thought to have different psychological profiles than those not involved.

    “and are thought to have different psychological profiles than sexual minority individuals not involved in the LGB community (Meyer and Wilson, 2009).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Meyer and Wilson, 2009

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In systematic reviews combining convenience- and population-based samples, the proportion of sexual minority youth in the overall population cannot be determined, and presented estimates are wide-ranging (6-100% of a study's cohort).

    “Furthermore, in systematic reviews that combine convenience-and population-based samples, the proportion of sexual minority youth in the overall population cannot be determined, and when these estimates are presented they are understandably wideranging (i.e.6-100% of a study's cohort) (e.g.Goldbach et al., 2014;King et al., 2008;Marshal et al., 2011;Plöderl and Tremblay, 2015).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Goldbach et al., 2014

      Not checked in the free run.

    • cites King et al., 2008

      Not checked in the free run.

    • cites Marshal et al., 2011

      Not checked in the free run.

  • May combine two claims.

    Study design and conductnone given

    Most studies were representative of the target population, had appropriate recruitment strategies, adequate sample sizes, and measured depressive symptoms in at least 70% of the sample.

    “Most studies were representative of the target population, had appropriate recruitment strategies, adequate sample sizes and measured depressive symptoms in at least 70% of the sample.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Computerized cognitive behavioural therapy called SPARX has been adapted and evaluated among sexual minority youth with depressive symptoms.

    “This approach has also been employed in the treatment of depressive symptoms using a form of computerized cognitive behavioural therapy, called SPARX (Merry et al., 2012), which has been adapted and evaluated among sexual minority youth with depressive symptoms (Lucassen et al., 2015b(Lucassen et al., , 2015c)).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Merry et al., 2012

      Not checked in the free run.

    • cites Lucassen et al., 2015b

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    • cites Lucassen et al., 2015c

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  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Study design and conductnone given

    Search strategies were inclusive and relevant, particularly in terms of the definition of sexual minority young people.

    “We were careful to utilize search strategies that were inclusive and relevant, particularly in terms of the definition of sexual minority young people.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Marshal et al. (2011) included 11 studies on depressive symptoms or depressive disorder in sexual minority youth, but included non-random samples.

    “Marshal et al. (2011) included 11 studies on depressive symptoms or depressive disorder in sexual minority youth in their analyses, but they included nonrandom samples, presumably because there were fewer population-based studies at the time.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Marshal et al., 2011

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    Sexual minority young people have approximately three times the odds of depressive symptoms or depressive disorder compared with heterosexual peers, and increased depressive symptoms of moderate effect size.

    “In this review and meta-analysis, we have shown that sexual minority young people have approximately three times the odds of depressive symptoms or a depressive disorder compared with their heterosexual peers, and increased depressive symptoms of moderate effect size.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Plöderl and Tremblay (2015) reported that in 97% of studies rates of depressive symptoms were elevated.

    “Based on their review of PubMed articles, they reported that in 97% of studies rates of depressive symptoms were elevated (Plöderl and Tremblay, 2015).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Plöderl and Tremblay, 2015

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationown data

    The findings of this review support the position statement and highlight particular needs for young people in the overall LGBTI population, particularly female sexual minority youth.

    “The findings from our review support this position statement, but also highlight particular needs for young people in the overall LGBTI population, particularly female sexual minority youth.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    When multiple publications came from the same dataset, data were extracted across the available papers and presented as one study to avoid over-representing these datasets.

    “In order to not over-represent these datasets (Liberati et al., 2009), the relevant data from the study were extracted across the available papers and presented as one study in this review (i.e.Williams and Chapman, 2011).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Liberati et al., 2009

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    • cites Williams and Chapman, 2011

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  • May combine two claims.

    Interpretationreasoning

    This review reinforces previous findings and strengthens the evidence on which they are based.

    “Our review not only reinforces previous findings but also strengthens the evidence on which they are based.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The systematic review was informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).

    “We have conducted a systematic review informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) (Moher et al., 2009).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Moher et al., 2009

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    Female sexual minority youth are at greater risk of depressive symptoms compared with male sexual minority youth, similar to females compared with males in the overall population.

    “Our analyses suggest that, similar to females compared to males in the overall population, female sexual minority youth are at greater risk of depressive symptoms when compared to male sexual minority youth.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Titles and abstracts were screened by one reviewer, and a random 5% sample was independently reviewed by a second researcher, with disagreements resolved by another researcher.

    “A researcher and R.S. randomly selected and reviewed 109 papers identified by the search strategies (i.e. 5% of the papers) and independently concluded that 94% (n = 103) of the abstracts were suitable, but queried the exclusion of six abstracts.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductnone given

    The review included only population-based studies and excluded non-random and potentially biased samples.

    “We included only population studies and excluded research that used non-random and potentially biased samples.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The quality of the included studies was appraised and summarized in Table 2.

    “Nonetheless, we have appraised the quality of the studies, and have summarized these in Table 2.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Mischievous responders could artificially inflate sexual minority numbers.

    “recent work has also indicated that 'mischievous responders' could artificially inflate sexual minority numbers (e.g.there may be heterosexual adolescents who think it is humorous to report that they are LGB, transgender and/or physically disabled in questionnaires; Robinson-Cimpian, 2014).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Robinson-Cimpian, 2014

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    A previous systematic review reported a greater risk of depressive symptoms or depressive disorder and suicide in sexual minority young people, including both population-based and convenience-based samples.

    “A previous systematic review reporting a greater risk of depressive symptoms or depressive disorder and suicide in sexual minority young people included both population-based studies and conveniencebased samples of sexual minority and heterosexual youth (with a sample mean age of ⩽18 years) (Marshal et al., 2011).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Marshal et al., 2011

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Attachment-based family therapy has been assessed with young people more generally and modified specifically for suicidal sexual minority youth.

    “Work in this area has begun, for instance where an existing intervention has been assessed with young people more generally, such as attachment-based family therapy (Devenish et al., 2016), which has been modified specifically with suicidal sexual minority youth in mind (Diamond et al., 2013).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Devenish et al., 2016

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    • cites Diamond et al., 2013

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  • May combine two claims.

    Interpretationreasoning

    The review strengthened previous findings by comparing male and female sexual minority youth, including more recent studies, assessing the evidence more closely, and excluding convenience-based studies.

    “Our review has strengthened previous findings by comparing male and female sexual minority youth, including more recent studies, assessing the evidence more closely, and excluding convenience-based studies.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Three prior reviews concluded that sexual minority individuals are more likely to report mental ill-health, two primarily focused on adults and one on young people.

    “Three prior reviews have also concluded that sexual minority individuals are more likely to report mental ill-health, two primarily focused on adults (King et al., 2008;Plöderl and Tremblay, 2015) and the other on young people (Marshal et al., 2011).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites King et al., 2008

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    • cites Plöderl and Tremblay, 2015

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    • cites Marshal et al., 2011

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Data extraction was carried out by one reviewer and checked by a second.

    “Data extraction was carried out by M.L. and checked by R.S.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    A random effects model was employed because methodological diversity and statistical heterogeneity were anticipated.

    “Due to methodological diversity in the studies (i.e.variations in how sexuality and depressive symptoms or depressive disorder were assessed), statistical heterogeneity was anticipated, and therefore a random effects model was employed.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    There has been a recent call to action recommending more research into the mental health of LGBTI people, including a position statement from the Royal Australian and New Zealand College of Psychiatrists.

    “there has been a recent call to action recommending that there should be more research into the mental health of lesbian, gay, bisexual, transgender and intersex (LGBTI) people, e.g., the recent position statement from the Royal Australian and New Zealand College of Psychiatrists highlighting the need to address the mental health needs”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Royal Australian and New Zealand College of Psychiatrists, 2016

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  • May combine two claims.

