Symptoms of Eating Disorders and Depression in Emerging Adults with Early-Onset, Long-Duration Type 1 Diabetes and Their Association with Metabolic Control

Abstract

BackgroundThis study analyzed the prevalence of and association between symptoms of eating disorders and depression in female and male emerging adults with early-onset, long-duration type 1 diabetes and investigated how these symptoms are associated with metabolic control.MethodsIn a nationwide population-based survey, 211 type 1 diabetes patients aged 18-21 years completed standardized questionnaires, including the SCOFF questionnaire for eating disorder symptoms and the Patient Health Questionnaire (PHQ-9) for symptoms of depression and severity of depressive symptoms (PHQ-9 score). Multiple linear and logistic regression models were used to analyze the association between eating disorder and depressive symptoms and their associations with HbA1c.ResultsA total of 30.2% of the women and 9.5% of the men were screening positive for eating disorders. The mean PHQ-9 score (standard deviation) was 5.3 (4.4) among women and 3.9 (3.6) among men. Screening positive for an eating disorder was associated with more severe depressive symptoms among women (βwomen 3.8, p<0.001). However, neither eating disorder symptoms nor severity of depressive symptoms were associated with HbA1c among women, while HbA1c increased with the severity of depressive symptoms among men (βmen 0.14, p=0.006).ConclusionsBecause of the high prevalence of eating disorder and depressive symptoms, their interrelationship, and their associations with metabolic control, particularly among men, regular mental health screening is recommended for young adults with type 1 diabetes.

Disordered eating and insulin restriction in youths receiving intensified insulin treatment: Results from a nationwide population‐based study

“…21 Furthermore, concurrent mental health problems (e.g., depressive symptoms) may be associated with the prevalence of disordered eating and metabolic outcomes, as previously shown for young adults with early-onset T1D. 22,23 In conclusion, disordered eating and IR are common among youths with early-onset and longduration T1D and are associated with poor metabolic outcomes. Future studies should analyze reasons for and predictors of disordered eating and IR, examine the potential benefits of short screening instruments such as the SCOFF in patient groups, and develop and evaluate strategies for early…”

“…Once established, disordered eating is highly persistent, with the potential to progress to full‐blown EDs . Furthermore, concurrent mental health problems (e.g., depressive symptoms) may be associated with the prevalence of disordered eating and metabolic outcomes, as previously shown for young adults with early‐onset T1D …”

Assessing the clinical utility of the diabetes eating problem survey‐revised (DEPS‐R) in adolescents with type 1 diabetes

“…In our study, a prior diagnosis of depression or anxiety was not associated with DE behaviours. Other studies have shown that young adults with T1D who screened positive for DE have more severe depressive symptoms . Neither of these studies used screening tools that were specific to the T1D population when looking at the prevalence of DE.…”

“…Other studies have shown that young adults with T1D who screened positive for DE have more severe depressive symptoms. 25,26 Neither of these studies used screening tools that were specific to the T1D population when looking at the prevalence of DE. Bachle et al, found that a minority of young adults with depressive symptoms met DSM-V criteria for depression, which may account for why no association was seen in our study.…”

“…DEPS scores of 8 [4-11.7], 16 [9][10][11][12][13][14][15][16][17][18][19][20][21][22] and 28 [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36], respectively, as shown in Figure 2.…”