Papers by Michal M Pitoňák
Studia Psychologica, Dec 30, 2022
Minority stress theory explains psychological vulnerability in sexual minorities; however, data i... more Minority stress theory explains psychological vulnerability in sexual minorities; however, data is scarce in the Central and Eastern European region. Combining the minority stress model with the Psychological Mediation Framework, we tested a theoretically developed path model. Participants were 1452 (M age = 24.9 years) Czech sexual-minority individuals (38.7% gay, 27.1% lesbian, 18.7% bisexual women). The model explained 55.5% of the variance of psychological distress in the overall sample, representing a total effect of 9.75% (p < .001) increase in measurement units by the modeled associations. Within the subsamples, the associations were similar between harassment and rejection, stigma awareness, and rejection sensitivity, as well as emotional dysregulation, rumination, and psychological distress. However, internalized homonegativity was a stronger factor of psychological well-being in gay men and lesbian women than in bisexual women. Bisexual women may have experienced less social support and more emotional dysregulation due to more concealment and rejection sensitivity, respectively. While we confirmed that the minority stress model applies to the Czech context and explained well psychological distress in sexual minorities, our data highlights notable differences between bisexual women who reported highest rates of distress compared to gay men and lesbian women.
Epidemiology and psychiatric sciences, 2024
Aims. The mental health of sexual minority (SM) individuals remains overlooked and understudied i... more Aims. The mental health of sexual minority (SM) individuals remains overlooked and understudied in Czechia. We aimed to estimate (1) the prevalence rate and (2) the relative risk of common mental disorders and (3) the mental distress severity among the Czech SM people compared with the heterosexual population. In addition, we aimed to investigate help-seeking for mental disorders in SM people. Methods. We used data from a cross-sectional, nationally representative survey of Czech community-dwelling adults, consisting of 3063 respondents (response rate = 58.62%). We used the Mini-International Neuropsychiatric Interview to assess the presence of mental disorders. In individuals scoring positively, we established help-seeking in the past 12 months. We assessed symptom severity using the 9-item Patient Health Questionnaire and the 7-item Generalized Anxiety Disorder scale. We computed the prevalence of mental disorders and the treatment gap with 95% confidence intervals. To assess the risk of having a mental disorder, we used binary logistic regression. Results. We demonstrated that the prevalence of current mental disorders was 18.85%
E-psychologie, 2024
Úvod: Tato studie hodnotí psychometrické vlastnosti české adaptace Škály suicidální ideace (Suici... more Úvod: Tato studie hodnotí psychometrické vlastnosti české adaptace Škály suicidální ideace (Suicidal Ideation Attributes Scale, SIDAS) vyvinuté za účelem snadné online administrace a hodnotí její použití u LGBT+ osob.
Metody: Pomocí konfirmační faktorové analýzy jsme zkoumali faktorovou strukturu a invarianci měření napříč jednotlivými LGBT+ skupinami ve výběrovém souboru 1 778 zúčastněných.
Výsledky: Naše data podporují jednofaktorovou strukturu SIDAS a částečnou invarianci měření, což umožňuje porovnávání suicidální ideace mezi jednotlivými skupinami LGBT+ osob. SIDAS koreluje se škálami měřícími pocit osamělosti, dysregulaci emocí, vnímaný stres, ruminaci a životní spokojenost.
Diskuse: SIDAS představuje cenný nástroj pro hodnocení sebevražedných myšlenek u LGBT+ osob, je vhodný pro online použití a má potenciál usnadňovat vývoj, plánování i vyhodnocování účinnosti cílených intervencí. Budoucí výzkum by měl prozkoumat stabilitu skóru v čase a vývoj dalších proměnných pro hodnocení závažnosti suicidality.
