Mental disorders and sexual orientation in college students across 13 countries of differing levels of LGBTQ+ acceptance

WHO WMH-ICS Collaborators; Roberto RENTERÍA; Claes ANDERSSON; Marcus BENDTSEN; Philippe MORTIER; Randy P. AUERBACH; Jason BANTJES; Harald BAUMEISTER; Anne H. BERMAN; Erik BOOTSMA; Ronny BRUFFAERTS; Irina F. COHUTCohut; Marcelo A. CROCKETT; Pim CUIJPERS; Oana A. DAVID; David D. EBERT; Raúl A. GUTIERREZ-GARCÍA; Penelope A. HASKING; Xanthe HUNT; Petra HURKS; Mathilde M. HUSKY; Ana Lucia JIMENEZ; Fanny KÄHLKE; Ann-Marie KÜCHLER; Scarlett MAC-GINTY; Arthur D.P. MAK; Vania MARTÍNEZ; Margaret MCLAFFERTY; Iris R. MONROY-VELASCO; Elaine K. MURRAY; Siobhan O'NEILL; Claudiu C. PAPASTERI; Priscilla PAZ; Codruta A. POPESCU; Kealagh ROBINSON; Elske SALEMINK; Oi-Ling SIU; Dan J. STEIN; Sascha Y. STRUIJS; Cristina TOMOIAGA; Sanne VAN LUENEN; Daniel V. VIGO; Angel Y. WANG; Reinout W. WIERS; Samuel Y.S. WONG; Corina BENJET; Yesica ALBOR; Patricia BAEZ; Guilherme BORGES; Elsie BREET; Anabell Covarrubias DÍAZ; Sergio CRUZ-HERNÁNDEZ; Jorge GAETE; Franco GERICKE; Praxedis Cristina HERNÁNDEZ URIBE; Kristen L. HUDEC; Karen JACOBS; Leontien JANSEN; Rozemarijn JEANNIN; Álvaro I. LANGER; M. Irene LÉNIZ; Maria Elena MEDINA-MORA; Lonna MUNRO; Richard J. MUNTHALI; Daniel NÚÑEZ; Maria Abigail PAZ-PERÉZ; Julia PEI; Ana Paula PRESCIVALLI; Guillermo QUEVEDO; Karla Patricia VALDÉS-GARCÍA; Ilse VANDEPOEL; Eunice VARGAS-CONTRERAS; Wouter VOORSPOELS

doi:10.1016/j.jpsychires.2025.04.021

Mental disorders and sexual orientation in college students across 13 countries of differing levels of LGBTQ+ acceptance

WHO WMH-ICS Collaborators, Roberto RENTERÍA^*, Claes ANDERSSON, Marcus BENDTSEN, Philippe MORTIER, Randy P. AUERBACH, Jason BANTJES, Harald BAUMEISTER, Anne H. BERMAN, Erik BOOTSMA, Ronny BRUFFAERTS, Irina F. COHUTCohut, Marcelo A. CROCKETT, Pim CUIJPERS, Oana A. DAVID, David D. EBERT, Raúl A. GUTIERREZ-GARCÍA, Penelope A. HASKING, Xanthe HUNT, Petra HURKSMathilde M. HUSKY, Ana Lucia JIMENEZ, Fanny KÄHLKE, Ann-Marie KÜCHLER, Scarlett MAC-GINTY, Arthur D.P. MAK, Vania MARTÍNEZ, Margaret MCLAFFERTY, Iris R. MONROY-VELASCO, Elaine K. MURRAY, Siobhan O'NEILL, Claudiu C. PAPASTERI, Priscilla PAZ, Codruta A. POPESCU, Kealagh ROBINSON, Elske SALEMINK, Oi-Ling SIU, Dan J. STEIN, Sascha Y. STRUIJS, Cristina TOMOIAGA, Sanne VAN LUENEN, Daniel V. VIGO, Angel Y. WANG, Reinout W. WIERS, Samuel Y.S. WONG, Corina BENJET, Yesica ALBOR, Patricia BAEZ, Guilherme BORGES, Elsie BREET, Anabell Covarrubias DÍAZ, Sergio CRUZ-HERNÁNDEZ, Jorge GAETE, Franco GERICKE, Praxedis Cristina HERNÁNDEZ URIBE, Kristen L. HUDEC, Karen JACOBS, Leontien JANSEN, Rozemarijn JEANNIN, Álvaro I. LANGER, M. Irene LÉNIZ, Maria Elena MEDINA-MORA, Lonna MUNRO, Richard J. MUNTHALI, Daniel NÚÑEZ, Maria Abigail PAZ-PERÉZ, Julia PEI, Ana Paula PRESCIVALLI, Guillermo QUEVEDO, Karla Patricia VALDÉS-GARCÍA, Ilse VANDEPOEL, Eunice VARGAS-CONTRERAS, Wouter VOORSPOELS

