Skip to main content

Advertisement

Log in

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

  • Published:
Journal of Clinical Psychology in Medical Settings Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • American Academy of Pediatrics Committee on Psychosocial Aspects of Child and Family Health. (1993). The pediatrician and the “new morbidity”. Pediatrics, 92, 731–733. Retrieved from http://www.pediatrics.org.

  • American Academy of Pediatrics Committee on Psychosocial Aspects of Child and Family Health. (2001). The new morbidity revisited: A renewed commitment to the psychosocial aspects of pediatric care. Pediatrics, 108, 1227–1230. Retrieved from http://www.pediatrics.org/cgi/content/full/108/5/1227.

  • Anderson, R. (2002). Deaths: Leading causes for 2000 (Vol. 50). Hyattsville, Md: National vital statistics reports: From the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System.

    Google Scholar 

  • Angold, A., Erkanli, A., Farmer, E., Fairbanks, J., Burns, B., Keeler, G., et al. (2002). Psychiatric disorder, impairment, and service use in rural African American and white youth. Archives of General Psychiatry, 59, 893–901. Retrieved from http://archpsyc.ama-assn.org/.

  • Asarnow, J., Jaycox, L., Duan, N., LaBorde, A., Rea, M., Murray, P., et al. (2005). Effectiveness of a quality improvement intervention for adolescent depression in primary care clinics a randomized controlled trial. Journal of the American Medical Association, 293, 311–319. doi:10.1001/jama.293.3.311.

    Article  CAS  PubMed  Google Scholar 

  • Bartlett, J., Schleifer, S., Johnson, R., & Keller, S. (1991). Depression in inner city adolescents attending an adolescent medicine clinic. Journal of Adolescent Health, 12, 316–318. Retrieved from http://www.journals.elsevierhealth.com/periodicals/jah/home.

  • Berer, M. (2003). Integration of sexual and reproductive health services: A health sector priority. Reproductive Health Matters, 11, 6–15. Retrieved from http://www.elsevier.com/wps/find/journaldescription.cws_home/622668/description#description.

  • Bower, P., Garralda, T., Kramer, R., Harrington, R., & Sibbald, B. (2001). The treatment of child and adolescent mental health problems in primary care: A systematic review. Family Practice, 18, 373–382. doi:10.1093/fampra/18.4.373.

    Article  CAS  PubMed  Google Scholar 

  • Buzi, R., Weimnan, M. L., & Smith, P. B. (1998). Ethnic differences in STD rates among female adolescents. Adolescence, 33, 313–319.

    CAS  PubMed  Google Scholar 

  • Cardemil, E. V., Reivich, K. J., & Seligman, M. E. P. (2002). The prevention of depressive symptoms in low-income minority middle school students. Prevention & Treatment, 5, 1–28. doi:10.1037/1522-3736.5.1.58a.

    Google Scholar 

  • Centers for Disease Control and Prevention. (2009) Sexual and reproductive health of persons aged 10–24 years—United States, 2002–2007. MMWR: Vol. 58 (No. SS-6 ed.).

  • Costello, J., Erkanli, A., & Andold, A. (2006). Is there an epidemic of child or adolescent depression? Journal of Child Psychology & Psychiatry, 47, 1263–1271. doi:10.1111/j.1469-7610.2006.01682.x.

    Google Scholar 

  • Costello, E., Mustillo, S., Erkanli, A., Keeler, G., & Angold, A. (2003). Prevalence and development of psychiatric disorders in childhood and adolescence. Archives of General Psychiatry, 60, 837–844.

    Article  PubMed  Google Scholar 

  • Cote, M., Mullins, L., Hartman, V., Hoff, A., Balderson, B., Chaney, J., et al. (2003). Psychosocial correlates of health care utilization for children and adolescents with type 1 diabetes mellitus. Children s Health Care, 32, 1–16. Retrieved from http://journalseek.net/cgi-bin/journalseek/journalsearch.cgi?field=issn&query=0273-9615.

  • Das, A., Olfson, M., McCurtis, H. L., Weissman, M. M. (2006). Depression in African Americans: Breaking barriers to detection and treatment. Journal of Family Practice, 55, 30–39. Retrieved from http://www.jfponline.com/.

  • Farmer, E., Burns, B., Phillips, S., Angold, A., & Costello, E. J. (2003). Pathways into and through mental health services for children and adolescents. Psychiatric Services, 54, 60–66. Retrieved from http://psychservices.psychiatryonline.org/.

  • Franko, D. L., Striegel-Moore, R. H., Bean, J., Tamer, R., Kraemer, H. C., Dohm, F. A., et al. (2005a). Psychosocial and health consequences of adolescent depression in black and white young adult women. Health Psychology, 24, 586–593. doi:10.1037/0278-6133.24.6.586.

    Article  PubMed  Google Scholar 

  • Franko, D. L., Striegel-Moore, R. H., Thompson, D., Schreiber, G. B., & Daniels, S. R. (2005b). Does adolescent depression predict obesity in black and white young adult women? Psychological Medicine, 35, 1505–1513. doi:10.1017/S0033291705005386.

