Abstract
ObjectiveTo evaluate mental health problems and associations between mental health problems and health-related quality of life in adolescents with type 1 diabetes in comparison with the general population.MethodA total of 629 11- to 17-year-olds with early-onset and long-lasting type 1 diabetes and their parents completed comprehensive questionnaires. Mental health was assessed using the parent- and self-report versions of the Strengths and Difficulties Questionnaire (SDQ). The Revised Children's Quality of Life Questionnaire (KINDL-R) was used to measure quality of life. The comparison group (n = 6,813) was a representative sample from the German KiGGS study.ResultsThe proportion of youths with mental health problems (defined as abnormal SDQ total difficulties score) was, based on self-reports, 4.4% in the patient group and 2.9% in the general population (adjusted OR = 1.61, p = 0.044); and based on proxy reports, 7.9% in the patient group and 7.2% in the general population (OR = 1.05, p = 0.788). Youths with type 1 diabetes and self-reported mental health problems scored worse in the KINDL-R subscales of physical well-being (adjusted average difference β = −16.74, p<0.001) and family (β = −11.09, p = 0.017), and in the KINDL-R total score (β = −8.09, p<0.001), than peers with self-reported mental health problems. The quality of life of diabetic adolescents and proxy-reported mental health problems did not differ from peers with proxy-reported mental health problems adjusted for confounders.ConclusionsCompared with the general population with mental health problems, the quality of life of adolescents with type 1 diabetes who report mental health problems is more severely impaired. This observation calls for early prevention and intervention as part of pediatric diabetes long-term care.
Highlights
Type 1 diabetes is a chronic disease that results from autoimmune destruction of insulin-producing beta cells of the pancreas
The quality of life of diabetic adolescents and proxy-reported mental health problems did not differ from peers with proxy-reported mental health problems adjusted for confounders
The results of this study offer insights into the mental health of 11- to 17-year-olds with early-onset and long-duration type 1 diabetes which are relevant for clinical practice
Summary
Type 1 diabetes is a chronic disease that results from autoimmune destruction of insulin-producing beta cells of the pancreas. Several studies have been conducted with regard to mental health problems in adolescents with type 1 diabetes [5,6,7,8,9,10] None of these studies focused on patients with type 1 diabetes onset during the first five years of life, who suffer from the disease for most of their lives. This is surprising because the incidence of early-onset type 1 diabetes has been steeply increasing in several Western countries for some years [11]. There is increasing evidence that the individual and societal impact in patients with early disease onset is higher than in patients with later onset [12,13]
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