Clinically significant depressive symptoms in African American adolescent females in an urban reproductive health clinic.

Adolescent depression is a major public health concern. Depression and depressive symptoms are more prevalent in adolescent females and are associated with high-risk sexual behavior. Only one third of adolescents receive professional help for their depression, although about 90% visit their primary care providers on average 2-3 times per year. It is imperative that health professionals seek additional methods in the identification and treatment of depressive symptoms. This paper presents findings of the presence of clinically significant depressive symptoms in African American female adolescents receiving routine health care services within an adolescent primary care reproductive health clinic. Results revealed higher rates of depressive symptoms in this subsample of African American adolescent females when compared to the national sample, suggesting that primary care reproductive health clinics are a viable setting for the identification of depressive symptoms among low income, African American female adolescents. Psychosocial interventions and recommendations for the integration of primary care reproductive health, and behavioral health consultation services are presented.

Service utilization patterns of maltreated and nonmaltreated children from low-income, African-American families.

OBJECTIVES: This study examined health care utilization patterns by maltreatment status among youths from low-income households across multiple service domains. METHODS: Face-to-face interviews were conducted with 153 African-American maltreated and nonmaltreated children (ages eight to 12). The youths were children of women recruited at a large inner-city public hospital for a study examining intimate partner violence and child maltreatment. Use of psychiatric, medical, child care, social support, and crisis health care services was assessed. RESULTS: Psychiatric and child care service utilization was significantly different between maltreated and nonmaltreated children across three categories of child maltreatment (emotional, physical, and sexual abuse). Maltreated youths were six to 13 times more likely than their nonmaltreated counterparts to use psychiatric and child care services. Medical service utilization was higher for emotionally abused youths. CONCLUSIONS: Results of this study may serve to facilitate improved screening, identify points of access for intervention, and enhance treatment for maltreated youths.

Neurodevelopmental screening in toddlers and early preschoolers with sickle cell disease.

Sickle cell disease is associated with an elevated risk for neurologic complications beginning in early childhood. Detecting higher-risk cases with developmental screening instruments may be a cost-effective method for identifying young children in need of more frequent or intensive assessment. We evaluated the validity of the Denver II test as a tool to detect lower levels of developmental attainment and their association with neurologic risk in 50 young children with sickle cell disease. Children with suspect Denver II outcomes showed lower scores for functional communication skills, had lower hematocrit percentage, higher mean velocities on transcranial Doppler ultrasound imaging, and were more likely to have had preterm birth. Validity of age equivalencies from specific Denver II areas was demonstrated for Language and Fine Motor scores, suggesting the instrument could be used to index children's developmental levels in these domains. The Denver II may be a useful behavioral screening tool for neurodevelopmental risk in sickle cell disease.