title: Depressive symptoms and behavioural health risks in young women attending an urban sexual health clinic.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  To assess depressive and behavioural health risks in attendees to a sexual health clinic (SHC) for young people.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Academic unit of Child and Adolescents Psychiatry, Imperial College, London, UK. v.heras@imperial.ac.uk
authors.forename: V
authors.initials: V
authors.lastname: Fernandez
authors.forename: T
authors.initials: T
authors.lastname: Kramer
authors.forename: G
authors.initials: G
authors.lastname: Fong
authors.forename: A
authors.initials: A
authors.lastname: Doig
authors.forename: M E
authors.initials: ME
authors.lastname: Garralda
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D000554:Ambulatory Care Facilities; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D004812:Epidemiologic Methods; D005260:Female; D015438:Health Behavior; D006801:Humans; D012725:Sexual Behavior / Q000523:psychology; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult