Endocrine Abstracts

Introduction: Chronic diseases such as type 1 diabetes can be associated with psychiatric disorders. Previous data suggest a high prevalence of depression, anxiety, disordered eating and diabetes distress among patients with diabetes. Mental health problems could interfere with treatment adherence, glucose control and chronic complications.

Objective: We aim to evaluate the prevalence of psychiatric disorders, drug abuse, and treatment adherence in patients with type 1 diabetes. We also aim to study the association of mental health problems with glycemic control and chronic complications.

Methods: A cross-sectional study was designed to apply face-to-face standardized questionnaires and to evaluate patients’ clinical data from medical records. We included patients with type 1 diabetes over the age of 10 who are assisted at two public hospitals linked to federal universities in Southern Brazil. Patients signed a consent form and the study was approved by Ethics Committee. We used Patient Health Questionnaire-2 (PHQ) and PHQ-9 to evaluate depression, Self Care Inventory-Revised to evaluate treatment adherence, and Eating Attitudes Test to study eating disorders. We also apply a questionnaire to investigate licit and illicit drugs use and anxiety symptoms.

Results: We included 166 patients with a median of 33 years (22–45 years), 53.6% were women, with a median of 14 years (6–25 years) since diabetes diagnosis, and a median of A1c of 8.5% (7.8–9.4%). 91 patients (54.8%) was diagnosed with one mental health disorders (20.5% of patients have depression and 40.4% have anxiety), and 79 (47.6%) patients had positive screening for eating disorder. About drug use, 16 (9.6%) patients are active smokers, 30 (18.1%) patients drink alcohol regularly, and 2 (1.2%) patients use illicit drugs. The comparison between patients with and without psychiatric illness showed a worse glycemic control in the group with mental disorder (A1c 9.0% vs 8.5% in controls); there was no other clinical or laboratorial difference between groups. Patients with suicidal ideation or attempt are almost entirely depressed (34 patients [94.4%]). 91 patients (54.8%) were considered to have good adeherence to treatment; this group of patients has a better A1c than non-adherent patients (8.4% vs 8.8%; P = 0.023).

Discussion: The prevalences of psychiatric illness, drug use and eating disorders are high among patients with type 1 diabetes and it is associated with a worse glycemic control. Clinical doctors should be aware of this scenario and, therefore, do screening for mental disorders in this population.