A comparison of the mental health and well-being of sexual minority and heterosexual first-year medical students: A report from the medical student CHANGE study

Julia M. Przedworski, John F. Dovidio, Rachel R. Hardeman, Sean M. Phelan, Sara Burke, Mollie A. Ruben, Sylvia P. Perry, Diana J. Burgess, David B. Nelson, Mark W. Yeazel, John M. Knudsen, Michelle Van Ryn

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Purpose Research is lacking on psychological distress and disorder among sexual minority medical students (students who identify as nonheterosexual). If left unaddressed, distress may result in academic and professional difficulties and undermine workforce diversity goals. The authors compared depression, anxiety, and self-rated health among sexual minority and heterosexual medical students. Method This study included 4,673 first-year students who self-reported sexual orientation in the fall 2010 baseline survey of the Medical Student Cognitive Habits and Growth Evaluation Study, a national longitudinal cohort study. The authors used items from published scales to measure depression, anxiety, self-rated health, and social stressors. They conducted bivariate and multivariate analyses to estimate the association between sexual identity and depression, anxiety, and self-rated health. Results Of 4,673 students, 232 (5.0%) identified as a sexual minority. Compared with heterosexual students, after adjusting for relevant covariates, sexual minority students had greater risk of depressive symptoms (adjusted relative risk [ARR] = 1.59 [95% confidence interval, 1.24-2.04]), anxiety symptoms (ARR = 1.64 [1.08-2.49]), and low self-rated health (ARR = 1.77 [1.15- 2.60]). Sexual minority students were more likely to report social stressors, including harassment (22.7% versus 12.7%, P < .001) and isolation (53.7% versus 42.8%, P = .001). Exposure to social stressors attenuated but did not eliminate the observed associations between minority sexual identity and mental and self-reported health measures. Conclusions First-year sexual minority students experience significantly greater risk of depression, anxiety, and low self-rated health than heterosexual students. Targeted interventions are needed to improve mental health and well-being.

Original languageEnglish (US)
Pages (from-to)652-659
Number of pages8
JournalAcademic Medicine
Volume90
Issue number5
DOIs
StatePublished - May 1 2015
Externally publishedYes

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Heterosexuality
first-year student
Medical Students
medical student
Mental Health
well-being
mental health
minority
Students
anxiety
Anxiety
Depression
health
Health
student
sexual disorder
sexual orientation
Sexual Minorities
habits
social isolation

ASJC Scopus subject areas

  • Medicine(all)
  • Education

Cite this

A comparison of the mental health and well-being of sexual minority and heterosexual first-year medical students : A report from the medical student CHANGE study. / Przedworski, Julia M.; Dovidio, John F.; Hardeman, Rachel R.; Phelan, Sean M.; Burke, Sara; Ruben, Mollie A.; Perry, Sylvia P.; Burgess, Diana J.; Nelson, David B.; Yeazel, Mark W.; Knudsen, John M.; Van Ryn, Michelle.

In: Academic Medicine, Vol. 90, No. 5, 01.05.2015, p. 652-659.

Research output: Contribution to journalArticle

Przedworski, JM, Dovidio, JF, Hardeman, RR, Phelan, SM, Burke, S, Ruben, MA, Perry, SP, Burgess, DJ, Nelson, DB, Yeazel, MW, Knudsen, JM & Van Ryn, M 2015, 'A comparison of the mental health and well-being of sexual minority and heterosexual first-year medical students: A report from the medical student CHANGE study', Academic Medicine, vol. 90, no. 5, pp. 652-659. https://doi.org/10.1097/ACM.0000000000000658
Przedworski, Julia M. ; Dovidio, John F. ; Hardeman, Rachel R. ; Phelan, Sean M. ; Burke, Sara ; Ruben, Mollie A. ; Perry, Sylvia P. ; Burgess, Diana J. ; Nelson, David B. ; Yeazel, Mark W. ; Knudsen, John M. ; Van Ryn, Michelle. / A comparison of the mental health and well-being of sexual minority and heterosexual first-year medical students : A report from the medical student CHANGE study. In: Academic Medicine. 2015 ; Vol. 90, No. 5. pp. 652-659.
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abstract = "Purpose Research is lacking on psychological distress and disorder among sexual minority medical students (students who identify as nonheterosexual). If left unaddressed, distress may result in academic and professional difficulties and undermine workforce diversity goals. The authors compared depression, anxiety, and self-rated health among sexual minority and heterosexual medical students. Method This study included 4,673 first-year students who self-reported sexual orientation in the fall 2010 baseline survey of the Medical Student Cognitive Habits and Growth Evaluation Study, a national longitudinal cohort study. The authors used items from published scales to measure depression, anxiety, self-rated health, and social stressors. They conducted bivariate and multivariate analyses to estimate the association between sexual identity and depression, anxiety, and self-rated health. Results Of 4,673 students, 232 (5.0{\%}) identified as a sexual minority. Compared with heterosexual students, after adjusting for relevant covariates, sexual minority students had greater risk of depressive symptoms (adjusted relative risk [ARR] = 1.59 [95{\%} confidence interval, 1.24-2.04]), anxiety symptoms (ARR = 1.64 [1.08-2.49]), and low self-rated health (ARR = 1.77 [1.15- 2.60]). Sexual minority students were more likely to report social stressors, including harassment (22.7{\%} versus 12.7{\%}, P < .001) and isolation (53.7{\%} versus 42.8{\%}, P = .001). Exposure to social stressors attenuated but did not eliminate the observed associations between minority sexual identity and mental and self-reported health measures. Conclusions First-year sexual minority students experience significantly greater risk of depression, anxiety, and low self-rated health than heterosexual students. Targeted interventions are needed to improve mental health and well-being.",
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AU - Hardeman, Rachel R.

