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Wang H, Wang Z, Li X, Liu J. Characteristics and risk factors of Health-Related Risky behaviors in adolescents with Depression. Child Adolesc Psychiatry Ment Health 2024; 18:34. [PMID: 38500185 PMCID: PMC10949750 DOI: 10.1186/s13034-024-00722-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 02/24/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGOUND To explore the characteristics and risk factors for health-related risky behaviours (HRRBs) in adolescents with depression. METHODS A total of 136 adolescents aged 12-18 years who met the diagnostic criteria for depression, and 272 healthy controls. All the subjects were assessed with the Adolescent Health-Related Risky Behavior Inventory (AHRBI), and the AHRBI scores of the two groups were compared with the Mann-Whitney U test. The depression group was assessed with the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Childhood Trauma Questionnaire (CTQ), Cognitive Emotion Regulation Questionnaire (CERQ), Egna Minnen av Barndoms Uppfostran (EMBU), and Family Adaptability and Cohesion Scale (FACES II-CV). Spearman correlation analysis and multiple linear regression were used to explore the risk factors for HRRBs in adolescents with depression. RESULTS The AHRBI total score and five-factor scores of self-injury and suicide (SS), aggression and violence (AV), rule-breaking (RB), smoking and drinking (SD), and health-compromising behavior (HCB) in the depression group were higher than those in the control group. The severity of anxiety, catastrophizing, cognitive emotional regulation strategy (self-blame and blaming of others), the frequency of depression, physical neglect, and sexual abuse all increased the risk of HRRBs in adolescents with depression, and paternal emotional warmth and understanding had protective effects. CONCLUSION First, depressed adolescents exhibited significantly more HRRBs than healthy adolescents. Second, there are many risk factors for HRRBs in adolescents with depression, and the risk factors for different types of HRRBs are also different.
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Affiliation(s)
- Hui Wang
- Institute of Mental Health, Peking University Sixth Hospital, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Zhixiong Wang
- Peking University HuiLongGuan Clinical Medical School, Bejing Huilongguan Hospital, Bejing, China
| | - Xue Li
- Institute of Mental Health, Peking University Sixth Hospital, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Jing Liu
- Institute of Mental Health, Peking University Sixth Hospital, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.
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Blaha Y, Cavelti M, Lerch S, Steinhoff A, Koenig J, Kaess M. Risk-taking and self-harm behaviors as markers of adolescent borderline personality disorder. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-023-02353-y. [PMID: 38194081 DOI: 10.1007/s00787-023-02353-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 12/05/2023] [Indexed: 01/10/2024]
Abstract
Adolescence is a critical period for early identification and intervention of borderline personality disorder (BPD). Risk-taking and self-harm behaviors (RSB) have been identified as promising early markers of BPD and correlates of depression in school-based samples. The present study aimed, first, to examine the association between RSB and BPD in a clinical sample of adolescents and, second, to examine whether RSB are also linked to depression. N = 405 participants (82.7% female) were recruited from an outpatient clinic for adolescents with RSB. RSB assessed included truancy, excessive media use, alcohol, tobacco, and illicit drug use, sexual risk-taking, and self-harm behavior. Regression analyses and generalized linear models were performed to examine the associations between individual RSB or patterns of RSB (identified using latent class analysis, LCA) and a diagnosis and severity of BPD or depression. All RSB (except excessive media use) were positively associated with BPD diagnosis and severity. In contrast, only non-suicidal self-injury (NSSI) and suicide attempts were positively associated with depression diagnosis and severity, while illicit drug use was negatively associated with depression severity. The LCA yielded two classes differing in the occurrence of RSB. The high RSB class was more likely to have a BPD diagnosis and greater BPD severity than the low RSB class. Classes did not differ regarding depression diagnosis or severity. As NSSI and suicide attempts were associated with both BPD and depression, the presence of additional RSB, besides self-harm behavior, may represent a specific risk marker for BPD in adolescents.
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Affiliation(s)
- Yasmine Blaha
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Marialuisa Cavelti
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Stefan Lerch
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Annekatrin Steinhoff
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Julian Koenig
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany.
