Published online July 1, 2005
PEDIATRICS Vol. 116 No. 1 July 2005, pp. 78-81 (doi:10.1542/peds.2004-1537)
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Adverse Health Consequences That Co-occur With Depression: A Longitudinal Study of Black Adolescent Females

Ralph J. DiClemente, PhD*,{ddagger},§, Gina M. Wingood, ScD, MPH*,§, Delia L. Lang, PhD, MPH*,§, Richard A. Crosby, PhD||, Laura F. Salazar, PhD*,§, Kathy Harrington, MPH, MAEd and Vicki Stover Hertzberg, PhD#

* Departments of Behavioral Sciences and Health Education
# Biostatistics, Emory University, Rollins School of Public Health, Atlanta, Georgia
{ddagger} Department of Pediatrics, Division of Infectious Diseases, Epidemiology, and Immunology, Emory University School of Medicine, Atlanta, Georgia
§ Emory Center for AIDS Research, Atlanta, Georgia
|| School of Public Health at the University of Kentucky, Lexington, Kentucky
Department of Pediatrics, University of Alabama, School of Medicine, Birmingham, Alabama

Objective. The purpose of this study was to identify adverse health consequences that may co-occur with depression among black female adolescents.

Methods. Adolescents were recruited from high-risk neighborhoods in Birmingham, Alabama. The sample comprised 460 black female adolescents (aged 14–18 years) who completed assessments at baseline and at 6 and 12 months. Only adolescents who consistently scored above the threshold for depression at all 3 assessments (n = 76) or below the threshold at all 3 assessments (n = 174) were included (N = 250) in the data analysis. Within this sample, adolescents who were depressed were compared with those who were not depressed with respect to the following health consequences: low self-esteem, emotional abuse, physical abuse, verbal abuse, poor body image, and antisocial behavior.

Results. Using generalized estimating equations and controlling for covariates, depressed adolescents were 5.3 times more likely to report low self-esteem, 4.3 times more likely to report emotional abuse, 3.7 times more likely to report being physically abused, and almost 3 times as likely to report being verbally abused. Furthermore, depressed adolescents were more than twice as likely to report poor body image and nearly twice as likely to report engaging in antisocial behaviors.

Conclusions. The findings suggest that a broad range of adverse health consequences may accompany depression among black female adolescents. Physicians need to be alert to the co-occurrence of depression and low self-esteem; emotional, physical, and verbal abuse; poor body image; and antisocial behaviors among this population.

Key Words: adolescent depression • adolescent health • adolescent sexual behavior • adverse outcomes • black

Abbreviations: CES-D, Center for Epidemiological Studies Depression Scale • GEE, generalized estimating equations

Accepted Oct 14, 2004.




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