Early onset and frequency of sexual experience are associated with problem behaviours such as delinquent acts, substance abuse and exposure to HIV. Sexual health services focus on young people may have a potential to identify those at risk.

To assess whether the levels, nature and associations of emotional and behavioural problems in adolescents attending a sexual health clinic differ from those of adolescents in the community.

A cross sectional survey was carried out at a London walk-in sexual clinic and an inner city school. We gathered demographic information and psychiatric and behavioural assessment using the Beck Depression Inventory (BDI), the Strengths and Difficulties Questionnaire (SDQ), a sexual attitude and behaviour questionnaire and the Westminster Substance Use Questionnaire.

We found significant differences between the groups in terms of their families (trouble with the police), sexual and health risks (sexual activity, pregnancy, number of sexual partners and Sexually Transmitted Diseases and more regular use of tobacco, alcohol and cannabis) and psychological risks (higher scores in BDI and SDQ emotional, conduct and hyperactivity subscales).

We conclude that urban sexual health clinics for adolescents appropriately attract young people, especially girls, with high sexual risk but also with high levels of substance use risk behaviours. However it also attracts girls with high levels of depressive disorder, and thus provides an opportunity to intervene not just for sexual risks, but also to provide psychoeducation and guidance on adolescent depressive symptoms.