Pozuelo JR, Desborough L, Stein A, et al. - A systematic review and meta-analysis were conducted to examine the relationship between depressive symptoms and risky behaviors among adolescents in low- and middle-income countries (LMICs). Researchers carried out searches of 15 electronic databases for published or unpublished cohort and case-control studies about adolescents in LMICs. They used no restrictions on date or language. The primary endpoint included the relationship (odds ratio [ORs]) between depressive symptoms and risky sexual behavior and substance use. Delinquency, adverse school behavior, self-harm, and suicidal behavior were considered as secondary endpoints. The results demonstrate that adolescents with depression in LMICs carry a double burden: they both suffer from depression and are at an increased risk of engaging in risky behaviors. The outcomes reveal that this combination may lead to further psychological and physical health problems that persist over the life course, and may impose a health burden on society as a whole. The data illustrate the urgent need for scalable and sustainable approaches to prevent and/or treat depression among adolescents in resource-poor settings.