Fernandez V, Kramer T, Fong G, Doig A, Garralda M E
Academic unit of Child and Adolescents Psychiatry, Imperial College, London, UK.
Child Care Health Dev. 2009 Nov;35(6):799-806. doi: 10.1111/j.1365-2214.2009.00982.x. Epub 2009 Jun 8.
Adolescence is a time of increased health risk behaviours and depressive symptoms and disorders. Most young people with depressive disorders, however, are not under the care of specialist child and adolescent mental health services, and there is increasing interest in identifying alternative appropriate settings which are acceptable for young people and may attract those at high risk for depressive disorders.
To assess depressive and behavioural health risks in attendees to a sexual health clinic (SHC) for young people.
Cross-sectional controlled study of women attending a SHC and school attendees, using questionnaires on depressive symptoms and mental health problems, sexual activity and substance use.
115/178 attendees 14-19 years old completed questionnaires. In the comparison between 66 women aged 16-18 years and 49 socio-demographically group-matched school controls, SHC attendees reported higher levels of sexual activity and substance use. They were significantly more at risk for depression (20/65 or 30% vs. 4/46 or 8%; chi(2)P < 0.01) on the Beck Depression Inventory, for emotional (12/66 or 18% vs. 1/49 or 2%; chi(2)P < 0.01), hyperactivity (11/66 or 16% vs. 2/46 or 4%; chi(2)P < 0.05) and conduct (8/66 or 12% vs. 0/49; chi(2)P < 0.05) problems on the Strengths and Difficulties Questionnaire. High depressive scores were significantly associated with a history of self-harm, earlier alcohol use and having tried cannabis, but not with sexual risk behaviours. Earlier age at first sexual intercourse was linked to higher sexual and substance use risks.
We have found high levels of depressive symptoms among attendees to a SHC for young people, which seem an appropriate setting for screening and providing guidance for depression and other health risk behaviours.
青春期是健康风险行为以及抑郁症状和障碍增加的时期。然而，大多数患有抑郁症的年轻人并未接受儿童和青少年心理健康专科服务，人们越来越关注确定对年轻人来说可接受的、可能吸引抑郁症高危人群的其他合适场所。
评估青少年性健康诊所（SHC）就诊者的抑郁和行为健康风险。
对在SHC就诊的女性和在校学生进行横断面对照研究，使用关于抑郁症状、心理健康问题、性活动和物质使用的问卷。
115名14至19岁的就诊者完成了问卷。在66名16至18岁女性与49名社会人口统计学匹配的学校对照之间的比较中，SHC就诊者报告的性活动和物质使用水平更高。在贝克抑郁量表上，他们患抑郁症的风险显著更高（20/65或30% 对比4/46或8%；卡方检验P < 0.01），在优势与困难问卷上，在情绪问题（12/66或18% 对比1/49或2%；卡方检验P < 0.01）、多动问题（11/66或16% 对比2/
46或4%；卡方检验P < 0.05）和品行问题（8/66或12% 对比0/49；卡方检验P < 0.05）方面也是如此。高抑郁得分与自残史、较早饮酒和尝试大麻显著相关，但与性风险行为无关。首次性交的年龄越早，性和物质使用风险越高。
我们发现青少年性健康诊所的就诊者中存在高水平的抑郁症状，这似乎是筛查以及为抑郁症和其他健康风险行为提供指导的合适场所。
