ESPE Abstracts

Background: Diabetes mellitus (DM) is a lifelong metabolic disorder requiring insulin injection or oral medication and lifestyle modification. Diabetic children may have psychological problems including depression, anxiety, and stress. The study was aim ed to screen the prevalence of psychologic abnormalities and to find the association of the psychological problems with the patients’ medical conditions.

Subjects and Methods: Pediatric patients diagnosed with DM in a single tertiary center were included in the study. We screened the levels of anxiety, depression, and stress by applying Depression, Anxiety, and Stress Scale-21 (DASS-21), General Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9). Based on a retrospective review of medical records, we analyzed the prevalence of psychological problems in patients and the relationship between psychological status and medical conditions of patients.

Results: A total of 83 diabetic children included in the study (49 T1DM, 32 T2DM, 2 MODY). Fifty-one were males. The mean age of participants at the time of survey was 15.07 years. Mean ages at initial diagnosis and duration of DM were 10.7 (SD 3.93) and 4.34 (SD 4.47) years, respectively. Seventeen (20%) showed abnormal scores in any of the 3 questionnaires. Corresponding percentage of patients scoring over mild in DASS depression, DASS anxiety, DASS stress, PHQ-9, and GAD-7 were 7.2%, 9.6%, 4.8%, 16.9%, and 8.4%, respectively. Three patients assessed to be over moderate scores in depression, also showed abnormalities in stress and anxiety. Female showed a higher rate of abnormal PHQ-9 scores (P <0.05), and there were more problematic results in non-T1DM children than in T1DM patients (P <0.05). HbA1c at the time of survey was meaningfully higher in DASS-stress abnormal (over mild) group (P < 0.05). A follow-up questionnaire performed to a total of 53 diabetic patients (31 T1DM, 20 T2DM, 2 MODY) revealed unchanged (40), improved (3), and worsened (10) psychological scores. Mean age at recent visit was of 12.7 years in group with improved psychological scores compared to 15.7 years in group with worsened psychological scores.

Conclusion: This study showed abnormal psychological conditions in diabetic children. Females and non-T1DM children had more abnormalities in psychological assessment scores. It appears necessary to pay attention to psychological aspects in managing children with DM.