Clinically Significant Depressive Symptoms in African American Adolescent Females in an Urban Reproductive Health Clinic

Abstract

Adolescent depression is a major public health concern. Depression and depressive symptoms are more prevalent in adolescent females and are associated with high-risk sexual behavior. Only one third of adolescents receive professional help for their depression, although about 90% visit their primary care providers on average 2-3 times per year. It is imperative that health professionals seek additional methods in the identification and treatment of depressive symptoms. This paper presents findings of the presence of clinically significant depressive symptoms in African American female adolescents receiving routine health care services within an adolescent primary care reproductive health clinic. Results revealed higher rates of depressive symptoms in this subsample of African American adolescent females when compared to the national sample, suggesting that primary care reproductive health clinics are a viable setting for the identification of depressive symptoms among low income, African American female adolescents. Psychosocial interventions and recommendations for the integration of primary care reproductive health, and behavioral health consultation services are presented.

Added benefits: reduced depressive symptom levels among African-American female adolescents participating in an HIV prevention intervention

“…Indeed, over 40% of young women endorsed moderate to severe levels of depressive symptoms upon enrollment in a sexual health intervention. This finding coincides with previous studies noting elevated depressive symptoms among young African-American women in general (Khan et al, 2009), and specifically among young women seeking sexual health services (Collins et al, 2010; Fernandez et al, 2009). Thus, sexual health services and intervention programs have the opportunity to improve both the sexual and mental health of African-American young women.…”

“…Young women are two times as likely to experience a major depressive episode relative to young men (SAMSHA, 2009). Furthermore, depressive symptoms have an earlier onset for young women, with symptom severity increasing during later adolescence (Collins et al, 2010; Rudolph, 2008). African-American adolescents may experience higher rates of depression relative to their non-minority peers (Khan et al, 2009).…”

“…For instance, in one study 19% of African-American women seeking sexual health services had elevated depressive symptoms, with 40% endorsing mild to moderate symptoms and 60% endorsing symptom levels suggestive of a clinical diagnosis of depression (Collins et al, 2010). In a second study examining the prevalence of depressive symptoms, adolescents in sexual health clinics had higher levels of self-reported depressive symptoms relative to a cohort of adolescents in schools (Fernandez et al, 2009).…”

Prevalence and Correlates of Mental Health Problems and Treatment Among Adolescents Seen in Primary Care

“…However, using the anxiety and depression items from the BSI and the suicidal ideation/attempt items captured more adolescents with mental health problems than either criteria would have captured independently. Additionally, where past studies suggest that adolescents in urban environments are exposed to more risk factors and are potentially more likely to have mental health problems [16,17], it may be that urban adolescents have a higher threshold for identifying emotions and behaviors as mental health problems [27]. Future studies should examine the possible presence of protective factors among these youth.…”

“…Despite evidence that adolescents in primary care have higher rates of mental health problems [6,15] and that adolescents in urban environments have higher rates of mental health problems [16,17], there has been little work examining the rate of mental health problems among adolescents in urban primary care settings. This is an important area for examination, as this may be a group who is especially vulnerable for developing mental health problems and the associated negative outcomes in the future due to potential exposure to multiple risk factors.…”