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Sexual Orientation Affects Women’s Risks for Overlapping Alcohol, Mental Health Problems

Posted on March 14th, 2016
Posted in Alcoholism, Articles

Non-heterosexual women affected by alcohol use disorder have significantly increased chances of experiencing overlapping problems with a separately diagnosable mental health problem, according to new findings from a team of American researchers.

Compared to heterosexual women, non-heterosexual women have statistically heightened odds of consuming alcohol in risky amounts and developing diagnosable symptoms of alcohol use disorder (alcohol abuse and/or alcohol addiction). In a study scheduled for publication in August 2015 in the journal Addictive Behaviors, researchers from two U.S. universities sought to determine if non-heterosexual women with alcohol use disorder develop overlapping problems with other mental health problems more often than their heterosexual counterparts. The researchers sought to answer the same question in relation to risks for other forms of substance use disorder.

Women’s Sexual Orientation and Alcohol Problems

Findings reported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and a range of other sources indicate that lesbian, bisexual and transgender women typically consume more alcohol than heterosexual women. In addition, non-heterosexual women may continue to drink alcohol in risky amounts substantially later in life than their heterosexual counterparts. A number of factors may help explain this situation, including the chronic mental stress produced by pervasive discrimination against non-heterosexuals, a potentially higher level of exposure to abuse during childhood and the relative importance placed on gathering in social settings (bars, clubs, etc.) where alcohol is served as a matter of course. Critically, even when lesbian, bisexual and transgender women don’t consume more alcohol than heterosexual women, they may have increased chances of developing diagnosable alcohol problems.

Alcohol Use Disorder and Mental Health

The alcohol use disorder diagnosis was formalized in 2013 by the American Psychiatric Association (APA), which sets the nation’s commonly accepted criteria for all illnesses with a significant mental health component. It includes symptoms formerly separately viewed as indications of alcohol dependence or alcoholism; it also includes symptoms formerly separately viewed as indications of non-dependent alcohol abuse. The APA established this new diagnosis in order to fully capture the intertwined nature of alcohol abuse and alcoholism.

People with drinking problems have statistically increased chances of developing a number of separately diagnosable mental illnesses, including major depression, bipolar disorder, various forms of anxiety disorder and antisocial personality disorder. The connection between alcohol problems and other mental health problems is intricate. In some cases, separate mental illness predates involvement in risky drinking; in other cases, risky drinking precedes separate mental illness. Overall, more than 33 percent of all people with alcohol use disorder also have other forms of mental problems. Unfortunately, alcohol problems and other mental health problems are comorbid. This means that a person affected by both issues typically has worse outcomes than a person affected by only one of the two issues.

Frequency of Overlapping Problems

In the study slated for publication in Addictive Behaviors, researchers from Brown University and the University of Arkansas for Medical Sciences used previously collected data from a nationwide project called National Epidemiological Survey on Alcohol and Related Conditions (NESARC) to help determine if non-heterosexual women affected by alcohol use disorder develop overlapping problems with separately diagnosable mental illness more often than heterosexual women. The NESARC sample included 4,342 women affected by alcohol abuse and/or alcoholism; 191 of these women described themselves as lesbian, bisexual or transgender. For each heterosexual and non-heterosexual participant, the researchers looked for a diagnosis of any other mental health issue at any point in time. They also looked for any diagnoses of drug- or medication- related substance use disorder.

The researchers used advanced analytic techniques to account for the socioeconomic and demographic differences among the participating women. After completing this process, they concluded non-heterosexual women with alcohol use disorder have substantially increased lifetime risks for developing overlapping symptoms of several types of mental illness, including major depression and bipolar disorder, as well as panic disorder and other forms of anxiety disorder. The researchers also concluded that non-heterosexual women have increased lifetime risks for developing diagnosable problems with other forms of substance abuse/addiction, including cannabis use disorder and prescription drug-related opioid use disorder.

Based on their findings, the study’s authors believe that non-heterosexual women with alcohol use disorder have unique risks for overlapping mental health issues. They urge other researchers to explore this topic; they also urge public health officials and substance and mental health programs to develop prevention and treatment options specific to lesbian, bisexual and transgender women with alcohol problems.

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