Psychological screening in adolescents with type 1 diabetes predicts outcomes one year later

Abstract Aims Adolescents with type 1 diabetes are at increased risk for depression and anxiety, which can adversely affect diabetes management, glycemic control, and quality of life (QOL). However, systematic psychological screening is rarely employed. We hypothesized that higher depression and anx...

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Published in:Diabetes research and clinical practice 2011-10, Vol.94 (1), p.39-44
Main Authors: Hilliard, Marisa E, Herzer, Michele, Dolan, Lawrence M, Hood, Korey K
Format: Article
Language:English
Subjects:
Adherence
Adolescent
Anxiety
Anxiety - blood
Anxiety - physiopathology
Blood Glucose - metabolism
Depression
Depression - blood
Depression - physiopathology
Diabetes Mellitus, Type 1 - blood
Diabetes Mellitus, Type 1 - psychology
Endocrinology & Metabolism
Female
Glycemic control
Humans
Male
Quality of Life
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Summary:Abstract Aims Adolescents with type 1 diabetes are at increased risk for depression and anxiety, which can adversely affect diabetes management, glycemic control, and quality of life (QOL). However, systematic psychological screening is rarely employed. We hypothesized that higher depression and anxiety screener scores would predict higher HbA1c, less frequent blood glucose monitoring (BGM), and poorer QOL one year later. Raw screener scores were expected to be more robust predictors than cutoff scores. Methods 150 adolescents age 13–18 with type 1 diabetes completed depression and anxiety screeners. One year later, blood glucose meters were downloaded to assess BGM frequency, HbA1c values were obtained, and caregivers rated the participants’ QOL. Separate regressions were conducted for each outcome, including demographic and medical covariates. Results Higher depression scores predicted less frequent BGM ( b = −0.05, p < .05) and poorer QOL ( b = −0.71, p < .01), and higher state anxiety scores predicted higher HbA1c ( b = 0.07, p < .05). Continuous screener scores identified risk for 12-month outcomes more robustly than clinical cut-off scores. Conclusions Psychological screeners predict diabetes outcomes one year later. Future clinical research studies should explore whether psychological screening and referral for appropriate intervention can prevent deteriorations in diabetes management and control commonly seen during adolescence.
ISSN:0168-8227
1872-8227
DOI:10.1016/j.diabres.2011.05.027