Psychiatric Disorders and Health-Related Quality of Life in Children With Type 1 Diabetes Mellitus

Agnieszka Butwicka; Wojciech Fendler; Adam Zalepa; Agnieszka Szadkowska; Malgorzata Zawodniak-Szalapska; Agnieszka Gmitrowicz; Wojciech Mlynarski

doi:10.1016/j.psym.2015.11.001

Psychiatric Disorders and Health-Related Quality of Life in Children With Type 1 Diabetes Mellitus

Psychosomatics. 2016 Mar-Apr;57(2):185-93. doi: 10.1016/j.psym.2015.11.001. Epub 2015 Nov 3.

Authors

Agnieszka Butwicka¹, Wojciech Fendler², Adam Zalepa³, Agnieszka Szadkowska², Malgorzata Zawodniak-Szalapska⁴, Agnieszka Gmitrowicz⁵, Wojciech Mlynarski²

Affiliations

¹ Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Child Psychiatry, Medical University of Warsaw, Warsaw, Poland. Electronic address: agnieszka.butwicka@ki.se.
² Department of Paediatrics, Oncology, Haematology and Diabetology, Medical University of Lodz, Lodz, Poland.
³ Department of Child Psychiatry, Medical University of Warsaw, Warsaw, Poland.
⁴ Department of Endocrinology and Metabolic Diseases, Polish Mother's Memorial Hospital, Lodz, Poland.
⁵ Department of Adolescent Psychiatry, Medical University of Lodz, Lodz, Poland.

PMID: 26774893
DOI: 10.1016/j.psym.2015.11.001

Abstract

Background: Type 1 diabetes mellitus (T1DM) is a chronic condition with major effect on health-related quality of life (HRQoL) and mental health. In 1990s, high rates of psychiatric disorders were reported among children with T1DM. Little is known, however, about current prevalence of psychiatric disorders in children with T1DM and the relation between psychiatric diagnosis and HRQoL.

Objective: The aim of the study was to determine the prevalence of Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision) psychiatric disorders and the association between psychiatric comorbidity and HRQoL in the pediatric population with T1DM.

Methods: We conducted a cross-sectional study of 207 children, aged 8-18 years, diagnosed with T1DM. The presence of psychiatric disorders has been assessed by the standard diagnostic interview according to Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision) criteria. HRQoL was measured by the general and diabetes mellitus-specific modules of the Paediatric Quality of Life Inventory.

Results: Of the evaluated patients, 26.6% (N = 55) met the criteria for psychiatric disorders at the time of evaluation. The most common diagnoses were anxiety (N = 32; 15.5%) and mood disorders (N = 8; 3.9%). One-third of the patients (N = 66, 31.9%) met the criteria for at least 1 psychiatric diagnosis in their lifetime. The presence of psychiatric disorders was related to an elevated hemoglobin A1c level (8.6% vs 7.6%) and a lowered HRQoL level in the general pediatric quality of life inventory. In the diabetes mellitus-specific pediatric quality of life inventory, children with psychiatric disorders revealed more symptoms of diabetes mellitus, treatment barriers, and lower adherence than children without psychiatric disorders.

Conclusions: T1DM in children is associated with a very high prevalence of psychiatric comorbidity, which is related to elevated hemoglobin A1c and lower HRQoL levels.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Child
Comorbidity
Cross-Sectional Studies
Diabetes Mellitus, Type 1 / epidemiology*
Diabetes Mellitus, Type 1 / psychology*
Female
Health Status*
Humans
Male
Mental Disorders / epidemiology*
Mental Disorders / psychology*
Quality of Life / psychology*
Surveys and Questionnaires