Psychiatric Comorbidities in Children and Youth With Type 2 Diabetes: A Systematic Review and Meta-Analysis

Abstract

Type 2 diabetes mellitus (T2DM) is on the rise in children and is associated with multiple comorbidities. This systematic review and meta-analysis aimed to estimate the prevalence of psychiatric comorbidities in pediatric T2DM, and the impact of sex and race on this prevalence. We searched MEDLINE, Embase, PsycINFO, CINAHL, Cochrane Library, and Web of Science from inception until April 4, 2021, for eligible articles. Two reviewers independently screened observational studies with ≥10 participants, reporting on the prevalence of mental health conditions in children and youth with T2DM. Twenty-two studies met the inclusion criteria. The pooled prevalence of behavioral, psychiatric, or developmental disorders in pediatric T2DM was 22.42% (95%CI 17.48-27.76, I2=37%, n=516). The prevalence of depressed mood or depressive symptoms was 19.03% (95%CI 15.33-23.02, I2=0%, n=415) and 21.55% (95%CI 16.89-26.59, I2=0%, n=282), respectively. The prevalence of depression was 9.68% (95%CI 3.36-18.60, I2=88%, n=620). Females were more likely than males to have depressive symptoms (16.8% vs. 11.1%) and disordered eating behaviours (53.1% vs. 45.3%). No data were available to explore the impact of race on psychiatric comorbidities. In conclusion, one in five pediatric T2DM patients have psychiatric comorbidities, and females may be at higher risk than males of these comorbidities. Supports for this population are urgently needed to improve mental health and glycemic outcomes.