The influence of race and gender on depressive and substance abuse symptoms in high-risk adolescents.

Concerns about the cultural competence of child mental health services has led to the examination of racial/ethnic and gender differences in the prevalence of psychiatric symptoms. This study examines racial and gender differences in depressive and substance abuse symptomatology in a high-risk population of adolescents living in five residential group homes in South Carolina. We surveyed 299 youth ages 12 to 17, including 101 African American and 198 Whites. They completed the Centers for Epidemiological Studies-Depression scale (CES-D) and questions on substance abuse, demographics, and psychosocial functioning. No significant differences were found in the percentages of Whites and African Americans scoring above 16+ and 23+ cutoff scores on the CES-D, but significant gender differences were identified. Neither race nor race by age group interactions were found to be significantly correlated in regression analyses with CES-D score nor multiple substance use, whereas gender (p < .001) and school performance were significantly correlated with CES-D score, and poverty was correlated with multiple substance use. Our results indicate that levels of depressive symptomatology as measured by the CES-D are much more sensitive to gender than to race in high-risk populations. Different gender cutoffs are indicated when using systematic instruments in the measurement of depressive symptoms.