An Initial Evaluation of the Design of Pediatric Psychology Consultation Service with Children with Diabetes

Abstract

The objective of this study was to review the process of psychology consultation with an outpatient pediatric diabetes service, and provide data regarding assessment and outcome. The purpose was to demonstrate that the inclusion of psychology in the care of the child would enhance the effectiveness of treatment delivery. Over a one-year period, 91 psychological consultations were reviewed for information related to reasons for referral, diagnosis, and treatment. Processes of assessment and collaboration are described. Nearly half of all the participants that were referred for a consultation met the criteria for a psychiatric disorder, including Attention-Deficit Hyperactivity Disorder, mood disorder or anxiety. Paired t-tests revealed significant improvement in metabolic control from referral to the next clinic appointment. Psychological consultation appears to have a positive impact on selected health outcomes. Given the large number of children with psychiatric disorder, psychological intervention may facilitate adherence and reduce complications associated with poor metabolic control.

Psychiatric Disorders in Youth With Perinatally Acquired Human Immunodeficiency Virus Infection

“…38 Similarly, the rates of psychiatric disorders in our cohort are comparable to those found in several studies of older children and adolescents with other chronic health conditions, including diabetes and cancer, in which 47%, on average, have met criteria for a psychiatric disorder. 39,40 In our study, there was not always concordance between caregiver and child reports of psychiatric disorders. Even though children and caregivers agreed on whether or not the child met criteria for a disorder in almost two-thirds of the dyads, there was greater concordance between caregivers and children when the child did not meet criteria.…”

Anxiety in Youth With Type 1 Diabetes

“…General anxiety was also associated with a higher risk of diabetes-related rehospitalization (OR = 1.79, CI 1.27–2.52) (Garrison et al, 2005), and poorer coping (beta = 0.39, p < 0.01) (Grey et al, 1991). Treatment of anxiety symptoms was associated with improved glycemic control by an average of 0.8 percentage points (p < 0.01) (Gelfand et al, 2004). …”

Comorbidity of attention deficit hyperactivity disorder and type 1 diabetes in children and adolescents: Analysis based on the multicentre DPV registry

“…Further research and studies are necessary to better understand the impact of ADHD on diabetes control and acute complications in order to give evidence‐based advice and improve both diabetes therapy as well as psychiatric help for this group of patients. A closer collaboration of paediatric diabetologists with paediatric psychologists/psychiatrists seems to be an important step . Increased awareness for behavioural patterns in everyday management is needed to improve diabetic care and outcome in diabetes patients with ADHD comorbidity.…”