Psychiatric comorbidity, early onset, and chronicity/persistence of disorder are important indicators of illness severity as well as adverse consequences (Aharonovich, Liu, Nunes, & Hasin, 2002; Hirschfield, Hasin, Keller, Endicott, & Wunder, 1990; Pine, Cohen, Gurley, Brook, & Ma, 1998), and several recently published studies with representative samples suggest that sexual minorities have elevated risk in each of these domains. Sexual minorities have higher rates of comorbidity than heterosexuals (Cochran et al., 2003; Fergusson et al., 2005; Sandfort et al., 2001). It appears that sexual minorities may also have an earlier age of onset for certain disorders, namely depression among gay men and substance use disorders among lesbians (Gilman et al., 2001). Although only one general population study has examined chronicity of disorder, lesbians were found to have greater persistence of past-year substance use disorders than heterosexual women (Gilman et al., 2001). The presence of multiple co-occurring disorders, earlier onset, and greater persistence of disorder among sexual minorities is striking and highlights the need for evidence-based treatments to address the increased mental health burden in this community.