Psychiatrie pro praxi, 2023
CZ: Tento článek kriticky posuzuje platnost tradičních modelů comingoutu v kontextu současného Če... more CZ: Tento článek kriticky posuzuje platnost tradičních modelů comingoutu v kontextu současného Česka, neboť integruje zažité přístupy a moderní realitu. Ke zkoumání vývoje tří milníků coming outu (M1-přitažlivost, M2-sebeoznačení a M3-odhalení) ve vývoji neheterosexuální identity byl využit online průzkum, kterého se zúčastnilo 1 778 osob (ve věku 15 až 71 let). Z výsledků vyplývá, že svou touhu neheterosexuální lidé rozpoznají kolem 13, roku života, průměrně přes dva další roky trvá, než tuto svou identitu poprvé pojmenují, a průměrně ještě téměř dva další roky trvá, než se daná osoba rozhodne svěřit někomu dalšímu. První "vnější coming out" tak probíhá průměrně ve věku necelých 17 let. V rámci studie jsme potvrdili generační i genderové rozdíly, přičemž mladší generace procházejí těmito vývojovými milníky rychleji a tradiční genderové rozdíly se u nich stírají. Článek také naznačuje budoucí směr výzkumu, včetně zkoumání nástupu přitažlivosti u bisexuálních a pansexuálních osob osob a vzorců přitažlivosti vůči trans a genderově rozmanitým osobám, a také posouzení toho, jak stigma a předsudky ovlivňují vývoj neheterosexuální identity.
ENG: This paper critically examines the applicability of traditional coming-out models in the context of contemporary Czechia, integrating rooted approaches and modern realities. An online survey of 1,788 participants (aged 15 to 71) was utilized to investigate progression between three coming-out milestones (M1-Attraction; M2-Self-Labeling; and M3-Disclosure) in the development of non-heterosexual identity. Results reveal that non-heterosexual individuals typically recognize their desire around age 13, self-label, on average, just over two years later, and disclose their identity to another person at an average age of just under 17. Notably, the study highlights generational and gender differences in these milestones, with younger generations progressing faster and traditional gender distinctions becoming less distinct. The paper also identifies future research directions, including exploring the onset of attractions in bisexual and pansexual individuals and attraction patterns toward trans and gender-diverse individuals, and assessing how stigma and prejudice shape non-heterosexual identity development.
Epidemiology and Psychiatric Sciences, 2024
Aims
The mental health of sexual minority (SM) individuals remains overlooked and understudied in... more Aims
The mental health of sexual minority (SM) individuals remains overlooked and understudied in Czechia. We aimed to estimate (1) the prevalence rate and (2) the relative risk of common mental disorders and (3) the mental distress severity among the Czech SM people compared with the heterosexual population. In addition, we aimed to investigate help-seeking for mental disorders in SM people.
Methods
We used data from a cross-sectional, nationally representative survey of Czech community-dwelling adults, consisting of 3063 respondents (response rate = 58.62%). We used the Mini-International Neuropsychiatric Interview to assess the presence of mental disorders. In individuals scoring positively, we established help-seeking in the past 12 months. We assessed symptom severity using the 9-item Patient Health Questionnaire and the 7-item Generalized Anxiety Disorder scale. We computed the prevalence of mental disorders and the treatment gap with 95% confidence intervals. To assess the risk of having a mental disorder, we used binary logistic regression.
Results
We demonstrated that the prevalence of current mental disorders was 18.85% (17.43–20.28), 52.27% (36.91–67.63), 33.33% (19.5–47.17) and 25.93% (13.85–38) in heterosexual, gay or lesbian, bisexual and more sexually diverse individuals, respectively. Suicidal thoughts and behaviours were present in 5.73% (4.88–6.57), 25.00% (11.68–38.32), 22.92% (10.58–35.25) and 11.11% (2.45–19.77) of heterosexual, gay or lesbian, bisexual and more sexually diverse individuals, respectively. After confounder adjustment, gay or lesbian individuals were more likely to have at least one current mental disorder compared with heterosexual counterparts (odds ratio = 3.51; 1.83–6.76). For bisexual and sexually more diverse individuals, the results were consistent with a null effect (1.85; 0.96–3.45 and 0.89; 0.42–1.73). The mean depression symptom severity was 2.96 (2.81–3.11) in heterosexual people and 4.68 (2.95–6.42), 7.12 (5.07–9.18) and 5.17 (3.38–6.95) in gay or lesbian, bisexual and more sexually diverse individuals, respectively. The mean anxiety symptom severity was 1.97 (1.85–2.08) in heterosexual people and 3.5 (1.98–5.02), 4.63 (3.05–6.2) and 3.7 (2.29–5.11) in gay or lesbian, bisexual and more sexually diverse individuals, respectively. We demonstrated broadly consistent levels of treatment gap in heterosexual and SM individuals scoring positively for at least one current mental disorder (82.91%; 79.5–85.96 vs. 81.13%; 68.03–90.56).
