Objective  To evaluate the prevalence of depression among sexual minorities in China by Meta-analysis.

Methods  Published literature related to depression among sexual minorities in China was searched electronically from CNKI, WanFang Data, VIP, PsycNet, PubMed and Web of Science. A Meta-analysis was conducted using Stata 17.0 and RevMan 5.4.1 software.

Results  A total of 29 articles were included, including 13 808 cases. The results of Meta-analysis showed that the prevalence of depression in Chinese sexual minorities was 41.00% [95%CI (38.00%, 45.00%), P﹤0.001]. The results of subgroup analysis showed that the prevalence of depression were 41.00% and 52.00% for men and women, respectively, and the difference was statistically significant (P=0.030).

Conclusion  The prevalence of depression among sexual minorities in China was relatively high, and there were certain differences in the prevalence of depression among sexual minorities in different gender.

1.Rusell ST, Fish JN. Mental health in lesbian, gay, bisexual, and transgender (LGBT) youth[J]. Annu Rev Clin Psycho, 2016, 12: 465-487. DOI: 10.1146/annurev-clinpsy-021815-093153.

2.联合国开发计划署. 中国性少数群体生存状况——基于性倾向、性别认同及性别表达的社会态度调查报告[EB/OL]. （2016-05-16）. [United Nations Development Programme. Being LGBTI in China—a national survey on social attitudes towards sexual orientation, gender identity and gender expression [EB/OL]. （2016-05-16）]. https://www.undp.org/sites/g/files/zskgke326/files/migration/cn/UNDP-CH-PEG-Being-LGBT-in-China_CH.pdf.

3.An X, Sun Q, Fang F, et al. The prevalence of depression associated with the infection status and sexual behaviors among men who have sex with men in Shenzhen, China: a cross-sectional study[J]. Int J Environ Res Public Health, 2019, 17(1): 127. DOI: 10.3390/ijerph17010127.

4.Chang R, Zeng C, Qiao S, et al. The mediating effect of depression on the relation between interpersonal needs and suicidal ideation among Chinese transgender women[J]. Front Public Health, 2022, 9: 764198. DOI: 10.3389/fpubh.2021.764198.

5.Li X, Yan H, Wang W, et al. Association between enacted stigma, internalized stigma, resilience, and depressive symptoms among young men who have sex with men in China: a moderated mediation model analysis[J]. Ann Epidemiol, 2021, 56: 1-8. DOI: 10.1016/j.annepidem.2021.01.001.

6.李世明, 冯为, 崔凤伟, 等. 中国男男性行为者抑郁患病率Meta分析[J]. 中国艾滋病性病, 2020, 26(12): 1318-1322. [Li SM, Feng W, Cui FW, et al. Prevalence of depression among men who have sex with men in China: a meta-analysis[J]. Chinese Journal of AIDS & STD, 2020, 26(12): 1318-1322.] DOI: 10.13419/j.cnki.aids.2020.12.13.

7.曾宪涛, 刘慧, 陈曦, 等. Meta分析系列之四:观察性研究的质量评价工具[J]. 中国循证心血管医学杂志, 2012, 4(4): 297-299. [Zeng XT, Liu H, Chen X, et al. Fourth part of series of Meta-analysis: quality evaluation tools for observational study[J]. Chinese Journal of Evidence-Based Cardiovascular Medicine, 2012, 4(4): 297-299.] DOI: 10.3969/j.1674-4055.2012.04.004.

8.Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in Meta-analyses[J]. Eur J Epidemiol, 2010, 25(9): 603-605. DOI: 10.1007/s10654-010-9491-z.

9.陈月红, 杜亮, 耿兴远, 等. 无对照二分类数据的Meta分析在RevMan软件中的实现[J]. 中国循证医学杂志, 2014, 14(7): 889-896. [Chen YH, Du L, Geng XY, et al. Implement meta-analysis with non-comparative binary data in RevMan software[J]. Chinese Journal of Evidence-Based Medicine, 2014, 14(7): 889-896.] DOI: 10.7507/ 1672-2531.20140147.

10.Liu J, Zhong X, Lu Z, et al. Anxiety and depression associated with anal sexual practices among HIV-negative men who have sex with men in western China[J]. Int J Environ Res Public Health, 2020, 17(2): 464. DOI: 10.3390/ijerph17020464.

