Symptoms of Emotional, Behavioral, and Social Difficulties in the Danish Population of Children and Adolescents with Type 1 Diabetes – Results of a National Survey

Abstract

ObjectiveTo assess the prevalence of psychological difficulties in Danish children and adolescents with type 1 diabetes using both child/adolescent and caregiver reports, and to investigate associations between these symptoms and metabolic control, adherence, and quality of life.Research Design and Method:A total of 786 children and adolescents (8–17 years) recruited through the Danish Registry of Childhood Diabetes completed subscales of the Beck's Youth Inventories (BYI-Y), while 910 caregivers completed the Strength and Difficulties Questionnaire (SDQ). The participants also completed questionnaires assessing adherence and quality of life. BYI-Y and SDQ responses were compared with results from normative samples.ResultsChildren with diabetes generally reported a lower level of symptoms of depression and anxiety, while older adolescents in most cases were comparable to the normative samples. However, the numbers of patients with elevated scores were similar to normative groups, especially regarding the proportion of participants with ‘Extremely elevated’ scores. Caregivers of children and adolescents with diabetes generally reported the prevalence of elevated scores on the SDQ to exceed the prevalence observed in the norm sample – particularly with regard to older boys. Both BYI-Y and SDQ responses were significantly correlated with HbA1c, adherence, and quality of life.ConclusionsThis study finds Danish children and adolescents with diabetes to report lower or comparable levels of emotional difficulties compared to norms, while caregiver reports are less positive. The results therefore support the value of a multi-informant approach to the assessment of symptoms of psychological difficulty in girls and boys with diabetes.

Assessment of family functioning in families with a child diagnosed with type 1 diabetes ‐ Validation and clinical relevance of the General Functioning subscale of the McMaster Family Assessment Device

“…HbA1c levels were significantly higher in families where the child was the only family member participating in the study. In addition, no significant differences were observed between those responding and those initially agreeing to participate but whose answers were missing, whereas HbA1c levels were higher in those who did not agree to participate …”

“…This validation study is part of a national web‐based survey performed in 2009 that included 1997 Danish children and adolescents (aged from 2 to 17 years) with T1D. The study aimed to assess the influence of several psychosocial variables (including family functioning) on glycemic control, adherence to treatment, and quality of life . Data collection was conducted in collaboration with the Danish Society for Diabetes in Childhood and Adolescence and the national database DanDiabKids.…”

“…The study aimed to assess the influence of several psychosocial variables (including family functioning) on glycemic control, adherence to treatment, and quality of life. [23][24][25] Data collection was conducted in collaboration with the Danish Society for Diabetes in Childhood and Adolescence and the national database DanDiabKids. This registry has collected information on Danish children and adolescents with T1D since 1996.…”

A Danish version of self‐efficacy in diabetes self‐management: A valid and reliable questionnaire affected by age and sex

“…Our study was conducted in 2009 as part of a nationwide websurvey that included all 1997 Danish children and adolescents (2-17 years) with T1D. 13,19,20 It contained 15 different questionnaires (including SEDM) and assessed the influence of psychosocial variables on adherence, glycemic control, and QoL and was conducted in collaboration with the Danish Society for Diabetes in Childhood and Adolescence, which administers the Danish Registry for Childhood and Adolescent Diabetes (DanDiabKids). This registry contains information dating back to 1996 on every child and adolescent with T1D in Denmark.…”

Trajectories of Health-Related Quality of Life and HbA1c Values of Children and Adolescents With Diabetes Mellitus Type 1 Over 6 Months: A Longitudinal Observational Study

“…The relationship between the clinical outcome parameter HbA1c concentration, as an indicator for the glycemic target, and HRQL has also been investigated in young patients with diabetes mellitus. While some studies, found no associations between HRQL and glycemic target (21)(22)(23), others were able to detect a relationship between both the two outcome parameters (24)(25)(26)(27). For example, it was found that higher scores in HRQL were associated with better metabolic control (25), while poor metabolic control was related to psychosocial problems in children and adolescents with T1DM (12,27).…”