    Article  PubMed  Google Scholar 

  • Garland, A. F., Lau, A. S., Yeh, M., McCabe, K. M., Hough, R. L., & Landsverk, J. A. (2005). Racial and ethnic differences in utilization of mental health services among high-risk youths. American Journal of Psychiatry, 162, 1336–1343. Retrieved from http://ajp.psychiatryonline.org/cgi/content/full/162/7/1336.

  • Horowitz, J. L., & Garber, J. (2006). The prevention of depressive symptoms in children and adolescents: A meta-analytic review. Journal of Consulting and Clinical Psychology, 74, 401–415. doi:10.1037/0022-006X.74.3.401.

    Article  PubMed  Google Scholar 

  • Johnson, J. G., Harris, E. S., Spitzer, R. L., & Williams, J. B. (2002). The patient health questionaire for adolescents: Validation of an instrument for the assessment of mental disorders among adolescent primary care patients. Journal of Adolescent Health, 30, 196–204. doi:1016/S1054-139X(01)00333-0.

    Article  PubMed  Google Scholar 

  • Juszczak, L., Melinkovich, P., Kaplan, D. (2003). Use of health and mental health services by adolescents across multiple delivery sites. Journal of Adolescent Health, 32, 108–118. 10.1016/S1054-139X(03)00073-9.

    Google Scholar 

  • Kaslow, N. J., Davis, S. P., & Smith, C. O. (2008). Biological and psychological interventions for depression in children and adolescents. In I. H. Gotlib, C. L. Hammen, et al. (Eds.), Handbook of depression (2nd ed.). New York: Guilford Press.

    Google Scholar 

  • Kelleher, K. J., Campo, J. V., & Gardner, W. P. (2006). Management of pediatric mental disorders in primary care: Where are we now and where are we going? Current Opinion in Pediatrics, 18, 649–653. doi:10.1097/MOP.0b013e3280106a76.

    Article  PubMed  Google Scholar 

  • Kessler, R. C., Avenevoli, S., & Merikangas, K. R. (2001). Mood disorders in children and adolescents: An epidemiologic perspective. Biological Psychiatry, 49, 1002–1014. doi:10.1016/S0006-3223(01)01129-5.

    Article  CAS  PubMed  Google Scholar 

  • Kramer, T., Beaudin, C., & Thrush, C. (2005). Evaluation and treatment of depression (Part I): Benefits for patients, providers, and payors. Disease Management and Health Outcomes, 13, 295–306. doi:1173-8790/05/0005-0295.

    Article  Google Scholar 

  • Mazzaferro, K., Murray, P., Ness, R., Bass, D., Tyus, N., & Cook, R. (2006). Depression, stress, and social support as predictors of high-risk sexual behaviors and STIs in young women. Journal of Adolescent Health, 39, 601–603. doi:10.1016/j.jadohealth.2006.02.004.

    Article  PubMed  Google Scholar 

  • Melnyk, B., Brown, H., Jones, D. C., Kreipe, R., & Novak, J. (2003). Improving the mental/psychosocial health of US children and adolescents: Outcomes and implementation strategies from the national KySS summit. Journal of Pediatric Health Care, 17, S1–S24. doi:10.1016/j.pedhc.2003.08.002.

    Article  PubMed  Google Scholar 

  • Olson, A., Kemper, K., Kelleher, K., Hammond, C., Zuckerman, B. & Dietrich, A. (2002). Primary care pediatricians’ roles and perceived responsibilities in the identification and management of maternal depression. Pediatrics, 110, 1169–1176. doi:10.1542/peds.110.6.1169.

    Article  PubMed  Google Scholar 

  • Radloff, L. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401. doi:10.1177/014662167700100306.

    Article  Google Scholar 

  • Radloff, L. (1991). The use of the Center for Epidemiologic Studies Depression Scale in adolescents and young adults. Journal of Youth and Adolescence, 20, 149–166. doi:10.1007/BF01537606.

    Article  Google Scholar 

  • Rifkin, A., Wortman, R., Reardon, G., & Siris, S. G. (1986). Psychotropic medication in adolescents: A review. The Journal of Clinical Psychiatry, 47, 400–408.

    CAS  PubMed  Google Scholar 

  • Riolo, S., Nguyen, T., Greden, J., & Greden, C. (2005). Prevalence of depression by race/ethnicity: Findings from the National Health and Nutrition Examination Survey III. American Journal of Public Health, 95, 998–1000. doi:10.2105/AJPH.2004.047225.

    Article  PubMed  Google Scholar 

  • Rudolph, K. D. (2008). Adolescent depression. In I. H. Gotlib & C. L. Hammen (Eds.), Handbook of depression (2nd ed., pp. 444–446). New York, NY: The Guilford Press.

    Google Scholar 

  • Rushton, J., Forcier, M., & Schectman, R. M. (2002). Epidemiology of depressive symptoms in the National Longitudinal Study of Adolescent Health. Journal of the American Academy of Child & Adolescent Psychiatry, 41, 199–205. Retrieved from http://journals.lww.com/jaacap/pages/default.aspx.

