Langille Don, Asbridge Mark, Kisely Steve, Wilson Kevin
Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada.
Sex Health. 2012 Jul;9(3):254-60. doi: 10.1071/SH11029.
Although depression is known to be associated with adolescent sexual risk-taking, Canadian studies are few, many have lacked appropriate controls and none has examined the associations of depression with multiple sexual risk-taking behaviours. We tested associations between multiple sexual risk-taking and risk of depression, controlling for other factors, including social capital, in high school students in Nova Scotia, Canada.
We surveyed sexually active male (n=418) and female (n=467) adolescents. Participants were asked about their risk of depression, perceptions of social capital, substance use, sociodemographic factors and sexual behaviours. Multinomial logistic regressions were used to determine associations of risk of depression with various levels of sexual risk-taking.
In unadjusted models, risk of depression was associated with two or more v. no sexual risk behaviours among both males and females. After controlling for other variables, risk of depression remained significantly associated with two or more sexual risks v. no risks for both females and males (relative risk ratios (RRR) of 2.5; 95% confidence interval (CI) 1.4-4.5 and 3.5; 95% CI 1.6-7.82 respectively) and for one v. no risks for females (RRR=1.9; 95% CI 1.1-3.5). One measure of social capital was associated with multiple risks in females.
The consistent, independent associations of risk of depression with multiple sexual risks should lead health care workers interacting with adolescents to ask about sexual risk behaviours among patients with symptoms of depression. Alternatively, patients who engage in sexual risk-taking might be screened for depression.
尽管已知抑郁症与青少年的性冒险行为有关，但加拿大的相关研究较少，许多研究缺乏适当的对照，且没有一项研究考察过抑郁症与多种性冒险行为之间的关联。我们在加拿大新斯科舍省的高中生中，检验了多种性冒险行为与抑郁症风险之间的关联，并对包括社会资本在内的其他因素进行了控制。
我们对有性行为的男性（n = 418）和女性（n = 467）青少年进行了调查。参与者被问及他们的抑郁风险、对社会资本的认知、物质使用情况、社会人口学因素以及性行为。采用多项逻辑回归来确定抑郁症风险与不同程度性冒险行为之间的关联。
在未调整的模型中，男性和女性中，有两种或更多种而非没有性冒险行为与抑郁症风险相关。在控制了其他变量后，女性和男性中，有两种或更多种性风险而非没有性风险与抑郁症风险仍显著相关（相对风险比分别为2.5；95%置信区间为1.4 - 4.5和3.5；95%置信区间为1.6 - 7.82），女性中有一种性风险而非没有性风险与抑郁症风险也显著相关（相对风险比 = 1.9；95%置信区间为1.1 - 3.5）。一种社会资本指标与女性的多种性风险相关。
抑郁症风险与多种性风险之间持续、独立的关联，应促使与青少年打交道的医护人员询问有抑郁症状患者的性冒险行为。或者，对有性冒险行为的患者进行抑郁症筛查。