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Die Ambulanz für Risikoverhalten und Selbstschädigung (AtR!Sk) – ein Pionierkonzept der ambulanten Früherkennung und Frühintervention von Borderline-Persönlichkeitsstörungen. Prax Kinderpsychol Kinderpsychiatr 2017; 66:404-422. [DOI: 10.13109/prkk.2017.66.6.404] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Cunningham K, Martinez DA, Scott-Sheldon LAJ, Carey KB, Carey MP. Alcohol Use and Sexual Risk Behaviors among Adolescents with Psychiatric Disorders: A Systematic Review and Meta-Analysis. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2017; 26:353-366. [PMID: 29204066 DOI: 10.1080/1067828x.2017.1305934] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Adolescents with psychiatric disorders appear to be at increased risk for acquiring HIV and other sexually transmitted infections; however, little is known about the prevalence of behavioral risk factors in this population. This meta-analysis aimed to assess the prevalence of alcohol use and sexual risk behaviors among adolescents with psychiatric disorders. Electronic database searches identified studies sampling adolescents diagnosed with psychiatric disorders and assessing both alcohol and sexual risk behaviors. Fourteen studies sampling 3,029 adolescents with psychiatric disorders were included. The majority of adolescents with psychiatric disorders report alcohol use and sexual risk behaviors. Risk reduction interventions targeting these two behaviors are needed.
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Affiliation(s)
- Karlene Cunningham
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA.,Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI, USA.,Bradley/Hasbro Children's Research Center, Rhode Island Hospital, Providence, RI, USA
| | - David A Martinez
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA.,Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI, USA.,Bradley/Hasbro Children's Research Center, Rhode Island Hospital, Providence, RI, USA
| | - Lori A J Scott-Sheldon
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA.,Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI, USA.,Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI, USA
| | - Kate B Carey
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI, USA.,Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
| | - Michael P Carey
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA.,Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI, USA.,Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI, USA
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Nalugya-Sserunjogi J, Rukundo GZ, Ovuga E, Kiwuwa SM, Musisi S, Nakimuli-Mpungu E. Prevalence and factors associated with depression symptoms among school-going adolescents in Central Uganda. Child Adolesc Psychiatry Ment Health 2016; 10:39. [PMID: 27800012 PMCID: PMC5081935 DOI: 10.1186/s13034-016-0133-4] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 10/17/2016] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Depression in adolescents constitutes a global public health concern. However, data on its prevalence and associated factors are limited in low income countries like Uganda. METHODS Using a cross-sectional descriptive study design, 519 adolescent students in 4 secondary schools in Mukono district, Uganda, were randomly selected after meeting study criteria. The 4 school types were: boarding mixed (boys and girls) school; day mixed school; girls' only boarding school; and, boys' only boarding school. The 519 participants filled out standardized questionnaires regarding their socio-demographic characteristics and health history. They were then screened for depression using the Children Depression Inventory (CDI) and those with a cut-off of 19 were administered the Mini International Neuro-Psychiatric Interview for Children and Adolescents 2.0 (MINI-KID), to ascertain the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM IV) diagnostic types of depression and any co morbidity. Logistic regression analyses were used to assess factors associated with significant depression symptoms (a score of 19 or more on the CDI). RESULTS There were 301 (58 %) boys and 218 (42 %) girls with age range 14-16 years and a mean age of 16 years (SD 2.18). Of 519 participants screened with the CDI, 109 (21 %) had significant depression symptoms. Of the 109 participants with significant depression symptoms, only 74 were evaluated with the MINI-KID and of these, 8 (11 %) met criteria for major depression and 6 (8 %) met criteria for dysthymia. Therefore, among participants that were assessed with both the CDI and the MINI-KID (n = 484), the prevalence of depressive disorders was 2.9 %. In this sample, 15 (3.1 %) reported current suicidal ideation. In the logistic regression analyses, significant depression symptoms were associated with single-sex schools, loss of parents and alcohol consumption. LIMITATIONS This is a cross-sectional study therefore, causal relationships are difficult to establish. Limited resources and the lack of collateral information precluded the assessment of a number of potential factors that could be associated with adolescent depression. The MINI-KID was administered to only 74 out of 109 students who scored ≥19 on the CDI since 35 students could not be traced again due to limited resources at the time. CONCLUSIONS Significant depression symptoms are prevalent among school-going adolescents and may progress to full-blown depressive disorders. Culturally sensitive psychological interventions to prevent and treat depression among school-going adolescents are urgently needed.