    Study design and conductown data

    Twenty-one studies were probability samples, but only seven explicitly stated that their analyses were weighted.

    “Twenty-one studies were probability samples, but only seven explicitly stated that their analyses were weighted.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The Joanna Briggs Institute Prevalence Critical Appraisal Tool was used to determine the quality of the studies.

    “We used the Joanna Briggs Institute Prevalence Critical Appraisal Tool (Munn et al., 2014) to determine the quality of the studies, and we have carried out a meta-analysis of results.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Munn et al., 2014

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Much is still unknown about the optimal treatment of depressive symptoms in adolescents.

    “Much is still unknown about the optimal treatment of depressive symptoms in adolescents (Malhi et al., 2015), hence it is time to consider in what ways young people overall can be treated, alongside gaining an understanding of how sexual minority young people can receive more targeted support and assistance, to ensure that their mental health is enhanced.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Malhi et al., 2015

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  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationreasoning

    Sexual minority youth face the double stigma of being in a marginalized group and having mental health problems.

    “Sexual minority youth face the double stigma of being in this marginalized group and having mental health problems.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Depressive symptoms and depressive disorder in adolescents are associated with considerable morbidity and tend to persist into adulthood.

    “Depressive symptoms and depressive disorder in adolescents are associated with considerable morbidity and tend to persist into adulthood (Thapar et al., 2012).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Thapar et al., 2012

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  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Premisecitation

    Sexual attraction is an appropriate measure to assess adolescent sexuality from a developmental perspective.

    “Moreover, we would recommend the use of sexual attraction to assess adolescent sexuality.We consider this is an appropriate measure to use from a developmental perspective and is a view supported by others (Saewyc et al., 2004).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Saewyc et al., 2004

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Standardized symptom measures or diagnostic assessments with established validity and reliability include the CDI, BDI, CES-D and RADS.

    “Future studies in this field would be improved by the inclusion of standardized symptom measures or diagnostic assessments that have established validity and reliability such as the CDI, BDI, CES-D and RADS (Stockings et al., 2015).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Stockings et al., 2015

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  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductnone given

    There are ongoing reliability issues in how sexuality is defined and depressive symptoms or depressive disorder are assessed in this area of research.

    “although there are ongoing reliability issues in terms of how sexuality is defined and depressive symptoms or depressive disorder are assessed in this area of research”
    Quote in the paperNot a substantial claim
45 of 45

  • The paper relies on this without support.

    Questions on sexuality are affected by social desirability bias because they are sensitive.

    “It should be noted that questions on sexuality, by virtue of being 'sensitive' are affected by social desirability bias.”
1 of 1

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The increased risk of mental ill-health among sexual minority youths is well-documented and attributed primarily to heightened stress stemming from discrimination, bullying, lack of social support, and identity struggles.

    “The increased risk of mental ill-health among sexual minority youths is well-documented, attributed primarily to heightened stress stemming from discrimination, bullying, lack of social support, and identity struggles [17, 18].”

    From Social inequalities in youth mental health in Canada, 2007–2022: a population-based repeated cross-sectional study (2025) · cites this paper as [18]

    The Conclusion reports robust evidence of elevated depressive symptoms and depressive disorder among sexual minority youth. The Introduction hypothesizes that minority stress, stigma, discrimination and victimization contribute to this risk and mentions bullying, but it does not establish these as the primary cause or identify lack of social support and identity struggles as causes. The indexed passages provide no page numbers. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Depression disproportionately affects young people who identify as LGBTQ.

    “Depression is a debilitating and burdensome mental health disorder that disproportionately affects young people who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ) [1,2,3,4].”

