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PEDIATRICS Vol. 113 No. 5 May 2004, pp. 1313-1320

Depressive Symptoms and Health Risk Among Rural Adolescents

James J. Burns, MD^*, Lesley Cottrell, PhD^*, Kathaleen Perkins, MD^*, Robert Pack, PhD^*, Bonita Stanton, MD, Gerald Hobbs, PhD^*, Lela Hobby, MSN^*, Derrick Eddy, MD^* and Andrew Hauschka, BA^*

^* West Virginia University School of Medicine, Morgantown, West Virginia
Children’s Hospital of Michigan, Wayne State University, Detroit, Michigan

Objective. To determine the stability of depression and its relationship with health risk factors among rural adolescents.

Methods. A clinic-based longitudinal study was conducted to test for depression and risk factors in 64 participants who attended a rural, primary care, adolescent medicine clinic. The primary measure of risk and depression was the Perkins Adolescent Risk Screen (PARS). Adolescent patients who were aged 12 to 18 years and had PARS assessments during a previous visit to the adolescent clinic were invited to complete a follow-up PARS assessment.

Results. The mean age of adolescents at baseline was 12.79 years; 14.59 years at follow-up. With age and gender being controlled, adolescent depression and various adolescent risk indices were significantly related at baseline. Longitudinally, baseline depression score on PARS were related to follow-up: depression, school problems, substance abuse, tobacco use, sexual activity, and violent behavior scores and a history of physical/sexual abuse. On multivariate analysis controlling for other significantly associated variables, the relationship persisted for baseline depression and follow-up: tobacco, substance abuse, depression, and history of physical/sexual abuse.

Conclusion. This study confirms a strong longitudinal relationship between baseline depressive symptoms and several important risk behaviors/factors measured at follow-up in a clinic population of rural adolescents. Also, longitudinal stability of depression over time is supported.

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Key Words: depression • health risk behaviors • rural adolescents • mental health services

Abbreviations: BMI, body mass index • PARS, Perkins Adolescent Risk Screen

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Received for publication Apr 10, 2003; Accepted Oct 10, 2003.

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