Understanding Health-Care Needs of Sexual and Gender Minority Veterans: How Targeted Research and Policy Can Improve Health
AuthorsMattocks, Kristin M.
Kauth, Michael R.
Matza, Alexis R.
Sullivan, J. Cherry
Shipherd, Jillian C.
UMass Chan AffiliationsDepartment of Quantitative Health Sciences
Document TypeJournal Article
Keywordsbiology and sexual/gender minority status
mental health needs veteran
Gender and Sexuality
Health Services Administration
Military and Veterans Studies
MetadataShow full item record
AbstractGiven the size of the patient population of the Veterans Health Administration (VHA), it is likely the largest single provider of health care for sexual and gender minority (SGM) individuals in the United States, including lesbian, gay, bisexual, and transgender persons. However, current VHA demographic data-collection strategies limit the understanding of how many SGM veterans there are, thereby making a population-based understanding of the health needs of SGM veterans receiving care in VHA difficult. In this article, we summarize the emergent research findings about SGM veterans and the first initiatives that have been implemented by VHA to promote quality care. Though the research on SGM veterans is in its infancy, it suggests that SGM veterans share some of the health risks noted in veterans generally and also risks associated with SGM status. Some promising resiliency factors have also been identified. These findings have implications for both VHA and non-VHA systems in the treatment of SGM veterans. However, more research on the unique needs of SGM veterans is needed to fully understand their health risks and resiliencies in addition to health-care utilization patterns.
Kristin M. Mattocks, Michael R. Kauth, Theo Sandfort, Alexis R. Matza, J. Cherry Sullivan, and Jillian C. Shipherd. LGBT Health. March 2014, 1(1): 50-57. doi:10.1089/lgbt.2013.0003.
Permanent Link to this Itemhttp://hdl.handle.net/20.500.14038/51040
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A gender analysis of the study of pharmacotherapy of psychotic depression (STOP-PD): gender and age as predictors of response and treatment-associated changes in body mass index and metabolic measuresDeligiannidis, Kristina M.; Rothschild, Anthony J.; Barton, Bruce A.; Kroll-Desrosiers, Aimee; Meyers, Barnett S.; Flint, Alastair J.; Whyte, Ellen M.; Mulsant, Benoit H.; STOP-PD Study Group (2013-10-01)BACKGROUND: Gender differences exist in psychiatric disorders; however, gender has not been well studied in psychotic depression. This analysis of the largest clinical trial in psychotic depression examined the effects of age and gender on clinical characteristics and predictors of treatment outcome and treatment-associated changes in body mass index (BMI) and metabolic measures. METHOD: Secondary analyses were performed on data from 259 subjects with major depressive disorder with psychotic features (DSM-IV-TR) aged 18-93 years in the double-blind randomized controlled trial of olanzapine plus sertraline versus olanzapine plus placebo for psychotic depression (Study of Pharmacotherapy of Psychotic Depression). Sociodemographic factors, clinical characteristics, treatment outcome, and treatment-associated changes in BMI and metabolic measures were analyzed by gender and age. Subjects were enrolled from December 2002 to June 2007. RESULTS: Female gender was associated with divorced (χ(2)(1) = 5.3, P = .03) or widowed (χ(2)(1) = 8.1, P ≤ .01) marital status. Comorbid anxiety disorders were more common in women than in men (χ(2)(1) = 4.9, P = .03). Hallucinations (χ(2)(1) = 7.8, P = .005) and delusions with disorganization (t(257) = -2.10, P = .04) were significantly associated with female gender, as were higher cholesterol measures (χ(2)(1) = 7.15, P = .008). There were no significant interactions between treatment and gender in terms of change in BMI. Gender was not associated with treatment response. DISCUSSION: This study is the first analysis of gender and age as predictors of treatment outcome and treatment-associated changes in BMI and metabolic adverse effects in psychotic depression. Gender differences exist in patients with psychotic depression, most notably with regard to the presence of hallucinations. Female gender was associated with metabolic measures. Future studies with larger sample sizes may detect small gender differences in treatment outcome and treatment-associated changes in BMI and metabolic measures in psychotic depression. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT00056472.
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