The Need for Data Analysis of Chronic Versus Acute Health Conditions and Depressive Symptoms in Adolescents

Introduction: While it is well-established that chronic health conditions cause depressive symptoms in adolescents, little is known about the comparative risks of acute versus chronic health conditions. Two studies on the matter have had mixed findings. Researches can incorporate analysis of chronic versus acute health conditions and depressive symptoms into their existing studies by using the following methods. If studies replicate findings that adolescents with acute health conditions are more likely to have depressive symptoms during hospitalization, interventions as simple as orienting adolescents to the hospital environment might reduce this risk. If the risks are similar among both groups, interventions for those with chronic health conditions might be expanded to include those with acute health conditions.

Methods: Data from a NIMH instrument development study database was used for this analysis. Four hundred adolescents completed the PHQ-A and answered questions about their health condition while they were hospitalized on the general medical floor of two urban, pediatric hospitals in the Eastern United States. The average age of the participants was 15.2 (SD=2.9). Participants were 47.3% White and 26.8% Black. A little more than half (59.3%) of the participants were female. A rater used the ICD-10-CM chronic condition indicator database to code the health conditions as chronic, acute, or other. A second rater independently coded 25% of the data. The inter-rater reliability was 96.8%.

Results: Adolescents with chronic health conditions were 65% more likely to experience depressive symptoms than those with acute health conditions (odds ratio = 1.65, p=.04). However, this likelihood reduced to 30% and did not generalize to the broader population when controlling for gender, race, and ethnicity (odds ratio = 1.30, p>.05).

Conclusions: While it is well-known that chronic health conditions can cause depressive symptoms in adolescents, research has not captured any differential effects of chronic versus acute health conditions. Existing studies easily can incorporate such analysis. The results would inform whether current interventions to prevent depressive symptoms in adolescents with chronic health conditions should be modified. New interventions could target those with acute health conditions, existing interventions could be expanded to include adolescents with acute health conditions, or interventions could be kept the same with full knowledge of why adolescents with acute health conditions are not included.