  • Saluja, G., Iachan, R., Scheidt, P., Overpeck, M., Sun, W., & Giedd, J. (2004). Prevalence of and risk factors for depressive symptoms among young adolescents. Archives of Pediatrics and Adolescent Medicine, 158, 760–765. Retrieved from http://archpedi.ama-assn.org/.

  • Schubiner, H., & Robin, A. (1990). Screening adolescents for depression and parent-teenager conflict in an ambulatory medical setting: A preliminary investigation. Pediatrics, 85, 813–818. Retrieved from http://www.pediatrics.org.

  • Shaffer, A., Forehand, R., & Kotchick, B. (2002). A longitudinal examination of correlates of depressive symptoms among inner-city African-American children and adolescents. Journal of Child and Family Studies, 11, 151–164. Retrieved from http://www.springer.com/psychology/child+&+school+psychology/journal/10826.

    Google Scholar 

  • Stein, R. E. K., Zitner, L. E., & Jensen, P. S. (2006). Interventions for adolescent depression in primary care. Pediatrics, 118, 669–682. doi:10.1542/peds.2005-2086.

    Article  PubMed  Google Scholar 

  • Tandon, D., & Solomon, B. (2009). Risk and protective factors for depressive symptoms in urban African American adolescents. Youth & Society, 41, 80–99. doi:10.1177/0044118X08327520.

    Article  Google Scholar 

  • U.S. Department of Health and Human Services. (2008). Results from the 2007 National Survey on Drug Use and Health: National findings. (DHHS Publication No. SMA 08-4343, NSDUH Series H-34). Rockville, MD: Substance Abuse and Mental Health Services Administration.

  • Walker, Z., Townsend, J., Oakley, L., Donovan, C., Smith, H., Hurst, Z., et al. (2002). Health promotion for adolescents in primary care: Randomised controlled trial. British Medical Journal, 325, 524–530. doi:10.1136/bmj.325.7363.524.

    Article  PubMed  Google Scholar 

  • Wight, R. G., Aneshensel, C. S., Botticello, A. L., & Sepúlveda, J. E. (2005). A multilevel analysis of ethnic variation in depressive symptoms among adolescents in the United States. Social Science & Medicine, 60, 2073–2084. doi:10.1016/j.socscimed.2004.08.065.

    Article  Google Scholar 

  • Williams, J., Klinepeter, K., Palmes, G., Pulley, A., & Williams, J. M. (2004). Diagnosis and treatment of behavioral health disorders in pediatric practice. Pediatrics, 114, 601–606. doi:10.1542/peds.2004-0090.

    Article  PubMed  Google Scholar 

  • Williams, S. B., O’Connor, E. A., Eder, M., & Whitlock, E. P. (2009). Screening for child and adolescent depression in primary care settings: A systematic evidence review for the US Preventive Services Task Force. Pediatrics, 123, e716–e736. doi:10.1542/peds.2008-2415.

    Article  PubMed  Google Scholar 

  • Williams, J., Palmes, G., Klinepeter, K., Pulley, A., & Foy, J. M. (2005). Referral by pediatricians of children with behavioral health disorders. Clinical Pediatrics, 44, 343–349. doi:10.1177/000992280504400410.

    Article  PubMed  Google Scholar 

  • Winter, L. B., Steer, R. A., Jones-Hicks, L., & Beck, A. T. (1999). Screening for major depression disorders in adolescent medical outpatients with the Beck Depression Inventory for Primary Care. Journal of Adolescent Health, 24, 389–394. doi:10.1016/S0163-8343(98)00070-X.

    Article  CAS  PubMed  Google Scholar 

  • Wu, P., Hoven, C. W., Cohen, P., Liu, X., Moore, R. E., Tiet, Q., et al. (2001). Factors associated with use of mental health services for depression by children and adolescents. Psychiatric Services, 52, 189–195. Retrieved from http://psychservices.psychiatryonline.org/.

    Google Scholar 

  • Zuckerbrot, R. A., Cheung, A. H., Jensen, P. S., Stein, R. E. K., & Laraque, D. (2007a). Guidelines for Adolescent Depression in Primary Care (GLAD-PC): I. Identification, assessment, and initial management. Pediatrics, 120, e1299–e1312. doi:10.1542/peds.2007-1144.

    Article  PubMed  Google Scholar 

  • Zuckerbrot, R. A., & Jensen, P. S. (2006). Improving recognition of adolescent depression in primary care. Archives of Pediatrics and Adolescent Medicine, 160, 694–704. Retrieved from www.archpediatrics.com.

  • Zuckerbrot, R. A., Pagar, D., Davies, M., Fisher, P. W., & Shaffer, D. (2007b). Adolescent depression screening in primary care: Feasibility and acceptability. Pediatrics, 119, 101–108. doi:10.1542/peds.2005-2965.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Marietta H. Collins.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Collins, M.H., Kelch-Oliver, K., Johnson, K. et al. Clinically Significant Depressive Symptoms in African American Adolescent Females in an Urban Reproductive Health Clinic. J Clin Psychol Med Settings 17, 175–182 (2010). https://doi.org/10.1007/s10880-010-9200-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10880-010-9200-9

Keywords

Navigation