^*Corresponding author for this work

Department of Psychology

Research output: Journal Publications › Journal Article (refereed) › peer-review

Abstract

Mental health disparities have been reported among sexual minority individuals; minority stress theory posits that such disparities are a result of stigma and discrimination. We estimated the prevalence of mental disorders across sexual orientation groups among first-year college students and whether differences across sexual orientation groups varied by gender and country-level LGBTQ+ (lesbian, gay, bisexual, transgender, queer) social acceptance. Using data (N = 53,175; 13 countries) from the World Mental Health Surveys International College Surveys, we performed multilevel logistic regressions to estimate the associations between sexual orientation (i.e., heterosexual, heterosexual with same-gender attraction [SGA], gay/lesbian, bisexual, asexual, questioning, and other) and five twelve-month DSM-5 disorders (major depressive disorder, generalized anxiety disorder, panic disorder, alcohol use disorder, drug use disorder). Heterosexual students with SGA (AORs 1.30–2.15), gay/lesbian (AORs 1.49–2.70), bisexual (AORs 2.26–3.49), questioning (AORs 1.38–2.04), and “other” (AORs 1.76–2.94) students had higher odds of all disorders compared to heterosexual students with no SGA; asexual students did not. Significant interactions with gender show that the gender difference in prevalence was greater among bisexual individuals for most disorders and among all sexual minorities (except “other”) for drug use disorder. Significant interactions with country level LGBT+ social acceptance showed some sexual minority groups had lower odds (AORs 0.83–0.95) of disorder as country-level acceptance increased. These findings provide further evidence of mental disorder disparities across a wide range of sexual orientations and how these disparities vary by gender and societal LGBTQ+ acceptance in students from diverse countries.

Original language	English
Pages (from-to)	331-340
Number of pages	10
Journal	Journal of Psychiatric Research
Volume	186
Early online date	18 Apr 2025
DOIs	https://doi.org/10.1016/j.jpsychires.2025.04.021
Publication status	E-pub ahead of print - 18 Apr 2025

Bibliographical note

Publisher Copyright:
© 2025 Elsevier Ltd

Keywords

College student
Cross-national
DSM-5
Mental disorder
Sexual orientation
Social acceptance

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jpsychires.2025.04.021

https://linkinghub.elsevier.com/retrieve/pii/S0022395625002560

Cite this

WHO WMH-ICS Collaborators, RENTERÍA, R., ANDERSSON, C., BENDTSEN, M., MORTIER, P., AUERBACH, R. P., BANTJES, J., BAUMEISTER, H., BERMAN, A. H., BOOTSMA, E., BRUFFAERTS, R., COHUTCohut, I. F., CROCKETT, M. A., CUIJPERS, P., DAVID, O. A., EBERT, D. D., GUTIERREZ-GARCÍA, R. A., HASKING, P. A., HUNT, X., ... VOORSPOELS, W. (2025). Mental disorders and sexual orientation in college students across 13 countries of differing levels of LGBTQ+ acceptance. Journal of Psychiatric Research, 186, 331-340. Advance online publication. https://doi.org/10.1016/j.jpsychires.2025.04.021

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title = "Mental disorders and sexual orientation in college students across 13 countries of differing levels of LGBTQ+ acceptance",