Conclusions
We provide evidence that SM people in Czechia have substantially worse mental health outcomes than their heterosexual counterparts. Systemic changes are imperative to provide not only better and more sensitive care to SM individuals but also to address structural stigma contributing to these health disparities.
Studia Psychologica: Theoria et Praxis, 2022
Minority stress theory explains psychological vulnerability in sexual minorities; however, data i... more Minority stress theory explains psychological vulnerability in sexual minorities; however, data is scarce in the Central and Eastern European region. Combining the minority stress model with the Psychological Mediation Framework, we tested a theoretically developed path model. Participants were 1452 (Mage = 24.9 years) Czech sexual-minority individuals (38.7% gay, 27.1% lesbian, 18.7% bisexual women). The model explained 55.5% of the variance of psychological distress in the overall sample, representing a total effect of 9.75% (p < .001) increase in measurement units by the modeled associations. Within the subsamples, the associations were similar between harassment and rejection, stigma awareness, and rejection sensitivity, as well as emotional dysregulation, rumination, and psychological distress. However, internalized homonegativity was a stronger factor of psychological well-being in gay men and lesbian women than in bisexual women. Bisexual women may have experienced less social support and more emotional dysregulation due to more concealment and rejection sensitivity, respectively. While we confirmed that the minority stress model applies to the Czech context and explained well psychological distress in sexual minorities, our data highlights notable differences between bisexual women who reported highest rates of distress compared to gay men and lesbian women.
Ceskoslovenska psychologie
Early affirmative approaches sensitive toward non-heterosexual (mostly gay) peopleʼs adjustment t... more Early affirmative approaches sensitive toward non-heterosexual (mostly gay) peopleʼs adjustment to societal stigma proposed numerous stage models, also known as coming out models, all of which postulated some universal progression from the point of first individualʼs awareness of their sexual attractions ultimately toward a synthesis of their sexual identity within their self-concept (Cass, 1984; Weinberg, 1972). Although these early approaches tapped into essential facets of sexual identity development, they became criticized for being overly essentialist, prescriptively unidirectional, and, most importantly, not being empirically validated (Cohler & Hammack, 2007; Savin
International Journal of Health Geographics, 2014
Background: A youths' neighborhood can play an important role in their physical, health, and emot... more Background: A youths' neighborhood can play an important role in their physical, health, and emotional development. The prevalence of health risk behavior (HRB) in Czech youth such as smoking, drug and alcohol use is the highest in Europe. Aim: To analyze differences in HRB in youth residents within different types of Prague's neighborhoods in relation to the perception of the built environment, quality of their school and home environments. Data and methods: The data is based on the on-line survey among elementary school students aged between 14-15 years, which was administered in19 selected schools in Prague, during the months of October 2013 to March 2014. Respondents were asked their opinions on various issues related to their HRB, about their indoor and outdoor housing and school environments. The questionnaire was completed by 407 students. Factor analysis with a principal components extraction was applied to determine the underlying structure in the variables. A consequent field research was conducted to map the opportunity hot spots and critical places around the elementary schools. Results: Binge drinking has been reported mainly by the students living in the housing estates with blocks of flats. The most frequent occurrence of daily smokers was found in the neighborhoods of old city apartment houses. High prevalence of risky marijuana use almost in all the surveyed types of neighborhoods. The respondents were more critical in their evaluation of school characteristics. The neighborhoods critically evaluated by the students as regards the school outdoor environments were the older apartment houses in the historical centre and inner city, the school indoor environment was worst assessed within the housing estate neighborhoods. Conclusions: Our results suggest that perceptions of problems in both residential and school environment are associated with HRB. This fact makes this issue of a serious importance also from the policy point of view. Mainly the school surroundings have to be better managed by the local authorities responsible for the public space. This research thus forms part of the Sophie project aiming to find the most efficient policies that would tackle with the inequalities in the health and quality of life.