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Affiliation(s)
- Joyce Nalugya-Sserunjogi
- Department of Psychiatry, Makerere University, College of Health Sciences, Kampala, Uganda ,Mulago National Referral and Teaching Hospital, Ministry of Health, Kampala, Uganda
| | - Godfrey Zari Rukundo
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Emilio Ovuga
- Department of Psychiatry, Gulu University, Gulu, Uganda
| | - Steven M. Kiwuwa
- Department of Child Health and Development, Makerere University, College of Health Sciences, Kampala, Uganda
| | - Seggane Musisi
- Department of Psychiatry, Makerere University, College of Health Sciences, Kampala, Uganda
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Field N, Prah P, Mercer CH, Rait G, King M, Cassell JA, Tanton C, Heath L, Mitchell KR, Clifton S, Datta J, Wellings K, Johnson AM, Sonnenberg P. Are depression and poor sexual health neglected comorbidities? Evidence from a population sample. BMJ Open 2016; 6:e010521. [PMID: 27009148 PMCID: PMC4809090 DOI: 10.1136/bmjopen-2015-010521] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 02/10/2016] [Accepted: 02/29/2016] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To examine associations between sexual behaviour, sexual function and sexual health service use of individuals with depression in the British general population, to inform primary care and specialist services. SETTING British general population. PARTICIPANTS 15,162 men and women aged 16-74 years were interviewed for the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3), undertaken in 2010-2012. Using age-adjusted ORs (aAOR), relative to a comparator group reporting no treatment or symptoms, we compared the sexual health of those reporting treatment for depression in the past year. OUTCOME MEASURES Sexual risk behaviour, sexual function, sexual satisfaction and sexual health service use. RESULTS 1331 participants reported treatment for depression (5.2% men; 11.8% women). Relative to the comparator group, treatment for depression was associated with reporting 2 or more sexual partners without condoms (men aAOR 2.07 (95% CI 1.38 to 3.10); women 2.22 (1.68 to 2.92)), and concurrent partnerships (men 1.80 (1.18 to 2.76); women 2.06 (1.48 to 2.88)), in the past year. Those reporting depression treatment were more likely to be dissatisfied with their sex lives (men 2.32 (1.74 to 3.11); women 2.30 (1.89 to 2.79)), and to score in the lowest quintile on the Natsal-sexual function measure. They were also more likely to report a recent chlamydia test (men 1.92 (1.15 to 3.20)); women (1.27 (1.01 to 1.60)), and to have sought help regarding their sex life from a healthcare professional (men 2.92 (1.98 to 4.30); women (2.36 (1.83 to 3.04)), most commonly from a family doctor. Women only were more likely to report attending a sexual health clinic (1.91 (1.42 to 2.58)) and use of emergency contraception (1.98 (1.23 to 3.19)). Associations were broadly similar for individuals with depressive symptoms but not reporting treatment. CONCLUSIONS Depression, measured by reported treatment, was strongly associated with sexual risk behaviours, reduced sexual function and increased use of sexual health services, with many people reporting help doing so from a family doctor. The sexual health of depressed people needs consideration in primary care, and mental health assessment might benefit people attending sexual health services.
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Affiliation(s)
- Nigel Field
- Research Department of Infection and Population Health, UCL, London, UK
| | - Philip Prah
- Research Department of Infection and Population Health, UCL, London, UK
| | | | - Greta Rait
- Research Department of Primary Care and Population Health, UCL, London, UK
| | - Michael King
- Division of Psychiatry (Faculty of Brain Sciences), UCL, London, UK
| | - Jackie A Cassell
- Division of Primary Care and Public Health, University of Brighton, Brighton, UK
| | - Clare Tanton
- Research Department of Infection and Population Health, UCL, London, UK
| | - Laura Heath
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Kirstin R Mitchell
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Soazig Clifton
- Research Department of Infection and Population Health, UCL, London, UK
| | - Jessica Datta
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Kaye Wellings
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Anne M Johnson
- Research Department of Infection and Population Health, UCL, London, UK
| | - Pam Sonnenberg
- Research Department of Infection and Population Health, UCL, London, UK
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Depressive Störungen im Kindes- und Jugendalter. Prax Kinderpsychol Kinderpsychiatr 2014. [DOI: 10.13109/prkk.2014.63.3.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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