11.Peng L, She R, Gu J, et al. The mediating role of self-stigma and self-efficacy between intimate partner violence (IPV) victimization and depression among men who have sex with men in China[J]. BMC Public Health, 2020, 20(1): 2. DOI: 10.1186/s12889-019-8125-y.

12.赖志胜, 李艳芳, 卢次勇, 等. 广州市男男性行为者抑郁状况及影响因素分析[J]. 预防医学情报杂志, 2019, 35(12): 1354-1358. [Lan ZS, Li YF, Lu CY, et al. Depression status and related influencing factors of men who have sex with men in Guangzhou city[J]. Journal of Preventive Medicine Information, 2019, 35(12): 1354-1358.] DOI: CNKI:SUN:YFYX.0.2019-12-005.

13.陈向凡. 儿童期不良经历对男男性行为人群抑郁影响的机制研究[D]. 武汉: 武汉大学, 2022. [Chen XF. A study on the mechanism of the effect of adverse childhood experiences on depression symptom among men who have sex with men[D]. Wuhan: Wuhan University, 2022.] DOI: 10.27379/d.cnki.gwhdu.2020.000700.

14.潘雪梅, 陈振波, 郑文娟, 等. 连州市男男性行为人群抑郁及生存质量现状及其影响因素[J].江苏预防医学, 2016, 27(1): 44-47. [Pan XM, Chen ZB, Zheng WJ, et al. Investigation of current status of depression, quality of life and influencing factors among men who have sex with men in Lianzhou[J]. Jiangsu Journal of Preventive Medicine, 2016, 27(1): 44-47.] DOI: 10.13668/j.issn.1006-9070. 2016.01.013.

15.高晓娟, 章任重, 李佑芳, 等. 昆明市男男性行为者的抑郁状况及影响因素分析[J]. 中国艾滋病性病, 2018, 24(2): 170-173. [Gao XJ, Zhang RZ, Li YF, et al. Depression and related influential factors among men who have sex with men in Kunming[J]. Chinese Journal of AIDS & STD, 2018, 24(2): 170-173.] DOI: 10.13419/j.cnki.aids.2018.02.16.

16.郭孟兰. 不同童年期不良经历的青少年男男性行为者抑郁发展轨迹及与性取向相关歧视的关系[D]. 武汉: 武汉大学, 2022. [Guo ML. The depressive trajectories among adolescents who have sex with men with different childhood adverse experiences and their associations with the stigma towards homosexuality[D]. Wuhan: Wuhan University, 2022.] DOI: 10.27379/d.cnki.gwhdu.2022.000234.

17.郭孟兰, 王丽茵, 段志洲, 等. 青少年女同性恋人群抑郁状况及与领悟社会支持关系[J]. 中国公共卫生, 2021, 37(12): 1805-1808. [Guo ML, Wang LY, Duan ZZ, et al. Depressive symptoms, perceived social support and their correlation among adolescent lesbians[J]. Chinese Journal of Public Health, 2021, 37(12): 1805-1808.] DOI: 10.11847/zgggws1132758.

18.洪也婷, 黄莹, 林铠浩, 等. 广州市青年男男性行为者儿童期性虐待经历对抑郁的影响[J]. 中国学校卫生, 2022, 43(5): 711-714. [Hong YT, Huang Y, Lin KH, et al. Impact of childhood sexual abuse on depression among young men who have sex with men in Guangzhou[J]. Chinese Journal of School Health, 2022, 43(5): 711-714.] DOI: 10.16835/j.cnki.1000-9817.2022.05.016.

19.胡珊. MSM人群焦虑抑郁的共病性及其与HIV高危行为的关系[D]. 重庆: 重庆医科大学, 2016. [Hu S. Comorbidity of anxiety and depression and their association with HIV high risk behaviors among men who have sex with men (MSM)[D]. Chongqing: Chongqing Medical University, 2016.] DOI: 10.7666/d.D01121251.

20.贾晓飞, 赖文健, 张宏, 等. 2016-2018年广州市男性同性恋人群抑郁症状与自杀意念的关联分析[J]. 预防医学情报杂志, 2020, 36(4): 371-375, 381. [Jia XF, Lai WJ, Zhang H, et al. Association between depressive symptoms and suicidal ideation among male homosexuals in Guangzhou city from 2016 to 2018[J]. Journal of Preventive Medicine Information, 2020, 36(4): 371-375, 381.] DOI: CNKI:SUN:YFYX.0.2020-04-002.

21.张丹丹, 洪航, 姜海波. 宁波市男男性行为人群抑郁状况调查[J]. 预防医学, 2018, 30(5): 442-445. [Zhang DD, Hong H, Jiang HB. Depression in men who have sex with men in Ningbo[J]. China Preventive Medicine Journal, 2018, 30(5): 442-445.] DOI: 10.19485/j.cnki.issn2096-5087.2018.05.003.

22.姜婷婷, 潘晓红, 王憓, 等. 浙江省男男性行为者抑郁和焦虑状况及其相关因素分析[J]. 中国艾滋病性病, 2016, 22(5): 357-360, 368. [Jiang TT, Pan XH, Wang H, et al. Depression, anxiety symptoms and related influential factors among man who have sex with man in Zhejiang[J]. Chinese Journal of AIDS & STD, 2016, 22(5): 357-360, 368.] DOI: 10.13419/j.cnki.aids.2016.05.15.

23.荆少华. 基于结构方程模型的男男性行为接触者焦虑、抑郁症状影响因素研究[D]. 重庆: 重庆医科大学, 2016. [Jing SH. Based on the structural equation model in contact with male research to the influential factors of anxiety and depression symptoms[D]. Chongqing: Chongqing Medical University, 2016.] DOI: 10.7666/d.D01121270.

24.王丽茵, 丁昌棉, 郭孟兰, 等. 中国女同性恋人群抑郁现状及影响因素[J]. 中华疾病控制杂志, 2021, 25(12): 1393-1397. [Wang LY, Ding CM, Guo ML, et al. Depression status and its influencing factors of lesbians in China[J]. Chinese Journal of Disease Control & Prevention, 2021, 25(12): 1393-1397.] DOI: 10.16462/j.cnki.zhjbkz. 2021.12.006.

25.李小燕. 青少年与非青少年男男性行为者性少数群体压力对其抑郁的影响[D]. 武汉: 武汉大学, 2020. [Li XY. The impact of sexuality minority stress on the depressive symptoms among adolescents and non-adolescents men who have sex with men[D]. Wuhan: Wuhan University, 2020.] DOI: 10.27379/d.cnki.gwhdu. 2020.000170.

26.刘珺, 郜艳晖, 梁自勉, 等. 广东省佛山市男男性行为者抑郁状况、性行为特征及关联研究[J]. 中华流行病学杂志, 2012, 33(5): 483-487. [Liu J, Gao YH, Liang ZM, et al. Depressive symptoms and associated sexual behaviors among men who have sex with men in Foshan, Guangdong province[J]. Chinese Journal of Epidemiology, 2012, 33(5): 483-487.] DOI: 10.3760/cma.j.issn.0254-6450.2012.05.008.

27.宋丽萍, 张振开, 汤杰, 等. 社会支持与男男性行为者抑郁症状的关系[J]. 中国艾滋病性病, 2017, 23(3): 240-243. [Song LP, Zhang ZK, Tang J, et al. Social support and depression among MSM[J]. Chinese Journal of AIDS & STD, 2017, 23(3): 240-243.] DOI:10.13419/j.cnki.aids. 2017.03.18.

28.王毅, 李六林, 周万明, 等. 男男性行为者焦虑抑郁症状与艾滋病知识、风险认知及性行为的关系[J]. 中华行为医学与脑科学杂志, 2019, 28(1): 80-84. [Wang Y, Li LL, Zhou WM, et al. The relationship of anxiety and depression symptoms with AIDS knowledge, cognition of risk and sex behavior in young men who have sex with men[J]. Chinese Journal of Behavioral Medicine and Brain Science, 2019, 28(1): 80-84.] DOI: 10.3760/cma.j.issn.1674-6554.2019.01.015.

