In the general population adolescents are at increased risk of developing anxiety and depression compared with other age groups. Adolescents with type 1 diabetes (T1D) may be even more vulnerable to these conditions, with prevalences of around 30%. Emotional problems have been shown to be associated with suboptimal glycemic outcomes and lower quality of life in young people with T1D. Also, demographic factors (e.g. gender, age, ethnicity) and diabetes-related factors (e.g. insulin pump therapy, frequency of blood glucose monitoring, HbA1c) have been shown to be related to anxiety and depression. One of the caveats of previous research is the use of self-report questionnaires and the focus on only the adolescents with T1D, overlooking links between parental and adolescent psychological functioning. The goals of this study were to assess:
In this observational cohort study, adolescents with T1D 12-18 years and their parents/caregivers were recruited at Diabeter, Meander Medical Center Amersfoort, and Albert Schweitzer hospital Dordrecht, as part of the ‘Longitudinal study of Emotional problems in Adolescents with T1D and their Parents/caregivers’ (Diabetes LEAP) project. Structured diagnostic psychiatric interviews and validated questionnaires were employed and both adolescent and parental correlates of anxiety/depression severity were included.
• Consistent with earlier literature, about 30% of adolescents with T1D reported having experienced an anxiety or mood disorder at some point in life
• Anxiety disorders were more prevalent than mood disorders
• Although comparison with earlier literature is difficult, mood disorder prevalence was lower than in previous studies, whereas anxiety disorder prevalence was higher
• Both anxiety and mood disorder prevalences were lower compared with the general Dutch population
• Less than half of adolescents who had experienced anxiety or mood disorders earlier in life had sought help from a health care professional
• Associations of symptom severity with age, gender, diabetes duration, insulin pump therapy and suboptimal glycemic control reported in other studies were not found in this study
• Higher adolescent diabetes-specific distress was related to higher adolescent anxiety and depressive symptom severity
• Parental distress was not related to adolescent anxiety or depression severity.
Concluding, the authors state