(PS7-C61) Clinical Characteristics of Sexual Minorities Accessing Different Levels of Care for OCD

Individuals who identify as a sexual minority are nine times more likely to be diagnosed with obsessive compulsive disorder (OCD) relative to heterosexual individuals (Pelts & Albright, 2015). Additionally, relative to sexual minority representation within the general population, individuals who identify as a sexual minority represent a larger percentage of residential and partial hospital programs treating psychiatric disorders (Beard et al, 2017; Brewton et al, 2022). These discrepancies suggest there may be unique distal and proximal stressors unique to sexual minorities which increase risk for experiencing emotional disorders and affect the levels of care being accessed (Hezel et al, 2019; Meyer, 2003). The present study aims to better understand the clinical and demographic presentations of sexual minorities accessing care for OCD and how these presentations may differ by level of care. 

Adults attending either a residential (n = 92) or virtual partial hospital program (VPHP) (n = 43) for OCD treatment were asked to complete self-report measures at admission. Within sexual minorities across both programs, 44.2% identified as female, 27.9% as male, 7.0% as non-binary, 7.0% as transgender, 9.3% as gender non-conforming, and 4.7% identified as a gender not listed. Sexual minorities across both programs identified primarily as non-Hispanic white (90.7%), with a mean age of 23.8 (SD = 5.1). The Yale-Brown Obsessive-Compulsive Scale Self-Report, Hamilton Depression Scale, and Quality of Life Enjoyment and Satisfaction - Short Form were used to assess OCD severity, depression severity, and quality of life, respectively.

Across the two programs 37% of the residential program and 20.9% of the VPHP identified as a sexual minority. This difference in sexual identity between the two programs was marginally significant [X2(1, n =135) = 2.92, p = 0.087]. There were no other significant sociodemographic differences (i.e., gender identity, racial identity, relationship status, employment status, age) among sexual minorities in the residential program versus the VPHP.  OCD symptom severity for sexual minority patients within the residential program and the VPHP had a non-significant difference with a small effect [t(12) = 0.54, p = 0.603, d = 0.20]. Sexual minorities in the residential program reported significantly greater depression symptoms than in VPHP with a large effect [t(16) = 2.69, p < .05, d= 0.94] and lower quality of life, with a medium effect [t(24) = -2.43, p < .05, d= 0.76] than in VPHP. 

Results suggest that upon admission to the same hospital, sexual minorities attending the residential program versus the VPHP differed in depression symptom severity and overall quality of life but did not differ demographically or in OCD symptom severity. This finding is important as it suggests there are factors above and beyond OCD symptom severity that play a role in how sexual minorities are accessing care for OCD. Understanding these additional factors can help foster more individualized and inclusive care, which will ultimately lead to better treatment experiences for sexual minorities. More research is needed to better understand these relationships and the role they may play in the experience of sexual minorities seeking mental health care.