Journal of Bisexuality, 2023
Sexuality and gender identity measures are rarely included in population-level health studies, ev... more Sexuality and gender identity measures are rarely included in population-level health studies, even though research shows that sexual minorities are among the groups most vulnerable to psychological distress. In this study, we strive to make the first step towards overcoming this gap in data availability in Czechia. We used data from a recent Czech General population sample (N = 1,841) aged from 15 to 92 with mean = 46,53 and SD = 17,68 years and a Czech sexual minority community sample (N = 1,788) aged from 15 to 71 with mean = 24.2 and SD = 10.1 years that included 642 gay or lesbian men (either cis or trans), 427 gay or lesbian women (either cis or trans), and 450 bisexual individuals (94 men and 356 women, both either cis or trans). We found that all LGB+ subgroups had significantly higher levels of psychological distress compared to general population as measured by Brief Symptom Inventory. This effect was more pronounced in bisexual participants than in gay and lesbian participants. This is the first Czech study focused on comparison of the differences in psychological distress between the general population and sexual minorities. Our study shows that overcoming the lack of inclusion of sexuality and gender identity measures in relevant population health surveys needs to be addressed soon.
Psychiatrie pro praxi, 2022
Minority stress theory is now a recognised interpretive framework through which we can understand... more Minority stress theory is now a recognised interpretive framework through which we can understand the factors that negatively affect the mental health of non-heterosexual people. In this review paper, I introduce the basic premises of this approach and discuss three key proximal minority stress processes - internalized homonegativity, motivation to conceal sexual identity, and rejection sensitivity. I conclude by highlighting current practice in transdiagnostic interventions.
Drawing on rigorous foreign, both Western and non-Western, literature, this thesis introduces sex... more Drawing on rigorous foreign, both Western and non-Western, literature, this thesis introduces sexuality and its connected spatial conceptualizations to Czech geography. In the beginning of the theoretical part, I discuss the framework under which geography studies sexuality. Then, I discuss the crucial terminology while pointing out at some changes in it. After understanding some of the major terminological issues, I delve into a description of the multiple and diverse development of sexuality related geographies. Focusing on queer geography, I delineate the queer standpoint and concentrate on understanding the spatial construction of sexuality in space while unveiling the heteronormativity of space. Using the queer approach, I implicitly deconstruct the binary of public and private space by pointing out at its spuriousness regarding the sexuality. I present a queer bar as a typical queer space while revealing the sexual closetedness of LGBTIQ people. Then I introduce the school env...
Geografický výzkum: participace a angažovanost, 2013
Studies of sexualities in geography challenged the profound omissions of issues connected with di... more Studies of sexualities in geography challenged the profound omissions of issues connected with difference as part of the human experience. This research began three decades ago in the Anglo-American geographic academy. I insist that it is time we developed this sensitivity to difference here as well. The cultural turn in geography and spatial turn in the other social sciences have intensified circulation of knowledge and most importantly with respect to this article have facilitated the production of knowledge based on the perspective of sexual difference. This paper reacts to the current state of Czech geography and aims to raise its awareness of various phenomena such as heteronormativity or queer subjectivity which are yet to be understood in Czech socio-spatial contexts.