abstract = "Mental health disparities have been reported among sexual minority individuals; minority stress theory posits that such disparities are a result of stigma and discrimination. We estimated the prevalence of mental disorders across sexual orientation groups among first-year college students and whether differences across sexual orientation groups varied by gender and country-level LGBTQ+ (lesbian, gay, bisexual, transgender, queer) social acceptance. Using data (N = 53,175; 13 countries) from the World Mental Health Surveys International College Surveys, we performed multilevel logistic regressions to estimate the associations between sexual orientation (i.e., heterosexual, heterosexual with same-gender attraction [SGA], gay/lesbian, bisexual, asexual, questioning, and other) and five twelve-month DSM-5 disorders (major depressive disorder, generalized anxiety disorder, panic disorder, alcohol use disorder, drug use disorder). Heterosexual students with SGA (AORs 1.30–2.15), gay/lesbian (AORs 1.49–2.70), bisexual (AORs 2.26–3.49), questioning (AORs 1.38–2.04), and “other” (AORs 1.76–2.94) students had higher odds of all disorders compared to heterosexual students with no SGA; asexual students did not. Significant interactions with gender show that the gender difference in prevalence was greater among bisexual individuals for most disorders and among all sexual minorities (except “other”) for drug use disorder. Significant interactions with country level LGBT+ social acceptance showed some sexual minority groups had lower odds (AORs 0.83–0.95) of disorder as country-level acceptance increased. These findings provide further evidence of mental disorder disparities across a wide range of sexual orientations and how these disparities vary by gender and societal LGBTQ+ acceptance in students from diverse countries.",

keywords = "College student, Cross-national, DSM-5, Mental disorder, Sexual orientation, Social acceptance",

author = "{WHO WMH-ICS Collaborators} and Roberto RENTER{\'I}A and Claes ANDERSSON and Marcus BENDTSEN and Philippe MORTIER and AUERBACH, {Randy P.} and Jason BANTJES and Harald BAUMEISTER and BERMAN, {Anne H.} and Erik BOOTSMA and Ronny BRUFFAERTS and COHUTCohut, {Irina F.} and CROCKETT, {Marcelo A.} and Pim CUIJPERS and DAVID, {Oana A.} and EBERT, {David D.} and GUTIERREZ-GARC{\'I}A, {Ra{\'u}l A.} and HASKING, {Penelope A.} and Xanthe HUNT and Petra HURKS and HUSKY, {Mathilde M.} and JIMENEZ, {Ana Lucia} and Fanny K{\"A}HLKE and Ann-Marie K{\"U}CHLER and Scarlett MAC-GINTY and MAK, {Arthur D.P.} and Vania MART{\'I}NEZ and Margaret MCLAFFERTY and MONROY-VELASCO, {Iris R.} and MURRAY, {Elaine K.} and Siobhan O'NEILL and PAPASTERI, {Claudiu C.} and Priscilla PAZ and POPESCU, {Codruta A.} and Kealagh ROBINSON and Elske SALEMINK and Oi-Ling SIU and STEIN, {Dan J.} and STRUIJS, {Sascha Y.} and Cristina TOMOIAGA and {VAN LUENEN}, Sanne and VIGO, {Daniel V.} and WANG, {Angel Y.} and WIERS, {Reinout W.} and WONG, {Samuel Y.S.} and Corina BENJET and Yesica ALBOR and Patricia BAEZ and Guilherme BORGES and Elsie BREET and D{\'I}AZ, {Anabell Covarrubias} and Sergio CRUZ-HERN{\'A}NDEZ and Jorge GAETE and Franco GERICKE and {HERN{\'A}NDEZ URIBE}, {Praxedis Cristina} and HUDEC, {Kristen L.} and Karen JACOBS and Leontien JANSEN and Rozemarijn JEANNIN and LANGER, {{\'A}lvaro I.} and L{\'E}NIZ, {M. Irene} and MEDINA-MORA, {Maria Elena} and Lonna MUNRO and MUNTHALI, {Richard J.} and Daniel N{\'U}{\~N}EZ and PAZ-PER{\'E}Z, {Maria Abigail} and Julia PEI and PRESCIVALLI, {Ana Paula} and Guillermo QUEVEDO and VALD{\'E}S-GARC{\'I}A, {Karla Patricia} and Ilse VANDEPOEL and Eunice VARGAS-CONTRERAS and Wouter VOORSPOELS",