29.王毅, 张洪波, 徐杰, 等. 男男性行为人群的抑郁症状及相关因素[J]. 中国心理卫生杂志, 2010, 24(5): 366-367, 369. [Wang Y, Zhang HB, Xu J, et al. Related factor of depressive disorder in men who have sex with men[J]. Chinese Mental Health Journal, 2010, 24(5): 366-367, 369.] DOI: 10.3969/j.issn.1000-6729.2010.05.012.

30.吴杰, 卢次勇, 郝元涛, 等. 广州市男男性接触人群社会心理状况调查[J]. 中国公共卫生, 2011, 27(4): 476-478. [Wu J, Lu CY, Hao YT, et al. Psychosocial status of MSM population in Guangzhou city[J]. Chinese Journal of Public Health, 2011, 27(4): 476-478.] DOI: CNKI:SUN:ZGGW.0.2011-04-046.

31.谢娟. 女同性恋者社会支持、自我效能感与心理健康的关系研究[D]. 成都: 四川师范大学, 2014. [Xie J. On the relations among lesbian's social support, self-self-efficacy and mental health[D]. Chengdu: Sichuan Normal University, 2014.] DOI: CNKI:CDMD:2.1014.333410.

32.易柳. 同性恋者身份认同、对社会态度的感知与心理健康的关系研究[D]. 广州: 广州大学, 2011. [Yi L. The relationship between competency and management performance of the manager in an enterprise[D]. Guangzhou: Guangzhou University, 2011.] https://cdmd.cnki.com.cn/Article/CDMD-11078-1012262557.htm.

33.张舒娴. 上海市部分男男性行为者焦虑抑郁现状及其相关因素研究[D]. 上海: 上海交通大学, 2020. [Zhang SX. The prevalence of anxiety and depression symptoms and their related factors among men who have sex with men (MSM) in Shanghai[D]. Shanghai: Shanghai Jiao Tong University, 2020.] DOI: 10.27307/d.cnki.gsjtu.2020.003724.

34.郑迎军, 许娟, 张洪波. 男男性接触者焦虑、抑郁与艾滋病高危性行为的关系[J]. 中国心理卫生杂志, 2005, 19(10): 699-701. [Zheng YJ, Xu J, Zhang HB, et al. Anxiety, depression and high-risk behaviors among men who have sex with men[J]. Chinese Mental Health Journal, 2005, 19(10): 699-701.] DOI: 10.3321/j.issn:1000-6729. 2005.10.021.

35.周娓, 吴锋, 龚静. 男男性行为者抑郁症状及相关因素研究[J]. 预防医学, 2015, 27(7): 657-660. [Zhou W, Wu F, Gong J. A study on the status of depressive symptoms and its influencing factors among men who have sex with men[J].  Preventive Medicine, 2015, 27(7): 657-660.] DOI: 10.19485/j.cnki.issn1007-0931.2015.07.003.

36.Oginni OA, Mosaku KS, Mapayi BM, et al. Depression and associated factors among gay and heterosexual male university students in Nigeria[J]. Arch Sex Behav, 2018, 47(4): 1119-1132. DOI: 10.1007/s10508-017-0987-4.

37.Björkenstam C, Björkenstam E, Andersson G, et al. Anxiety and depression among sexual minority women and men in Sweden: is the risk equally spread within the sexual minority population?[J]. J Sex Med, 2017, 14(3): 396-403. DOI: 10.1016/j.jsxm.2017.01.012.

38.Huang Y, Wang Y, Wang H, et al. Prevalence of mental disorders in China: a cross-sectional epidemiological study[J]. Lancet Psychiatry, 2019, 6(3): 211-224. DOI: 10.1016/S2215-0366(18)30511-X.

39.Malhi GS, Outhred T, Das P, et al. Modeling suicide in bipolar disorders[J]. Bipolar disord, 2018, 20(4): 334-348. DOI: 10.1111/bdi.12622.

40.Miranda-Mendizabal A, Castellví P, Parés-Badell O, et al. Gender differences in suicidal behavior in adolescents and young adults: systematic review and meta-analysis of longitudinal studies[J]. Int J Public Health, 2019, 64(2): 265-283. DOI: 10.1007/s00038-018-1196-1.

