Children with Diabetes Compared to Peers: Depressed? Distressed?

Abstract

Background It is not clear from the literature whether children with diabetes have more psychological difficulties than their peers. Purpose This study aims to use meta-analysis to determine if children with diabetes differ from children without a chronic illness in a variety of domains reflecting psychological well-being. Method A meta-analysis was undertaken of 22 studies that compared children with diabetes to a comparison group. Outcomes included depression, anxiety, behavioral problems, and related constructs. Results Children with diabetes were more likely than comparison groups to experience a variety of psychological difficulties. However, these effects were small to medium in magnitude and were typically smaller among more recent studies and studies with well-matched comparison groups. Conclusions This meta-analysis suggests that children with diabetes are at slightly elevated risk for psychological difficulties. Future work will need to help identify children at the highest risk, and to identify factors associated with resilience.

Major Depressive Disorder and Bipolar Disorder Predispose Youth to Accelerated Atherosclerosis and Early Cardiovascular Disease

“…65 Moreover, among young adult males in 2 Finnish population samples, severity of depressive symptoms was associated with insulin resistance. 66,67 In meta-analytic findings, depressive symptoms along with other psychological symptoms were more common among children with versus without T2DM, 68 and there was preliminary evidence that the association between depression and T2DM was especially strong in youth. 69 There is pharmacoepidemiological evidence of elevated rates of hyperglycemia and †"Youth" is used in this statement as an umbrella term for children, adolescents, and/or young adults (defined here as mean sample age within 1 standard deviation of 30 years).…”

Cardiovascular Disease Risk Factors in Youth With Diabetes Mellitus

“…367 A meta-analysis of 22 case-control studies found that psychological problems, including depressive symptoms, were more likely among children with versus without diabetes mellitus, 368 although exceptions exist. 369,370 In a large study of youth with T1DM, 17% had significant depressive symptoms, half of whom did not discuss these symptoms with their pediatrician or nurse.…”

Anxiety and depressive disorders in children and adolescents suffering from diabetes mellitus

“…A meta-analytic report, which included 22 studies, indicated that children suffering from DM, compared to peers, experience elevated levels of depression, anxiety and psychological distress, although the effect was found to be small to medium 18 . Furthermore, it showed that children with poor metabolic control amongst DM patients manifest larger anxiety and psychosocial distress, meaning that poorer control of the disease could lead to mental problems 18 . Another systematic review and meta-analysis 19 , which included 14 studies, showed that the occurrence of anxiety symptoms is raising up to every third child and adolescent suffering from T1D.…”

“…Nevertheless, even if DM is shown to be a risk factor for depression onset 18 , the relationship could be bidirectional, since it is possible for mental health problems to also cause poorer metabolic control 22,23 . A few authors state that DM is not a risk factor for depression, although it can strengthen the severity of psychological symptoms 19 .…”