Depression tied to risky teen sex

Sexually experienced middle- and high-school teenagers with higher levels of depressive symptoms are more likely to engage in risky sexual behavior, a new study shows.

"The study findings underscore that it is important for parents to be familiar with signs of depression among adolescent boys and girls," Dr. Jocelyn A. Lehrer of the University of California, San Francisco, the study's lead author, told Reuters Health. "In addition to providing strong and consistent emotional support to their teens, it is important for parents to encourage and actively support their teens in seeking mental health care when needed."

As many as 20% of adolescents may experience major depression, Lehrer and her team note in the July issue of the medical journal Pediatrics. Half of new cases of sexually transmitted infections occur in adolescents, while teens also face a disproportionate risk of contracting HIV.

To investigate whether symptoms of depression might be linked to sexual risk taking, Lehrer and her colleagues analyzed results of a large national study of adolescent health that included 4,152 boys and girls who were interviewed at home in 1995 and once again a year later. Interviewers assessed study participants' levels of depressive symptoms using a 19-item questionnaire.

The higher boys scored on the test at the first interview, the more likely they were to report a year later that they had not used condoms or any other type of birth control the last time they had sex, Lehrer and her colleagues found. They were also more likely to have used drugs or alcohol before their last sexual encounter.

Girls who scored high on the test were less likely to have used birth control or condoms the last time they had sex, and were more likely to have had three or more sexual partners over the previous year.

While other studies have suggested a link between depression and risky sex, Lehrer and her team note, their analysis is unique because it looked at a large, nationally representative sample over a one-year period.

There are many possible reasons why teens with symptoms of depression might be more likely to take sexual risks, Lehrer noted. "Youth who are both emotionally distressed and socially isolated may be more likely to seek or be successfully pressured into sexual activity, in the name of some kind of shared intimacy, or to maintain relationships that they value," she told Reuters Health. Teens may also use sex as a way to cope with their symptoms of depression, Lehrer added.

The findings provide "only further reason to increase our efforts to promote mental health, and to prevent, identify and treat depressive symptoms and disorders among adolescents," she concluded.

SOURCE: Pediatrics, July 2006.