Ceskoslovenska psychologie, 2021
Proč se potřebujeme ptát na sexualitu? Otázky týkající se sexuality, na rozdíl od pohlaví, věku n... more Proč se potřebujeme ptát na sexualitu? Otázky týkající se sexuality, na rozdíl od pohlaví, věku nebo výše příjmu, nepatří mezi běžně zařazované demografické položky v rámci dotazníkových šetření. Jen 15 ze 36 zemí OECD se doposud alespoň jedenkrát na sexualitu respondentů dotázalo v rámci národně-reprezentativního výzkumu (Bates et al., 2019). V důsledku historické perzekuce sexuálních menšin lze sice opatrnost ohledně monitorování sexuální orientace v populaci chápat, přehlížení sexuality jako klíčové proměnné v rámci relevantních výzkumů veřejného zdraví, epidemiologie, psychologie, demografie, sociální péče a dalších oblastí je však zároveň hlavní příčinou nedostatku informací například o kvalitě života a zdravotním stavu skupin obyvatel, které se odlišují od ostatních primárně v oblasti sexuality.
European Journal of Public Health, 2020
Background Evidence shows that sexual minorities are more vulnerable to substance use and psychol... more Background Evidence shows that sexual minorities are more vulnerable to substance use and psychological distress as a result of minority stress compared with heterosexuals. So far, research conducted outside North America or Western Europe has been underrepresented. This research compares for the first time the substance use, quality of mental health and life satisfaction between the sexual minority people and heterosexuals using a nationally representative probability sample in the Czech population. Methods Sample of the general population aged 15+ years surveyed within the National Survey on Substance Use in 2016 in randomly selected households (N = 3,601, F2F interviews). Prevalence of licit and illicit substance use, psychological distress (MHI-5 scale) and life satisfaction (SWLS scale) were analyzed by respondents' self-reported sexual identity and behaviors. Logistic regressions were applied to evaluate the differences between groups. Adjustment for basic sociodemographic...
Geografie, 2014
The relevance and importance of sexualities as a geographical issue is yet to be recognized in Cz... more The relevance and importance of sexualities as a geographical issue is yet to be recognized in Czechia, wherefore the main purpose of this article is to give spark to momentum to Czech geographies of sexualities. Consecutively, understandings of the issue produced from outside of the ‘West’ may contribute to our general knowledge about diverse spatialities of sexualities. For the sake of coherence, I narrow my discussion to urban geographies of sexualities and their various epistemologies. I begin with presenting evidence which suggests that sexualities have already been considered to be an important geographical subject in most Anglophone countries over the past 20 years. For this reason, the article is focused mostly on an Anglo-Saxon literature review figuring sexualities as being either social relations, axis of difference, social identities or categories not less important than gender, race and social class. I highlight the importance of discourse and its role in the social con...
Gender, Place & Culture, 2019
In this contribution we discuss the obstacles and share our opinions about the causes of delayed ... more In this contribution we discuss the obstacles and share our opinions about the causes of delayed development of feminist and queer approaches in Czech and to some extent also Slovak human geographies. We primarily focus on a critical description of causes and factors that affected and continue to hinder their presence within local mainstream geographical thought. Among the most pressing problems, we identify the historically conditioned isolation of local geography from the 'Western' developments, the continued conservativism of the mainstream geographers, and we attempt to open up a discussion about several types of 'disciplinary anxieties' that may perpetuate these problems. Further, we stress the continued shared development of the Czech and Slovak geographies and contextualize it within recent advancements in other neighboring countries where scholars also 'fight for recognition'. Our contribution concludes with a call for intensification of cooperation and networking within (and outside of) the Central and Eastern European region which we believe is a crucial factor required for building up vibrant feminist and queer geographies with both local and international recognition.
