The identification of risk factors associated with depression and suicidal ideation in adolescence is critical to early diagnosis and treatment. The findings from our study provide strong evidence that adolescents presenting with symptoms of sleep disturbance are at increased risk for both depressive symptoms and suicidal ideation. In this large sample of adolescents, sleep clinic patients reported clinically significant levels of depressive symptoms at more than twice the rate of patients in other sub-specialty clinics (cardiology, endocrinology, gastroenterology, hematology nephrology, neurology, pulmonary, rehabilitative medicine, and rheumatology). Surprisingly, the rate of positive depression screens in patients across many comparison specialty clinics was consistent with or lower than the general population prevalence rate of 4% to 5%, 1 compared to the 14% to 15% prevalence rate observed in studies of medically ill children.
In contrast, the rate of positive depression screens in the sleep clinic was more than twice as high as the rate of depression found in the general adolescent population. This discrepancy may be explained by the hospital’s broad implementation of the depression screener in outpatient specialty clinics, which captured a much larger number of patients, many of whom may have had milder forms of illness, rather than a life-limiting condition.
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