Depressive symptoms of adolescents and general practice

Background. Depressive symptoms are frequent in adolescents. They may be associated with difficulty for access to health care and to general practitioner (GP) and with lack of adherence to treatment. These associations may be explained by socioeconomic, school, health and behavioral difficulties. Aim. To assess the associations between depressive symptoms and access to health care, access to GP, and lack of adherence to treatment, as well as the confounding role of socioeconomic, school, health and behavioral difficulties. Methods: Cross-sectional study in 1559 middle-school adolescents from north-eastern France who completed a questionnaire to gather sex, age, socioeconomic factors (family structure and parents' education, occupation and income), school performance, health and behavioral difficulties (obesity, substance use, health status, and relational problem), depressive symptoms (Kandel scale, score >= 17), access to health care, access to GP, LLTE, lack of adherence to treatment, and GP change. The Data was analysed using linear and logistic regression models. Results. Depressive-symptoms affected 13.3% of adolescents. Unsatisfied access to health care represented 2.8%, difficult access to GP 6.3%, and lack of adherence to treatment 38.0%. The depressive symptoms were associated with unsatisfied access to health care (ORsa=3.89, p< 0.001, 95% CI=1.96-7.59), difficult access to GP (2.08; 0.01; 1.25-3.46), and lack of adherence to treatment (1.61; 0.01; 1.19-2.18). These associations were relatively strongly explained by socioeconomic factors (19, 37 and 16%, respectively). They became non-significant when further accounting for school, health and behavioural difficulties. Conclusion. This study revealed the typology of depressive symptoms, barriers to care, and associated risk factors in younger adolescents. This knowledge may help screening and care for adolescent depressive symptoms.