Psychiatric disorders during early adulthood in those with childhood onset type 1 diabetes: Rates and clinical risk factors from population-based follow-up

Cooper, Matthew N.; Lin, Ashleigh; Alvares, Gail A.; Klerk, Nicholas de; Jones, Timothy W.; Davis, Elizabeth A.

doi:10.1111/pedi.12469

Cited by 62 publications

(81 citation statements)

References 36 publications

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“…Cooper et al . 41 found that young people with Type 1 diabetes (average age of 9 years at baseline) had a 2.5 times increased hazard of developing incident anxiety over 26 years. Furthermore, Huang et al .…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, as anxiety disorder tends to occur in adolescence or early adulthood 44 the approach taken by Cooper et al . 41 following people up from a younger age may better allow us to make inferences on diabetes as a cause of incident anxiety.…”

Section: Discussionmentioning

confidence: 99%

“…Cooper et al . 41). In addition, there are also possibly issues with only examining anxiety ‘cases’.…”

Section: Discussionmentioning

confidence: 99%

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Investigating the longitudinal association between diabetes and anxiety: a systematic review and meta‐analysis

2018

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AimPrevious research has indicated an association between diabetes and anxiety. However, no synthesis has determined the direction of this association. The aim of this study was to determine the longitudinal relationship between anxiety and diabetes.MethodsWe searched seven databases for studies examining the longitudinal relationship between anxiety and diabetes. Two independent reviewers screened studies from a population aged 16 or older that examined either anxiety as a risk factor for incident diabetes or diabetes as a risk factor for incident anxiety. Studies that met eligibility criteria were put forward for data extraction and meta‐analysis.ResultsIn total 14 studies (n = 1 760 800) that examined anxiety as a risk factor for incident diabetes and two (n = 88 109) that examined diabetes as a risk factor for incident anxiety were eligible for inclusion in the review. Only studies examining anxiety as a risk factor for incident diabetes were put forward for the meta‐analysis. The least adjusted (unadjusted or adjusted for age only) estimate indicated a significant association between baseline anxiety with incident diabetes (odds ratio 1.47, 1.23–1.75). Furthermore, most‐adjusted analyses indicated a significant association between baseline anxiety and incident diabetes. Included studies that examined diabetes to incident anxiety found no association.ConclusionsThere was an association between baseline anxiety and incident diabetes. The results also indicate the need for more research to examine the direction of association from diabetes to incident anxiety. This work adds to the growing body of evidence that poor mental health increases the risk of developing diabetes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Investigating the longitudinal association between diabetes and anxiety: a systematic review and meta‐analysis

2018

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“…Esto hace que para un adolescente con DMT1 el tratamiento diario sea aún más difícil de controlar 31 . Existe una mayor incidencia de problemas psicosociales en comparación a la población general, que alcanza a 2,3 veces 32 . No es raro que muchos adolescentes, presentan sentimientos de ira, miedo, infelicidad o incluso crisis de angustia por la presencia de la DMT1 2 .…”

Section: Adolescencia Y Problemas Psicosocialesunclassified

“…Muchos de los pacientes con diabetes relatan que tienen preocupación por las reacciones y los problemas con la familia, amigos y compañeros que no son diabéticos 1 . En los jóvenes diabéticos se ha reportado que los trastornos psiquiátricos más frecuentes son la ansiedad, depresión y trastornos alimenticios 1,5,32 . En Chile, jóvenes con DMT1 presentaron altos niveles de estrés, debido a los serios y complejos desafíos psicológicos y conductas, los que pueden llevar a presentar sínto-mas depresivos, mala adherencia a la insulinoterapia y llegar así a un pobre control metabólico 31 .…”

Section: Adolescencia Y Problemas Psicosocialesunclassified

Impacto psicosocial de la diabetes mellitus tipo 1 en niños, adolescentes y sus familias. Revisión de la literatura

Henríquez-Tejo¹,

Cartes‐Velásquez

2018

Rev. chil. pediatr.

