Linh Anh Nguyen, Frans Pouwer, Per Winterdijk, Esther Hartman, Roos Nuboer, Theo Sas, Ineke de Kruijff, Willie Bakker-Van Waarde, Henk-Jan Aanstoot, Giesje Nefs

Prevalence and course of mood and anxiety disorders, and correlates of symptom severity in adolescents with type 1 diabetes: Results from diabetes LEAP. Pediatr Diabetes. 2021 Jun; 22(4):638-648.

In the general population adolescents are at increased risk of developing anxiety and depression compared with other age groups. Adolescents with type 1 diabetes 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 type 1 diabetes. 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 type 1 diabetes, overlooking links between parental and adolescent psychological functioning. The goals of this study were to assess:

 

• the prevalence of anxiety and mood disorders in adolescents with type 1 diabetes in the Netherlands
• if demographic and clinical characteristics, adolescent diabetes distress and parental distress are associated with the severity of adolescent anxiety and depressive symptoms

In this observational cohort study, adolescents with type 1 diabetes 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 type 1 diabetes 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.

 

Key findings:
• Consistent with earlier literature, about 30% of adolescents with type 1 diabetes 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

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