Sexual orientation and depression in Canada.

OBJECTIVES: Depression is a global concern and it is well known that certain segments of the population are at greater risk. Sexual minorities are recognized as being more likely to suffer from depression due to social stigma and prejudice. The aim of this study was to describe the relationship between sexual orientation and depression in the Canadian population. METHODS: The study used the 2012 Canadian Community Health Survey - Mental Health data. The sample comprised 24,788 Canadians living in the ten provinces. Logistic regression analyses were used to examine the relationship of depression and sexual orientation. RESULTS: After adjusting for known risk factors for depression, there was no difference in prevalence of past 12-month or lifetime major depressive episode between sexual minorities and heterosexuals. Bisexuals did have a near significant trend towards higher prevalence of both past 12-month and lifetime depression as a combined group, but there were not clear differences when stratified by sex. CONCLUSION: This study supports important emerging trends in the relationship between sexual orientation and depression. Research on the mental health of sexual minority people must take into account differences between sexual minority groups and avoid aggregating mental health disorders into broad categories. These findings have implications for public health planning and clinical recommendations.

Depression in Lesbian, Gay, and Bisexual Members of the Canadian Armed Forces.

PURPOSE: Lesbians, gay men, and bisexuals have been shown to have different risks for mood and anxiety disorders than heterosexuals in population studies, but there is a paucity of research in this area in military populations. This study examined the relationship between sexual orientation and depression in the Canadian Armed Forces (CAF). METHODS: Data were drawn from the Canadian Forces Mental Health Survey 2013 (n = 8165), a representative sample of Regular and Reserve members of the Canadian military. Binomial logistic regression was used to predict 12-month and lifetime odds ratios for major depressive episode (MDE) stratified by sexual orientation and sex. RESULTS: Gay male members had higher risk (AOR = 3.80, 95% CI 1.60-9.05) for lifetime MDE, but not for past 12-month MDE compared to heterosexual males. There was no significant difference in risk for lesbians or bisexuals compared to heterosexuals. CONCLUSIONS: The results suggest that gay male members of the CAF are at higher risk for a history of MDE, but not current MDE. This may be a result of ongoing discrimination and stigma faced by gay men in the military or may reflect MDE that occurred before military service. The lack of difference in MDE risk for lesbian and bisexual members compared to heterosexual members is an important positive finding.

The relationship between sexual orientation and depression in a national population sample.

AIMS AND OBJECTIVES: The aim of this study was to examine the relationship between sexual orientation and depression in a nationally representative population to determine if sexual minorities report higher levels of depression than the remainder of the population. BACKGROUND: Depression is a highly prevalent and disabling chronic disorder worldwide. Prior research utilizing national population samples have reported that members of sexual minorities are at higher risk for depression when compared to heterosexual people. More recent studies have revealed differences in depression risk based on sexual orientation, sexual activity and sex. There have been significant shifts in societal attitudes towards sexual minorities in recent decades. Continuing research into predictors for reporting depression amongst sexual minorities is needed. METHODS: National Health and Nutrition Examination Survey cycles 2005-2012 were used to identify sexual minority status based on declared sexual orientation and presence of same-sex sexual activity. Complex samples logistic and multivariate regression models were used to predict depression adjusted for sexual orientation, sexual activity, age, sex, marital status, education, income, race/ethnicity, employment and health status. RESULTS: Sexual orientation was not a significant independent predictor of depressive symptoms overall. Gay men reported lower levels of depressive symptoms than heterosexual men. In the sex stratified analyses, men who reported having sex with men were five times more likely to report depressive symptomatology compared to men who reported opposite sex partners (2005-2008 adjusted odds ratios: 5·00; 95% confidence interval: 1·44-17·38; 2009-2012 adjusted odds ratios: 5·10; 95% confidence interval: 1·33-19·54) after controlling for sexual orientation. CONCLUSIONS: Results of our analyses indicate that homosexually experienced heterosexual men appear to be at highest risk for depression. Furthermore, reported physical health status was a significant independent predictor of depression in all models, suggesting a strong link between physical and mental health. RELEVANCE TO CLINICAL PRACTICE: Health care providers should inquire about sexual orientation and sexual behaviour as part of a routine health history and be familiar with the unique health needs of sexual minorities to tailor clinical practice and foster safe, inclusive, health care environments.

The feasibility and effectiveness of emergency department based hypertension screening: a systematic review.

PURPOSE: Hypertension is a highly prevalent risk factor for cardiovascular disease, and its early identification and management results in reductions in morbidity and mortality. Our objectives were to: (1) determine the extent to which the emergency department (ED) has been used to screen patients for undiagnosed hypertension; (2) estimate the incidence of undiagnosed hypertension in the ED population; (3) identify and describe the programs for ED hypertension screening; and (4) determine the feasibility of ED-based hypertension screening programs and the requirements for further study. DATA SOURCES: An online search of databases (i.e., OVID Search, CINAHL, Scopus, Web of Science), unpublished sources (i.e., ProQuest Dissertation & Theses and Papers First), and grey literature (i.e., OpenSIGLE and the New York Academy of Grey Literature) was conducted. A manual search of the reference lists of relevant studies was also completed. CONCLUSION: Hypertension screening in the ED is feasible. Individuals with elevated blood pressure (BP) in the ED should be referred for follow-up. Further study is needed to develop an ED screening tool that is predictive of persistently elevated BP in undiagnosed individuals. IMPLICATIONS FOR PRACTICE: Nurse practitioners in the ED should identify patients with elevated BP, provide hypertension education, and ensure appropriate intervention and referral.

The effect of age and gender on arterial stiffness in healthy Caucasian Canadians.

AIMS AND OBJECTIVES: We aimed to investigate age and gender differences in arterial stiffness, and whether this cardiovascular risk factor was detectable in healthy Caucasians before established disease was manifest. BACKGROUND: A growing number of risk factors including diabetes, obesity, hypertension, hyperlipidaemia, smoking and age have been linked to the adverse cardiovascular end-points of myocardial infarction, stroke and heart failure. These risk factors lead to an increase in arterial stiffness. Measuring this stiffness at an early age may identify candidates for primary preventative intervention strategies by nurses. METHODS: Caucasian Canadians (n = 176) were recruited. Peripheral and central blood pressure, pulse pressure, augmentation pressure, arterial compliance (augmentation index and pulse wave velocity) and sub-endocardial viability ratio (SEVR), were assessed using applanation tonometry (SphygmoCor system). Blood was drawn for fasting lipid and glucose profiling. RESULTS: Women participants had significantly stiffer arteries than men (augmentation index: 28 SEM = 1% vs. 18 SEM = 2% respectively; p < 0.001). Pulse wave velocity, however, was not different (7.7 SEM = 0.2 m/s vs. 8.3 SEM = 0.1 m/s respectively; p < 0.001). Age was a strong predictor of arterial stiffening in both genders, but the effect was greater in women. CONCLUSIONS: Women having stiffer arteries than men, thus at greater cardiovascular risk, may require earlier screening. The effect might be postmenopausal, and mechanisms require further investigation. However, both middle-aged men and women considering themselves 'healthy' may benefit from more proactive primary prevention. RELEVANCE TO CLINICAL PRACTICE: Applanation tonometry, used extensively by nurses, provides early detection of central haemodynamic changes and vascular compliance at all ages. Knowledge of arterial stiffness could guide the management of primary prevention in the nursing cardiovascular risk reduction clinic.