Mental Health & Prevention, 2017
Compared to heterosexuals, non-heterosexuals report: a) higher overall prevalence of internalizin... more Compared to heterosexuals, non-heterosexuals report: a) higher overall prevalence of internalizing mental disorders such as depression and anxiety; b) several-fold higher levels of suicidal behavior; c) elevated rates of tobacco, alcohol, and substance (ab)use; d) higher rates of risky-sexual behaviors that include higher risks of contracting STD's. This review explicates two of the most salient explanatory frameworks-Meyer's Minority Stress Theory (MST) and Hatzenbuehler's Psychological Mediation Framework (PMF) available for explaining these health outcomes. Prospects for future transdiagnostic interventions are outlined.
Central European Journal of Public Health
Objectives: Chemsex is a phenomenon highly relevant to public health concerns. Our primary aim is... more Objectives: Chemsex is a phenomenon highly relevant to public health concerns. Our primary aim is to describe the Czech chemsex scene regarding substances used, sexual behaviour, mental health, sexual life satisfaction, internalization of homonegative attitudes, and prevalent chemsex patterns. Methods: The data from the European Men Who Have Sex With Men Internet Survey (EMIS) 2017 were used. The mental health of chemsex users was assessed by the Patient Health Questionnaire 4 (PHQ4), internalized homonegativity was measured using the Short Internalized Homonegativity Scale. A sample of 87 men who have sex with men (MSM) chemsex users and a comparison group of 261 MSM were selected from the total sample of 1,688 respondents. Mann-Whitney and χ² tests were used to compare groups. Results: Active chemsex users made up 5% of the sample (87 of 1,688), with an average age of 37 years. Chemsex users were more likely to engage in condomless sex with non-steady partners (χ² = 46.8, p < 0.001), and had dramatically more STIs, such as HIV (χ² = 52.9, p < 0.001), HCV (χ² = 25.9, p < 0.001), and syphilis (χ² = 41.5, p < 0.001). Chemsex users frequently injected drugs (n = 19, 20%). More than half (n = 48; 55%) of chemsex users had sober sex in the last 4 weeks. Chemsex culture was associated with riskier substance use, both in terms of mode and frequency. The mental health of chemsex users in our sample did not differ significantly from the comparison group (χ² = 0.2, p < 0.7). Chemsex users did not conceal their sexual identity more often than the comparison group, on the contrary, 69% (n = 59) of them were out to most significant others, compared to 53% (n = 134) in the comparison group (χ² = 8.8, p < 0.05). In addition, we did not find differences in the degree of internalized homonegativity (χ² = 0.9, p < 0.4). Chemsex users were clearly and significantly more satisfied with their sex life than the comparison group (Mann-Whitney U test, p < 0.001). Conclusions: In our sample, chemsex use was not associated with a negative impact on health or wellbeing. Our results suggest that chemsex is not a homogeneous phenomenon. Many different patterns and subcultures exist, some of them are riskier, some safer than others.
Uploads
Papers by Michal M Pitoňák
Metody: Pomocí konfirmační faktorové analýzy jsme zkoumali faktorovou strukturu a invarianci měření napříč jednotlivými LGBT+ skupinami ve výběrovém souboru 1 778 zúčastněných.
Výsledky: Naše data podporují jednofaktorovou strukturu SIDAS a částečnou invarianci měření, což umožňuje porovnávání suicidální ideace mezi jednotlivými skupinami LGBT+ osob. SIDAS koreluje se škálami měřícími pocit osamělosti, dysregulaci emocí, vnímaný stres, ruminaci a životní spokojenost.
Diskuse: SIDAS představuje cenný nástroj pro hodnocení sebevražedných myšlenek u LGBT+ osob, je vhodný pro online použití a má potenciál usnadňovat vývoj, plánování i vyhodnocování účinnosti cílených intervencí. Budoucí výzkum by měl prozkoumat stabilitu skóru v čase a vývoj dalších proměnných pro hodnocení závažnosti suicidality.
