Abstract
Assessing mental health in children and adolescents with insulin-dependent diabetes (IDD) is an issue that is underperformed in clinical practice and outpatient clinics. The evaluation of their thoughts, emotions and behaviors has an important role in understanding the interaction between the individual and the disease, the factors that can influence this interaction, as well as the effective methods of intervention. The aim of this study is to identify psychopathology in adolescents with diabetes and the impact on treatment management. A total of 54 adolescents with IDD and 52 adolescents without diabetes, aged 12–18 years, completed APS–SF (Adolescent Psychopathology Scale–Short Form) for the evaluation of psychopathology and adjustment problems. There were no significant differences between adolescents with diabetes and control group regarding psychopathology. Between adolescents with good treatment adherence (HbA1c < 7.6) and those with low treatment adherence (HbA1c > 7.6), significant differences were found. In addition, results showed higher scores in girls compared with boys with IDD with regard to anxiety (GAD), Major Depression (DEP), Post-Traumatic Stress Disorder (PTSD), Eating Disturbance (EAT), Suicide (SUI) and Interpersonal Problems (IPP). No significant differences were found regarding the duration of the disease. Strategies such as maladaptive coping, passivity, distorted conception of the self and the surrounding world and using the negative problem-solving strategies of non-involvement and abandonment had positive correlation with poor glycemic control (bad management of the disease). The study highlighted the importance of promoting mental health in insulin-dependent diabetes management.
Highlights
Insulin-dependent diabetes (IDD) is one of the most common chronic diseases in children and adolescents
The present research attempted an analysis of psychological functioning through the self-assessment of behavior, observation of rules, predisposition to react through anger/violence, perception of school problems, eating disorders, interpersonal problems, anxiety, depression, post-traumatic stress and ideation, as well as suicide attempts in adolescents with insulin-dependent diabetes (IDD) (n = 54) and those without this chronic disease (n = 52)
There were no significant differences in the median distribution of psychiatric psychopathology identified by the ASP–SF between two groups—adolescents with and without diabetes (Figure 1)
Summary
Insulin-dependent diabetes (IDD) is one of the most common chronic diseases in children and adolescents. IDD management involves blood sugar measuring, carbohydrate calculation, dosing and administration of insulin, a healthy lifestyle, regular physical activity, rest and avoidance of risky behaviors such as use of alcohol, tobacco and drugs [3] Compliance with these conditions has a determining role in physical and psychological integrity. The negative influence of psychiatric co-morbidities, such as anxiety, depression and eating disorders, on the management of diabetes is highlighted in several studies [4,6,7], and diabetes, as a chronic illness, is considered one of the main causes of emotional exhaustion and suicide risk factor in children and adolescents with diabetes [8,9] This data does not exclude the existence of mental disorders in children without diabetes. William Dikel says that one in five adolescents suffers from a mental disorder, and the age of adolescence is a vulnerable stage; adults must pay special attention to the manifestations of such disorders at during this time, promoting efficient coping methods [10]
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