41.白银霜. 女同性恋的出柜过程——一项叙事研究 [D]. 武汉: 华中师范大学, 2021. [Bai YS. The process of lesbian coming out of the closet: a narrative study[D]. Wuhan: Central China Normal University, 2021.] DOI: 10.27159/d.cnki.ghzsu.2020.002349.

42.宋思. 社会化媒体下的男同性恋身份认同研究——以社交媒体Blued为例[D]. 广州: 暨南大学, 2017. [Song S. Research on the identity of male homosexual under social media: a case study on the social media Blued[D]. Guangzhou: Jinan University, 2017.] https://d.wanfangdata.com.cn/thesis/D01030792.

43.张宇迪, 张迪. 异性恋大学生认为同性恋正常吗?——多元文化接受度的分析[J]. 中国健康心理学杂志, 2020, 28(2): 222-226. [Zhang YD, Zhang D. Do heterosexual college students think homosexuality is normal?—an analysis based on the acceptance of multiculturalism[J]. China Journal of Health Psychology, 2020, 28(2): 222-226.] DOI: 10.13342/j.cnki.cjhp. 2020. 02.016.

44.秦韬. 重庆市男同性恋者生活状况及主观幸福感调查研究[D]. 重庆: 西南大学, 2010. [Qin T. Investigation on living conditions and subjective well-being of gay men in Chongqing[D]. Chongqing: Southwest University, 2010.] DOI: 10.7666/d.y1640910.

45.达福文. 基于互联网的中国男同性恋人口空间格局研究[D]. 兰州: 兰州大学, 2019. [Da FW. Research on the spatial pattern of Chinese gay population—based on internet[D]. Lanzhou: Lanzhou University, 2019.] https://d.wanfangdata.com.cn/thesis/D01768958.

46.孙振晓, 刘化学, 焦林瑛, 等. 两种抑郁自评量表对心血管疾病患者抑郁症状评定的一致性研究[J]. 中华临床医师杂志(电子版), 2016, 10(23): 3535-3537. [Sun ZX, Liu HX, Jiao LY, et al. Agreement of two scales in assessment depression in patients with cardiovascular diseases[J]. Chinese Journal of Clinicians (Electronic Edition), 2016, 10(23): 3535-3537.] DOI: 10.3877/cma.j.issn.1674-0785.2016.23.010.

47.严梦琴, 肖水源, 胡宓. 我国一些抑郁量表的中文翻译与信效度问题[J]. 中国心理卫生杂志, 2016, 30(7): 501-505. [Yan MQ, Xiao SY, Hu M. Reliability and validity of some depression scales in China[J]. Chinese Mental Health Journal, 2016, 30(7): 501-505.] DOI: 10.3969/j.issn.1000-6729.2016.07.005.

48.贾长旺. 我国同性恋群体人身权益保护问题研究[D]. 北京: 中国人民公安大学, 2021. [Jia CW. Research on the protection of the personal rights and interests of homosexual groups in China[D]. Beijing: People's Public Security University of China, 2021.] https://kns.cnki.net/kcms2/article/abstract?v=-0THPtffOh2-er1BjiIbSCoGv-pcRu7BvCb5ht-kt7nuNR4sD0sf79i9JDgDXv1Iy5O6XrhWWWAkGakVC7XzJfZe0fSoSja3_-AtOomKPySx-VXPz4BubS5zRyxeu3wyF5F3rP_iJ0DCg2mnjDxlAw==&uniplatform=NZKPT&language=CHS.

49.Otte C, Gold SM, Penninx BW, et al. Major depressive disorder[J]. Nat Rev Dis Primers, 2016, 2: 16065. DOI: 10.1038/nrdp.2016.65.

50.谭晓东. 现代人的精神卫生及社会管理[J]. 人民论坛, 2020, (29): 76-78. [Tan XD. Modern mental health and social management[J]. People's Tribune, 2020, (29): 76-78.] DOI: 10.3969/j.issn.1004-3381.2020.29.027.

51.黄怡. 当代中国大学生同性恋现状及伦理困境研究——以XX大学为例[D]. 南昌: 南昌大学, 2017. [Huang Y. Study on homosexual status and ethical dilemmas of contemporary college students in China—in the case of the XX university[D]. Nanchang: Nanchang University, 2017.] DOI: 10.7666/d.D01054277.