Using a cross-sectional comparison group design, 4,746 ethnically diverse middle and high school students from 31 public schools in a metropolitan area were surveyed about their health, emotional factors (self-esteem, depressive symptoms, and suicidality), and behaviors (tobacco, alcohol, and drug use). Based on regression analyses that adjusted for gender, race, school level, and socioeconomic status, adolescents with chronic health conditions were significantly more likely to report depressive symptoms and low self-esteem than adolescents without chronic health conditions; they were almost twice as likely to have considered suicide and over 31/2 times more likely to have attempted suicide. They also reported greater use of cigarettes, marijuana, and illicit drugs. Given the extent of behavioral and emotional problems among adolescents with chronic health conditions, appropriate referrals and mental health services for these adolescents are warranted.
Bibliographical noteFunding Information:
This study was supported by grant MCJ-27034 from the Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services. This article was developed while the first author, Julie D. Erickson, was a fellow in training in the Leadership Education in Adolescent Health Program at the University of Minnesota and was supported in part from grant 1T71MC00025-01 from the Maternal and Child Health Bureau.