AU - Phelan, Sean M.

AU - Burke, Sara

AU - Ruben, Mollie A.

AU - Perry, Sylvia P.

AU - Burgess, Diana J.

AU - Nelson, David B.

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AU - Knudsen, John M.

AU - Van Ryn, Michelle

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N2 - Purpose Research is lacking on psychological distress and disorder among sexual minority medical students (students who identify as nonheterosexual). If left unaddressed, distress may result in academic and professional difficulties and undermine workforce diversity goals. The authors compared depression, anxiety, and self-rated health among sexual minority and heterosexual medical students. Method This study included 4,673 first-year students who self-reported sexual orientation in the fall 2010 baseline survey of the Medical Student Cognitive Habits and Growth Evaluation Study, a national longitudinal cohort study. The authors used items from published scales to measure depression, anxiety, self-rated health, and social stressors. They conducted bivariate and multivariate analyses to estimate the association between sexual identity and depression, anxiety, and self-rated health. Results Of 4,673 students, 232 (5.0%) identified as a sexual minority. Compared with heterosexual students, after adjusting for relevant covariates, sexual minority students had greater risk of depressive symptoms (adjusted relative risk [ARR] = 1.59 [95% confidence interval, 1.24-2.04]), anxiety symptoms (ARR = 1.64 [1.08-2.49]), and low self-rated health (ARR = 1.77 [1.15- 2.60]). Sexual minority students were more likely to report social stressors, including harassment (22.7% versus 12.7%, P < .001) and isolation (53.7% versus 42.8%, P = .001). Exposure to social stressors attenuated but did not eliminate the observed associations between minority sexual identity and mental and self-reported health measures. Conclusions First-year sexual minority students experience significantly greater risk of depression, anxiety, and low self-rated health than heterosexual students. Targeted interventions are needed to improve mental health and well-being.

AB - Purpose Research is lacking on psychological distress and disorder among sexual minority medical students (students who identify as nonheterosexual). If left unaddressed, distress may result in academic and professional difficulties and undermine workforce diversity goals. The authors compared depression, anxiety, and self-rated health among sexual minority and heterosexual medical students. Method This study included 4,673 first-year students who self-reported sexual orientation in the fall 2010 baseline survey of the Medical Student Cognitive Habits and Growth Evaluation Study, a national longitudinal cohort study. The authors used items from published scales to measure depression, anxiety, self-rated health, and social stressors. They conducted bivariate and multivariate analyses to estimate the association between sexual identity and depression, anxiety, and self-rated health. Results Of 4,673 students, 232 (5.0%) identified as a sexual minority. Compared with heterosexual students, after adjusting for relevant covariates, sexual minority students had greater risk of depressive symptoms (adjusted relative risk [ARR] = 1.59 [95% confidence interval, 1.24-2.04]), anxiety symptoms (ARR = 1.64 [1.08-2.49]), and low self-rated health (ARR = 1.77 [1.15- 2.60]). Sexual minority students were more likely to report social stressors, including harassment (22.7% versus 12.7%, P < .001) and isolation (53.7% versus 42.8%, P = .001). Exposure to social stressors attenuated but did not eliminate the observed associations between minority sexual identity and mental and self-reported health measures. Conclusions First-year sexual minority students experience significantly greater risk of depression, anxiety, and low self-rated health than heterosexual students. Targeted interventions are needed to improve mental health and well-being.

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