Using the Guidelines for Adolescent Preventive Services to Estimate Adolescent Depressive Symptoms in School-based Health Centers

Background and Objectives: The study objective was to understand the relationship between depressive symptoms and demographic, behavioral, and environmental risk variables among adolescents attending school-based health centers (SBHCs) using the Guidelines for Adolescent Preventive Services (GAPS) questionnaires. Methods: Using GAPS questionnaires, we conducted a retrospective medical record review of 672 adolescents attending two Detroit-area school-based health clinics. Bivariate and multivariate analyses were conducted to determine which factors were associated with depressive symptoms while adjusting for other relevant factors. Results: Overall, 26.5% of adolescents reported depressive symptoms. Bivariate analysis revealed associations between depressive symptoms and female gender, older age, disordered eating, lack of physical activity, sexual activity, poor school performance, substance use of all types, violence, law trouble, and an abuse history. Multivariate regression models revealed that female gender, sexual activity, weapon carrying, law trouble, poor physical activity, and a history of abuse were most strongly related to self reported depressive symptoms. Substance use was not a significant factor after controlling for potential confounders. Conclusions: Targeting the above factors during routine adolescent examinations may help providers at SBHCs and other clinics identify those at highest risk for depression and provide appropriate interventions.