ESPE Abstracts

Background: The course of type one diabetic disease (T1DM) varies according to the period of life and in response to various external or internal factors. Adolescence is an evolutionary phase that involves important developmental changes and identity construction. Diabetes disease and its management, especially in this life period, can lead to psychological distress and impact on Self-redefinition.

Method: We conducted a retrospective analysis on psychological data that emerged within the school camps conducted in recent years (2013-2019) with preadolescents (PA 12-14 years) and adolescents (A 15-17 years). We investigated: adaptation to diabetes (PAID, PA=213, A=209); self-esteem (Culture-Free Self-Esteem Inventory for Children Form, PA=158, A=154); mood (WHO-5, PA=205, A=211); anxiety (RCMAS-2/SAFA-A, PA=166, A=167) and disordered eating behaviors (DEPS-R, PA=124, A=124).

Results: Psychological scores were within normal range but with a wide dispersion and vary according to age. Diabetes related distress (PAID) was greater in PA compared to A (P = .03). Significant lower self-esteem levels were found in A than in PA (P = .0002). Lower emotional wellbeing scores emerged in A compared with PA (P < .0001). Anxiety, tested by two different questionnaires among years, didn’t show significant differences between PA and A. Concerning to eating disorder behaviors, difference between the two groups was found to be not quite statistically significant (P = 0.06), with an occurrence of clinical cases equal to 18% (PA) and 23% (A).

Conclusions: Our data highlighted a vulnerability in the areas investigated, with variations according to the age and developmental needs of the young patients. For the younger ones, the most complex aspect seems to be the adaptation to diabetes, probably due to their level of self-management skills and psycho-developmental challenges. Teens seem to be more aware of T1DM management, while their difficulties are more focused on mood and self-esteem. These aspects could be linked to the need to integrate the chronic condition in the vision of themselves and in the process of building identity. Data about eating disorders showed a frequency in line with literature but must be deepened in a larger group. Camps can improve psychological processing of the DMT1 condition giving the opportunity for peers of sharing the same daily life experience, decreasing sense of diversity. The data must be studied in a larger sample, also involving those who do not attend the camps but can be a starting point for planning interventions differentiated by age.