note = "Publisher Copyright: {\textcopyright} 2025 Elsevier Ltd",

year = "2025",

month = apr,

day = "18",

doi = "10.1016/j.jpsychires.2025.04.021",

language = "English",

volume = "186",

pages = "331--340",

journal = "Journal of Psychiatric Research",

issn = "0022-3956",

publisher = "Elsevier Ltd",

}

WHO WMH-ICS Collaborators, RENTERÍA, R, ANDERSSON, C, BENDTSEN, M, MORTIER, P, AUERBACH, RP, BANTJES, J, BAUMEISTER, H, BERMAN, AH, BOOTSMA, E, BRUFFAERTS, R, COHUTCohut, IF, CROCKETT, MA, CUIJPERS, P, DAVID, OA, EBERT, DD, GUTIERREZ-GARCÍA, RA, HASKING, PA, HUNT, X, HURKS, P, HUSKY, MM, JIMENEZ, AL, KÄHLKE, F, KÜCHLER, A-M, MAC-GINTY, S, MAK, ADP, MARTÍNEZ, V, MCLAFFERTY, M, MONROY-VELASCO, IR, MURRAY, EK, O'NEILL, S, PAPASTERI, CC, PAZ, P, POPESCU, CA, ROBINSON, K, SALEMINK, E, SIU, O-L, STEIN, DJ, STRUIJS, SY, TOMOIAGA, C, VAN LUENEN, S, VIGO, DV, WANG, AY, WIERS, RW, WONG, SYS, BENJET, C, ALBOR, Y, BAEZ, P, BORGES, G, BREET, E, DÍAZ, AC, CRUZ-HERNÁNDEZ, S, GAETE, J, GERICKE, F, HERNÁNDEZ URIBE, PC, HUDEC, KL, JACOBS, K, JANSEN, L, JEANNIN, R, LANGER, ÁI, LÉNIZ, MI, MEDINA-MORA, ME, MUNRO, L, MUNTHALI, RJ, NÚÑEZ, D, PAZ-PERÉZ, MA, PEI, J, PRESCIVALLI, AP, QUEVEDO, G, VALDÉS-GARCÍA, KP, VANDEPOEL, I, VARGAS-CONTRERAS, E & VOORSPOELS, W 2025, 'Mental disorders and sexual orientation in college students across 13 countries of differing levels of LGBTQ+ acceptance', Journal of Psychiatric Research, vol. 186, pp. 331-340. https://doi.org/10.1016/j.jpsychires.2025.04.021

TY - JOUR

T1 - Mental disorders and sexual orientation in college students across 13 countries of differing levels of LGBTQ+ acceptance

AU - WHO WMH-ICS Collaborators

AU - RENTERÍA, Roberto

AU - ANDERSSON, Claes

AU - BENDTSEN, Marcus

AU - MORTIER, Philippe

AU - AUERBACH, Randy P.

AU - BANTJES, Jason

AU - BAUMEISTER, Harald

AU - BERMAN, Anne H.

AU - BOOTSMA, Erik

AU - BRUFFAERTS, Ronny

AU - COHUTCohut, Irina F.

AU - CROCKETT, Marcelo A.

AU - CUIJPERS, Pim

AU - DAVID, Oana A.

AU - EBERT, David D.

AU - GUTIERREZ-GARCÍA, Raúl A.

AU - HASKING, Penelope A.

AU - HUNT, Xanthe

AU - HURKS, Petra

AU - HUSKY, Mathilde M.

AU - JIMENEZ, Ana Lucia

AU - KÄHLKE, Fanny

AU - KÜCHLER, Ann-Marie

AU - MAC-GINTY, Scarlett

AU - MAK, Arthur D.P.

AU - MARTÍNEZ, Vania

AU - MCLAFFERTY, Margaret

AU - MONROY-VELASCO, Iris R.

AU - MURRAY, Elaine K.

AU - O'NEILL, Siobhan

AU - PAPASTERI, Claudiu C.

AU - PAZ, Priscilla

AU - POPESCU, Codruta A.

AU - ROBINSON, Kealagh

AU - SALEMINK, Elske

AU - SIU, Oi-Ling

AU - STEIN, Dan J.

AU - STRUIJS, Sascha Y.

AU - TOMOIAGA, Cristina

AU - VAN LUENEN, Sanne

AU - VIGO, Daniel V.

AU - WANG, Angel Y.

AU - WIERS, Reinout W.

AU - WONG, Samuel Y.S.

AU - BENJET, Corina

AU - ALBOR, Yesica

AU - BAEZ, Patricia

AU - BORGES, Guilherme

AU - BREET, Elsie

AU - DÍAZ, Anabell Covarrubias

AU - CRUZ-HERNÁNDEZ, Sergio

AU - GAETE, Jorge

AU - GERICKE, Franco

AU - HERNÁNDEZ URIBE, Praxedis Cristina

AU - HUDEC, Kristen L.

AU - JACOBS, Karen

AU - JANSEN, Leontien

AU - JEANNIN, Rozemarijn

AU - LANGER, Álvaro I.

AU - LÉNIZ, M. Irene

AU - MEDINA-MORA, Maria Elena

AU - MUNRO, Lonna

AU - MUNTHALI, Richard J.