ENG: This paper critically examines the applicability of traditional coming-out models in the context of contemporary Czechia, integrating rooted approaches and modern realities. An online survey of 1,788 participants (aged 15 to 71) was utilized to investigate progression between three coming-out milestones (M1-Attraction; M2-Self-Labeling; and M3-Disclosure) in the development of non-heterosexual identity. Results reveal that non-heterosexual individuals typically recognize their desire around age 13, self-label, on average, just over two years later, and disclose their identity to another person at an average age of just under 17. Notably, the study highlights generational and gender differences in these milestones, with younger generations progressing faster and traditional gender distinctions becoming less distinct. The paper also identifies future research directions, including exploring the onset of attractions in bisexual and pansexual individuals and attraction patterns toward trans and gender-diverse individuals, and assessing how stigma and prejudice shape non-heterosexual identity development.
The mental health of sexual minority (SM) individuals remains overlooked and understudied in Czechia. We aimed to estimate (1) the prevalence rate and (2) the relative risk of common mental disorders and (3) the mental distress severity among the Czech SM people compared with the heterosexual population. In addition, we aimed to investigate help-seeking for mental disorders in SM people.
Methods
We used data from a cross-sectional, nationally representative survey of Czech community-dwelling adults, consisting of 3063 respondents (response rate = 58.62%). We used the Mini-International Neuropsychiatric Interview to assess the presence of mental disorders. In individuals scoring positively, we established help-seeking in the past 12 months. We assessed symptom severity using the 9-item Patient Health Questionnaire and the 7-item Generalized Anxiety Disorder scale. We computed the prevalence of mental disorders and the treatment gap with 95% confidence intervals. To assess the risk of having a mental disorder, we used binary logistic regression.
Results
We demonstrated that the prevalence of current mental disorders was 18.85% (17.43–20.28), 52.27% (36.91–67.63), 33.33% (19.5–47.17) and 25.93% (13.85–38) in heterosexual, gay or lesbian, bisexual and more sexually diverse individuals, respectively. Suicidal thoughts and behaviours were present in 5.73% (4.88–6.57), 25.00% (11.68–38.32), 22.92% (10.58–35.25) and 11.11% (2.45–19.77) of heterosexual, gay or lesbian, bisexual and more sexually diverse individuals, respectively. After confounder adjustment, gay or lesbian individuals were more likely to have at least one current mental disorder compared with heterosexual counterparts (odds ratio = 3.51; 1.83–6.76). For bisexual and sexually more diverse individuals, the results were consistent with a null effect (1.85; 0.96–3.45 and 0.89; 0.42–1.73). The mean depression symptom severity was 2.96 (2.81–3.11) in heterosexual people and 4.68 (2.95–6.42), 7.12 (5.07–9.18) and 5.17 (3.38–6.95) in gay or lesbian, bisexual and more sexually diverse individuals, respectively. The mean anxiety symptom severity was 1.97 (1.85–2.08) in heterosexual people and 3.5 (1.98–5.02), 4.63 (3.05–6.2) and 3.7 (2.29–5.11) in gay or lesbian, bisexual and more sexually diverse individuals, respectively. We demonstrated broadly consistent levels of treatment gap in heterosexual and SM individuals scoring positively for at least one current mental disorder (82.91%; 79.5–85.96 vs. 81.13%; 68.03–90.56).
Conclusions
We provide evidence that SM people in Czechia have substantially worse mental health outcomes than their heterosexual counterparts. Systemic changes are imperative to provide not only better and more sensitive care to SM individuals but also to address structural stigma contributing to these health disparities.
Metody: Pomocí konfirmační faktorové analýzy jsme zkoumali faktorovou strukturu a invarianci měření napříč jednotlivými LGBT+ skupinami ve výběrovém souboru 1 778 zúčastněných.
Výsledky: Naše data podporují jednofaktorovou strukturu SIDAS a částečnou invarianci měření, což umožňuje porovnávání suicidální ideace mezi jednotlivými skupinami LGBT+ osob. SIDAS koreluje se škálami měřícími pocit osamělosti, dysregulaci emocí, vnímaný stres, ruminaci a životní spokojenost.
