HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2008.153510v1 99/12/2275    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 Google Scholar Articles by Hatzenbuehler, M. L. Articles by Hasin, D. S. PubMed PubMed Citation Articles by Hatzenbuehler, M. L. Articles by Hasin, D. S. Related Collections Epidemiology Mental Health Lesbian/Gay/Bisexual/Transgender Persons

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

Mark L. Hatzenbuehler is with the Department of Psychology, Yale University, New Haven, CT. Katherine M. Keyes is with the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, and the New York State Psychiatric Institute, New York. Deborah S. Hasin is with the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York; the New York State Psychiatric Institute, New York; and the Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York.

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

Objectives. We investigated the modifying effect of state-level policies on the association between lesbian, gay, or bisexual status and the prevalence of psychiatric disorders.

Methods. Data were from wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a nationally representative study of noninstitutionalized US adults (N = 34 653). States were coded for policies extending protections against hate crimes and employment discrimination based on sexual orientation.

Results. Compared with living in states with policies extending protections, living in states without these policies predicted a significantly stronger association between lesbian, gay, or bisexual status and psychiatric disorders in the past 12 months, including generalized anxiety disorder (F = 3.87; df = 2; P = .02), post-traumatic stress disorder (F = 3.42; df = 2; P = .04), and dysthymia (F = 5.20; df = 2; P = .02). Living in states with policies that did not extend protections also predicted a stronger relation between lesbian, gay, or bisexual status and psychiatric comorbidity (F = 2.47; df = 2; P = .04).

Conclusions. State-level protective policies modify the effect of lesbian, gay, or bisexual status on psychiatric disorders. Policies that reduce discrimination against gays and lesbians are urgently needed to protect the health and well-being of this population.