    From Findings from a feasibility study of an adapted cognitive behavioral therapy group intervention to reduce depression among lgbtq (Lesbian, gay, bisexual, transgender, or queer) young people (2019) · cites this paper as [1]

    The Discussion reports that sexual minority youth had approximately three times the odds of depressive symptoms or a depressive disorder compared with heterosexual peers. The Introduction defines that group by sexual attraction or orientation, including LGB and questioning youth; the findings do not establish the same comparison for transgender youth as a distinct group. Page numbers were not available in our copy. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • An intervention gap remains for LGB women as well as queer, transgender, and genderqueer young people.

    “Therefore, an intervention gap remains for LGB women as well as queer, transgender, and genderqueer young people—individuals who often experience even higher rates of depressive symptoms, compared to cisgender gay and bisexual men [1,34,35].”

    From Findings from a feasibility study of an adapted cognitive behavioral therapy group intervention to reduce depression among lgbtq (Lesbian, gay, bisexual, transgender, or queer) young people (2019) · cites this paper as [1]

    In Comparisons to prior reviews (page unavailable), the paper calls for more targeted support for sexual minority youth and reports greater depressive-symptom risk among female than male sexual minority youth. It does not establish an intervention gap specifically for LGB women or queer, transgender, and genderqueer young people, or compare those groups with cisgender gay and bisexual men. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • LGB women, queer, transgender, and genderqueer young people often experience even higher rates of depressive symptoms compared to cisgender gay and bisexual men.

    “Therefore, an intervention gap remains for LGB women as well as queer, transgender, and genderqueer young people—individuals who often experience even higher rates of depressive symptoms, compared to cisgender gay and bisexual men [1,34,35].”

    From Findings from a feasibility study of an adapted cognitive behavioral therapy group intervention to reduce depression among lgbtq (Lesbian, gay, bisexual, transgender, or queer) young people (2019) · cites this paper as [1]

    The meta-analysis results report that female sexual minority youth had more depressive symptoms than male sexual minority youth (d = 0.34, p < 0.001). They do not establish the claimed comparison for queer, transgender, or genderqueer youth against cisgender gay and bisexual men; the reported comparison for questioning youth versus LGB youth was not statistically significant. The cited passages have no page number in our copy. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

Cites

Flagged first, then by citations

Research works printed but not linked: 2

  1. Beck AT, Steer RA, Brown GK (1996) Manual for the Beck Depression Inventory Second Edition (BDI-II). San Antonio, CA: Psychological Corporation.
  2. Royal Australian and New Zealand College of Psychiatrists (2016) Position Statement 83: Recognising and Addressing the Mental Health Needs of the LGBTI Population. Melbourne, VIC, Australia: Royal Australian and New Zealand College of Psychiatrists.

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Authors
Lucassen, M. F., Stasiak, K., Samra, R., Frampton, C. M., & Merry, S. N.
Affiliations
  • University of Auckland (NZ)
  • The Open University (GB)
  • University of Otago (NZ)
Corresponding author
Lucassen, Mathijs FG
ORCID
Venue
Australian & New Zealand Journal of Psychiatry
Publisher
SAGE Publications
Published
2017-06
Volume
51
Issue
8
Pages
774-787
ISSN
  • 0004-8674 (ISSN-L)
  • 1440-1614
DOI
10.1177/0004867417713664
OpenAlex
W2619602308
Semantic Scholar
018d10cbb755aae5f443133919ad5342f9f5c94e
Cited by
292
References
63
Citations by year
2026: 38 · 2025: 33 · 2024: 39 · 2023: 40 · 2022: 56 · 2021: 29 · 2020: 27 · 2019: 17 · 2018: 11 · 2017: 1
FWCI
2.36
Type
journal article
Language
en
Open access
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • Australian & New Zealand Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Open Research Online - ORO (The Open University) (acceptedVersion)
Topics
  • Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
sexual minority youth, depressive symptoms, depressive disorders, adolescents, sexual orientation, gender differences, mental health disparities, population-based study
MeSH terms
Sexual and Gender Minorities, Adolescent, Depression, Depressive Disorder, Humans, Sexuality

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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