Diskuse: SIDAS představuje cenný nástroj pro hodnocení sebevražedných myšlenek u LGBT+ osob, je vhodný pro online použití a má potenciál usnadňovat vývoj, plánování i vyhodnocování účinnosti cílených intervencí. Budoucí výzkum by měl prozkoumat stabilitu skóru v čase a vývoj dalších proměnných pro hodnocení závažnosti suicidality.
ENG: This paper critically examines the applicability of traditional coming-out models in the context of contemporary Czechia, integrating rooted approaches and modern realities. An online survey of 1,788 participants (aged 15 to 71) was utilized to investigate progression between three coming-out milestones (M1-Attraction; M2-Self-Labeling; and M3-Disclosure) in the development of non-heterosexual identity. Results reveal that non-heterosexual individuals typically recognize their desire around age 13, self-label, on average, just over two years later, and disclose their identity to another person at an average age of just under 17. Notably, the study highlights generational and gender differences in these milestones, with younger generations progressing faster and traditional gender distinctions becoming less distinct. The paper also identifies future research directions, including exploring the onset of attractions in bisexual and pansexual individuals and attraction patterns toward trans and gender-diverse individuals, and assessing how stigma and prejudice shape non-heterosexual identity development.
The mental health of sexual minority (SM) individuals remains overlooked and understudied in Czechia. We aimed to estimate (1) the prevalence rate and (2) the relative risk of common mental disorders and (3) the mental distress severity among the Czech SM people compared with the heterosexual population. In addition, we aimed to investigate help-seeking for mental disorders in SM people.
Methods
We used data from a cross-sectional, nationally representative survey of Czech community-dwelling adults, consisting of 3063 respondents (response rate = 58.62%). We used the Mini-International Neuropsychiatric Interview to assess the presence of mental disorders. In individuals scoring positively, we established help-seeking in the past 12 months. We assessed symptom severity using the 9-item Patient Health Questionnaire and the 7-item Generalized Anxiety Disorder scale. We computed the prevalence of mental disorders and the treatment gap with 95% confidence intervals. To assess the risk of having a mental disorder, we used binary logistic regression.
Results
We demonstrated that the prevalence of current mental disorders was 18.85% (17.43–20.28), 52.27% (36.91–67.63), 33.33% (19.5–47.17) and 25.93% (13.85–38) in heterosexual, gay or lesbian, bisexual and more sexually diverse individuals, respectively. Suicidal thoughts and behaviours were present in 5.73% (4.88–6.57), 25.00% (11.68–38.32), 22.92% (10.58–35.25) and 11.11% (2.45–19.77) of heterosexual, gay or lesbian, bisexual and more sexually diverse individuals, respectively. After confounder adjustment, gay or lesbian individuals were more likely to have at least one current mental disorder compared with heterosexual counterparts (odds ratio = 3.51; 1.83–6.76). For bisexual and sexually more diverse individuals, the results were consistent with a null effect (1.85; 0.96–3.45 and 0.89; 0.42–1.73). The mean depression symptom severity was 2.96 (2.81–3.11) in heterosexual people and 4.68 (2.95–6.42), 7.12 (5.07–9.18) and 5.17 (3.38–6.95) in gay or lesbian, bisexual and more sexually diverse individuals, respectively. The mean anxiety symptom severity was 1.97 (1.85–2.08) in heterosexual people and 3.5 (1.98–5.02), 4.63 (3.05–6.2) and 3.7 (2.29–5.11) in gay or lesbian, bisexual and more sexually diverse individuals, respectively. We demonstrated broadly consistent levels of treatment gap in heterosexual and SM individuals scoring positively for at least one current mental disorder (82.91%; 79.5–85.96 vs. 81.13%; 68.03–90.56).
Conclusions
We provide evidence that SM people in Czechia have substantially worse mental health outcomes than their heterosexual counterparts. Systemic changes are imperative to provide not only better and more sensitive care to SM individuals but also to address structural stigma contributing to these health disparities.