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Sexual orientation differences in psychological treatment outcomes for depression and anxiety: National cohort study.
J Consult Clin Psychol. 2019 Jul; 87(7):577-589.JC

Abstract

OBJECTIVE

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. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Authors+Show Affiliations

Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London.Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London.Talking Therapies Southwark, South London and Maudsley NHS Foundation Trust.Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31219292

Citation

Rimes, Katharine A., et al. "Sexual Orientation Differences in Psychological Treatment Outcomes for Depression and Anxiety: National Cohort Study." Journal of Consulting and Clinical Psychology, vol. 87, no. 7, 2019, pp. 577-589.
Rimes KA, Ion D, Wingrove J, et al. Sexual orientation differences in psychological treatment outcomes for depression and anxiety: National cohort study. J Consult Clin Psychol. 2019;87(7):577-589.
Rimes, K. A., Ion, D., Wingrove, J., & Carter, B. (2019). Sexual orientation differences in psychological treatment outcomes for depression and anxiety: National cohort study. Journal of Consulting and Clinical Psychology, 87(7), 577-589. https://doi.org/10.1037/ccp0000416
Rimes KA, et al. Sexual Orientation Differences in Psychological Treatment Outcomes for Depression and Anxiety: National Cohort Study. J Consult Clin Psychol. 2019;87(7):577-589. PubMed PMID: 31219292.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sexual orientation differences in psychological treatment outcomes for depression and anxiety: National cohort study. AU - Rimes,Katharine A, AU - Ion,Denisa, AU - Wingrove,Janet, AU - Carter,Ben, PY - 2019/6/21/entrez PY - 2019/6/21/pubmed PY - 2019/10/29/medline SP - 577 EP - 589 JF - Journal of consulting and clinical psychology JO - J Consult Clin Psychol VL - 87 IS - 7 N2 - OBJECTIVE: 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. (PsycINFO Database Record (c) 2019 APA, all rights reserved). SN - 1939-2117 UR - https://www.unboundmedicine.com/medline/citation/31219292/Sexual_orientation_differences_in_psychological_treatment_outcomes_for_depression_and_anxiety:_National_cohort_study_ L2 - http://content.apa.org/journals/ccp/87/7/577 DB - PRIME DP - Unbound Medicine ER -