AU - NÚÑEZ, Daniel

AU - PAZ-PERÉZ, Maria Abigail

AU - PEI, Julia

AU - PRESCIVALLI, Ana Paula

AU - QUEVEDO, Guillermo

AU - VALDÉS-GARCÍA, Karla Patricia

AU - VANDEPOEL, Ilse

AU - VARGAS-CONTRERAS, Eunice

AU - VOORSPOELS, Wouter

PY - 2025/4/18

Y1 - 2025/4/18

N2 - Mental health disparities have been reported among sexual minority individuals; minority stress theory posits that such disparities are a result of stigma and discrimination. We estimated the prevalence of mental disorders across sexual orientation groups among first-year college students and whether differences across sexual orientation groups varied by gender and country-level LGBTQ+ (lesbian, gay, bisexual, transgender, queer) social acceptance. Using data (N = 53,175; 13 countries) from the World Mental Health Surveys International College Surveys, we performed multilevel logistic regressions to estimate the associations between sexual orientation (i.e., heterosexual, heterosexual with same-gender attraction [SGA], gay/lesbian, bisexual, asexual, questioning, and other) and five twelve-month DSM-5 disorders (major depressive disorder, generalized anxiety disorder, panic disorder, alcohol use disorder, drug use disorder). Heterosexual students with SGA (AORs 1.30–2.15), gay/lesbian (AORs 1.49–2.70), bisexual (AORs 2.26–3.49), questioning (AORs 1.38–2.04), and “other” (AORs 1.76–2.94) students had higher odds of all disorders compared to heterosexual students with no SGA; asexual students did not. Significant interactions with gender show that the gender difference in prevalence was greater among bisexual individuals for most disorders and among all sexual minorities (except “other”) for drug use disorder. Significant interactions with country level LGBT+ social acceptance showed some sexual minority groups had lower odds (AORs 0.83–0.95) of disorder as country-level acceptance increased. These findings provide further evidence of mental disorder disparities across a wide range of sexual orientations and how these disparities vary by gender and societal LGBTQ+ acceptance in students from diverse countries.

AB - Mental health disparities have been reported among sexual minority individuals; minority stress theory posits that such disparities are a result of stigma and discrimination. We estimated the prevalence of mental disorders across sexual orientation groups among first-year college students and whether differences across sexual orientation groups varied by gender and country-level LGBTQ+ (lesbian, gay, bisexual, transgender, queer) social acceptance. Using data (N = 53,175; 13 countries) from the World Mental Health Surveys International College Surveys, we performed multilevel logistic regressions to estimate the associations between sexual orientation (i.e., heterosexual, heterosexual with same-gender attraction [SGA], gay/lesbian, bisexual, asexual, questioning, and other) and five twelve-month DSM-5 disorders (major depressive disorder, generalized anxiety disorder, panic disorder, alcohol use disorder, drug use disorder). Heterosexual students with SGA (AORs 1.30–2.15), gay/lesbian (AORs 1.49–2.70), bisexual (AORs 2.26–3.49), questioning (AORs 1.38–2.04), and “other” (AORs 1.76–2.94) students had higher odds of all disorders compared to heterosexual students with no SGA; asexual students did not. Significant interactions with gender show that the gender difference in prevalence was greater among bisexual individuals for most disorders and among all sexual minorities (except “other”) for drug use disorder. Significant interactions with country level LGBT+ social acceptance showed some sexual minority groups had lower odds (AORs 0.83–0.95) of disorder as country-level acceptance increased. These findings provide further evidence of mental disorder disparities across a wide range of sexual orientations and how these disparities vary by gender and societal LGBTQ+ acceptance in students from diverse countries.

KW - College student

KW - Cross-national

KW - DSM-5

KW - Mental disorder

KW - Sexual orientation

KW - Social acceptance

UR - http://www.scopus.com/inward/record.url?scp=105003374953&partnerID=8YFLogxK

U2 - 10.1016/j.jpsychires.2025.04.021

DO - 10.1016/j.jpsychires.2025.04.021

M3 - Journal Article (refereed)

SN - 0022-3956

VL - 186

SP - 331

EP - 340

JO - Journal of Psychiatric Research

JF - Journal of Psychiatric Research

ER -

Mental disorders and sexual orientation in college students across 13 countries of differing levels of LGBTQ+ acceptance

Abstract

Bibliographical note

Keywords

UN SDGs

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