Teens who engage in high-risk behaviors involving sex and drugs have significantly higher odds of depression

Teens who engage in high-risk behaviors involving sex and drugs have significantly higher odds of depression, suicidal thoughts and suicide attempts than teens who say no to sex and drugs, according to a study.

“These results suggest that healthcare professionals who identify adolescent patients reporting sexual intercourse or drug use should strongly consider screening for depression and risk of suicide,” says study author Denise D. Hallfors, Ph.D., a Senior Research Scientist at the Pacific Institute for Research and Evaluation in Chapel Hill, North Carolina.

Adolescents are no strangers to the phenomena of depression and suicide. Previous research found 28 percent of U.S. high school students experienced severe depression, and the third leading cause of death for 15- to 19-year-olds is suicide. Suicide death rates among 15- to 19-year-olds doubled between 1960 and 2001, according to the study.

Hallfors and colleagues analyzed various sex and drug behavior patterns via data from a survey of nearly 19,000 teens in grades 7 through 12. The data were gathered in the mid-1990s from 132 U.S. schools as part of the National Longitudinal Study of Adolescent Health.

The researchers clustered the teens in 16 groups according to their behaviors. Groups included the abstainers, who eschewed sex and drugs; sex dabblers; alcohol and sex dabblers; teens with multiple sexual partners; and illegal drug users.

Abstainers had the lowest levels of depression, suicidal thoughts and suicide attempts, while teens in groups associated with sex and drugs, and heavy use of illegal drugs such as marijuana had the highest levels. In between were the dabblers in sex, drugs, alcohol and tobacco.

The results appear in the current issue of the American Journal of Preventive Medicine.

The researchers found girls less likely than boys to pursue high-risk behaviors, but girls who did were more vulnerable than boys to the constellation of depression, suicidal thoughts and suicide attempts.

Another interesting finding involved the association of socioeconomic status with depression. While higher socioeconomic status reduced the likelihood of depression by about half, it increased the risk of suicidal thoughts. Hallfors and colleagues call for more research to examine this phenomenon.

Further research is needed to understand which comes first: sex and drugs or poor mental health. But until then, Hallfors and colleagues advise healthcare professionals to screen all teens for sexual behaviors and drug use. Those who engage in such behaviors—especially those who do more than dabble in them—should be screened for depression and suicide risk also.

“It is particularly important not to miss opportunities to diagnose depression because effective treatments are available, or to overlook suicide risk because suicide can be prevented,” Hallfors says.

Funding for the study was from the National Institute of Drug Abuse.

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