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ResumenLa diabetes mellitus tipo 1 es la patología endocrina crónica más común en niños. El tratamiento incluye dieta, actividad física, medicación con insulina y un autocontrol adecuado. Este autocontrol puede ser dificultoso, provocando que niños, adolescentes y sus familias sufran diversas complicaciones psicosociales. Existe una relación inversa entre autocontrol y presencia de complicaciones psicosociales, siendo los principales problemas ansiedad y depresión, donde los adolescentes llegan a ser 2,3 veces más propensos a presentar problemas de salud mental. Las familias se ven afectadas inicialmente en el período de debut por un estado de shock, con sentimientos de angustia e ira. Los necesarios cambios de hábitos y estilos de vida pueden generar problemas psicosociales entre los que destacan trastornos ansiosos, depresivos y alimenticios. Posteriormente, el niño o adolescente y su grupo familiar pueden transitar a un nuevo equilibrio caracterizado por un buen autocontrol y adherencia al tratamiento o profundizar los trastornos individuales y grupales, trastornos que pueden reaparecer, especialmente en la adolescencia. El tratamiento integral de la diabetes mellitus tipo 1 requiere atender estos aspectos mediante equipos multidisciplinarios que incluyen profesionales médicos y del ámbito psicosocial. En esta revisión se analizan los principales aspectos relacionados al impacto psicosocial en niños y adolescentes con diabetes mellitus tipo 1 y sus familias. Keywords:Diabetes mellitus type 1; psychosocial impact; family AbstractType 1 diabetes mellitus is the most common chronic endocrine pathology among children. Treatment includes diet, physical activity, insulin medication, and proper self-control. This self-control may be difficult, resulting in children, adolescents and their families suffering diverse psychosocial complications. There is an inverse relationship between self-control and psychosocial complications, the main problems being anxiety and depression, where adolescents are 2.3 times more likely to have mental

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Psychotropic Medication Use in Children and Adolescents With Type 1 Diabetes

Liu,

Lagerberg,

Ludvigsson

et al. 2023

JAMA Netw Open

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ImportanceChildren and adolescents with type 1 diabetes (T1D) face elevated risks of psychiatric disorders. Despite their nonnegligible adverse effects, psychotropic medications are a common cost-effective approach to alleviating psychiatric symptoms, but evidence regarding their dispensation to children and adolescents with T1D remains lacking.ObjectiveTo examine the trends and patterns of psychotropic medication dispensation among children and adolescents with T1D in Sweden between 2006 and 2019.Design, Setting, and ParticipantsThis cohort study used data from multiple Swedish registers. The main study cohort included children and adolescents residing in Sweden from 2006 to 2019 and was followed up until the earliest of December 31, 2019, 18th birthday, emigration, or death. Data analyses were conducted from November 1, 2022, to April 30, 2023.ExposuresType 1 diabetes.Main Outcomes and MeasuresThe primary outcomes were trends and patterns of psychotropic medication dispensation (including antipsychotics, antidepressants, anxiolytics, hypnotics, mood stabilizers, and medications for attention-deficit/hyperactivity disorder [ADHD]), psychotropic medication initiation, and history of neurodevelopmental and psychiatric diagnosis. Cumulative incidence curves and Cox proportional hazard models were used to estimate the aggregated incidence and hazard ratios of medication initiation after diabetes onset.ResultsOf 3 723 745 children and adolescents (1 896 199 boys [50.9%]), 13 200 (0.4%; 7242 boys [54.9%]) had T1D (median [IQR] age at diagnosis, 11.1 [7.6-14.7] years). Between 2006 and 2019, psychotropic medication dispensation increased from 0.85% (95% CI, 0.65%-1.10%) to 3.84% (3.11%-4.69%) among children and from 2.72% (95% CI, 2.15%-3.39%) to 13.54% (95% CI, 12.88%-14.23%) among adolescents with T1D, consistently higher than their peers without T1D. The most commonly dispensed medications included hypnotics, ADHD medications, anxiolytics, and selective serotonin reuptake inhibitors, and all exhibited increasing trends. For those with T1D, psychiatric care was the primary prescription source, and up to 50.1% of treatments lasted more than 12 months. In addition, children and adolescents with T1D showed higher cumulative incidence and hazard ratios of medication initiation after diabetes onset than their same-age and same-sex counterparts.Conclusions and RelevanceThis cohort study found an increasing trend in psychotropic medication dispensation among children and adolescents with T1D from 2006 to 2019, persistently higher than those without T1D. These findings call for further in-depth investigations into the benefits and risks of psychotropic medications within this population and highlight the importance of integrating pediatric diabetes care and mental health care for early detection of psychological needs and careful monitoring of medication use.

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Psychiatric disorders during early adulthood in those with childhood onset type 1 diabetes: Rates and clinical risk factors from population-based follow-up

Abstract: Our findings highlight the need for access to mental health support services as part of routine patient care for young adults with T1D, and for better predictive tools to facilitate targeting at-risk patients with early intervention programs.

Cited by 62 publications

References 36 publications

Investigating the longitudinal association between diabetes and anxiety: a systematic review and meta‐analysis

Investigating the longitudinal association between diabetes and anxiety: a systematic review and meta‐analysis

Impacto psicosocial de la diabetes mellitus tipo 1 en niños, adolescentes y sus familias. Revisión de la literatura

Psychotropic Medication Use in Children and Adolescents With Type 1 Diabetes

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