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This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2009.168815v1 100/3/452    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Hatzenbuehler, M. L. Articles by Hasin, D. S. Search for Related Content PubMed PubMed Citation Articles by Hatzenbuehler, M. L. Articles by Hasin, D. S. Related Collections Epidemiology Mental Health Lesbian/Gay/Bisexual/Transgender Persons Human Rights

Mark L. Hatzenbuehler, MS, MPhil, Katie A. McLaughlin, PhD, Katherine M. Keyes, MPH and Deborah S. Hasin, PhD

Mark L. Hatzenbuehler is in the Department of Psychology, Yale University, New Haven, CT. Katie A. McLaughlin is in the Department of Society, Human Development, and Health, Harvard School of Public Health, Harvard University, Boston, MA. Katherine M. Keyes is in the Department of Epidemiology, Mailman School of Public Health, Columbia University, and the New York State Psychiatric Institute, New York City. Deborah S. Hasin is in Department of Epidemiology, Mailman School of Public Health, Columbia University; the New York State Psychiatric Institute; and the Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY.

Correspondence: Address correspondence to Mark L. Hatzenbuehler, Department of Psychology, Yale University, PO Box 208205, New Haven, CT 06520 (e-mail: mark.hatzenbuehler{at}yale.edu). Reprints can be ordered at http://www.ajph.org by clicking on the "Reprints/Eprints" link.

Objectives. We examined the relation between living in states that instituted bans on same-sex marriage during the 2004 and 2005 elections and the prevalence of psychiatric morbidity among lesbian, gay, and bisexual (LGB) populations.

Methods. We used data from wave 1 (2001–2002) and wave 2 (2004–2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (N = 34 653), a longitudinal, nationally representative study of noninstitutionalized US adults.

Results. Psychiatric disorders defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, increased significantly between waves 1 and 2 among LGB respondents living in states that banned gay marriage for the following outcomes: any mood disorder (36.6% increase), generalized anxiety disorder (248.2% increase), any alcohol use disorder (41.9% increase), and psychiatric comorbidity (36.3% increase). These psychiatric disorders did not increase significantly among LGB respondents living in states without constitutional amendments. Additionally, we found no evidence for increases of the same magnitude among heterosexuals living in states with constitutional amendments.

Conclusions. Living in states with discriminatory policies may have pernicious consequences for the mental health of LGB populations. These findings lend scientific support to recent efforts to overturn these policies.