Microaggression toward LGBTIQ people and implications for mental health: A systematic review.

BACKGROUND: Research suggests that microaggressions detrimentally impact the mental health of members of marginalized social groups. AIMS: The aim of this systematic review was to assess the exposure to microaggressions and related implications on mental health of Lesbian, Gay, Bisexual, Transgender, Intersex, and Queer (LGBTIQ) people. METHOD: Medline, Scopus, PsycINFO, CINAHL, and EMBASE were searched until January 2023. Studies reporting data on the exposure to microaggressions toward LGBTIQ people were identified. Meta-analyses of rates of exposure to microaggression and of the association between microaggressions and mental health outcomes were based on odds ratio (OR) and standardized mean difference (SMD) with 95% confidence intervals (95% CI), estimated through inverse variance models with random effects. RESULTS: The review process led to the selection of 17 studies, involving a total of 9036 LGBTIQ people, of which 6827 identifying as cisgenders, and 492 as heterosexuals, were included in the quantitative synthesis. Overall, LGBTIQ people showed an increased risk of microaggression (SMD: 0.89; 95% CI [0.28, 1.50]), with Transgender people having the highest risk (OR: 10.0; 95% CI [3.08, 32.4]). Microaggression resulted associated with risk of depression (SMD: 0.21; 95% CI [0.05, 0.37]), anxiety (SMD: 0.29; 95% CI [0.17, 0.40]), suicide attempts (OR: 1.13; 95% CI [1.08, 1.18]), alcohol abuse (OR: 1.32; 95% CI [1.13, 1.54]), but not to suicidal ideation (OR: 1.56; 95% CI [0.64, 3.81]) and cannabis abuse (OR: 1.44; 95% CI [0.82, 2.55]). The quality of the evidence was limited by the small number of studies. CONCLUSIONS: LGBTIQ people are at higher risk of microaggressions compared with their cisgender/heterosexual peers, which may lead to mental health consequences. This evidence may contribute to public awareness of LGBTIQ mental health needs and suggest supportive strategies as well as preventive interventions (e.g., supportive programs and destigmatizing efforts) as parts of tailored health-care planning aimed to reduce psychiatric morbidity in this population.

Post-traumatic stress disorder among LGBTQ people: a systematic review and meta-analysis.

AIMS: Lesbian, gay, bisexual, transgender and queer people (LGBTQ) are at increased risk of traumatization. This systematic review aimed to summarize data regarding the risk of post-traumatic stress disorder (PTSD) for LGBTQ people and their subgroups. METHODS: Medline, Scopus, PsycINFO and EMBASE were searched until September 2022. Studies reporting a comparative estimation of PTSD among LGBTQ population and the general population (i.e., heterosexual/cisgender), without restrictions on participants' age and setting for the enrolment, were identified. Meta-analyses were based on odds ratio (OR and 95% confidence intervals [CI]), estimated through inverse variance models with random effects. RESULTS: The review process led to the selection of 27 studies, involving a total of 31,903 LGBTQ people and 273,842 controls, which were included in the quantitative synthesis. Overall, LGBTQ people showed an increased risk of PTSD (OR: 2.20 [95% CI: 1.85; 2.60]), although there was evidence of marked heterogeneity in the estimate (I2 = 91%). Among LGBTQ subgroups, transgender people showed the highest risk of PTSD (OR: 2.52 [95% CI: 2.22; 2.87]) followed by bisexual people (OR: 2.44 [95% CI: 1.05; 5.66]), although these comparisons are limited by the lack of data for other sexual and gender minorities, such as intersex people. Interestingly, the risk of PTSD for bisexual people was confirmed also considering lesbian and gay as control group (OR: 1.44 [95% CI: 1.07; 1.93]). The quality of the evidence was low. CONCLUSIONS: LGBTQ people are at higher risk of PTSD compared with their cisgender/heterosexual peers. This evidence may contribute to the public awareness on LGBTQ mental health needs and suggest supportive strategies as well as preventive interventions (e.g., supportive programs, counselling, and destigmatizing efforts) as parts of a tailored health-care planning aimed to reduce psychiatric morbidity in this at-risk population.

Psychiatric symptoms in Long-COVID patients: a systematic review.

Objective: People who have been infected by COVID-19 showing persistent symptoms after 4 weeks from recovery are thought to suffer from Long-COVID syndrome (LC). There is uncertainty on the clinical manifestations of LC. We undertook a systematic review to summarize the available evidence about the main psychiatric manifestations of LC. Method: PubMed (Medline), Scopus, CINHAL, PsycINFO, and EMBASE were searched until May 2022. Studies reporting estimation of emerging psychiatric symptoms and/or psychiatric diagnoses among adult people with LC were included. Pooled prevalence for each psychiatric condition was calculated in absence of control groups to compare with. Results: Thirty-three reports were included in the final selection, corresponding to 282,711 participants with LC. After 4 weeks from COVID-19 infection recovery, participants reported the following psychiatric symptoms: depression, anxiety, post-traumatic symptoms (PTS), cognitive and sleeping disturbances (i.e., insomnia or hypersomnia). The most common psychiatric manifestation resulted to be sleep disturbances, followed by depression, PTS, anxiety, and cognitive impairment (i.e., attention and memory deficits). However, some estimates were affected by important outlier effect played by one study. If study weight was not considered, the most reported condition was anxiety. Conclusions: LC may have non-specific psychiatric manifestations. More research is needed to better define LC and to differentiate it from other post-infectious or post-hospitalization syndromes. Systematic review registration: PROSPERO (CRD42022299408).

Dysphoria Spectrum in the Evaluation of Suicide Risk: An Overview and Exploratory Study.

BACKGROUND: The aim of the present paper was to summarize the role of dysphoria in the development of suicidality. We performed an exploratory study to evaluate dysphoria dimensions in inpatients suffering from borderline personality disorder (BPD), mood disorders, and schizophrenia spectrum disorders who were evaluated due to suicidal ideation or suicide attempt. SUBJECTS AND METHODS: Subjects aged 18-70, diagnosed with BPD, mood disorders, or schizophrenia spectrum disorders according to the DSM-5 criteria who were hospitalized following suicidal ideation or suicidal attempt were recruited in the present study. Dysphoria was assessed by the Nepean Dysphoria Scale, Italian version (NDS-I), a 24-item auto-administered tool evaluating the different dimensions of dysphoria. Between-group comparisons were performed by means of the Chi-square and Mann-Whitney U test. RESULTS: In the present sample (n=30), 15 (50%) subjects were admitted following a suicide attempt and 15 (50%) presented suicidal ideation. There were no significant differences in the NDS-I scores between subjects who performed a suicide attempt and those who presented suicidal ideation, neither for the total score nor for the subscales. Subjects suffering from BPD scored significantly higher at the NDS-I than those who were diagnosed with a mood disorder or a schizophrenia spectrum disorder. The result was replicated for the NDS-I subscales, except for the one analyzing discontent. When comparing subjects suffering from mood disorders to those with a diagnosis schizophrenia spectrum disorders, the two subgroups did not differ except for the irritability subscale, where subjects with mood disorders scored significantly higher. CONCLUSIONS: The dimension of dysphoria should be evaluated when assessing subjects who display high suicide risk. Dysphoria could be reconsidered a third affective pole representing psychopathological correlate of suicidality in subjects suffering from BPD.