Endocrine Abstracts

JOINT409

Objectives: Paediatric diabetes mellitus is of increasing prevalence over the past decade worldwide. It is a life-long endocrine illness that poses both physical and psychogical burdens to our affected youths. Up to 14% of youths with diabetes reported at least mildly depressed mood. Mental health screening in these individuals, is therefore a standard of medical care in diabetes according to latest recommendations. Regular screening allows early identification of patients who are at risk of depression, and timely psychological intervention can lead to better diabetic control and overall well-being in these patients. The aim of our study is to evaluate the prevalence and severity of depressive symptoms in paediatric patients with diabetes mellitus, and identify factors associated with the development of depressive symptoms.

Research Design and Method: The Patient Health Questionnaire-9 (PHQ-9), a validated and efficacious self-reported tool recommended by the American Diabetes Association (ADA) and the U. S. Preventive Services Task Force (USPSTF) for screening depression, was completed by 90 paediatric patients with diabetes mellitus from year 2020- 2022 who received regular follow up in our hospital. Data including demographics and characteristics of patients were collected and analysed.

Results: Sixteen out of 90 patients (17. 8%, 95% CI: 9. 9%- 25. 7%) reported moderate or above severity of depressive symptoms as defined by a PHQ-9 score ≥10. 13. 7% and 12. 2% of patients had a PHQ-9 score ≥10 in year 2021 and 2022 respectively, compared to none in year 2020. Higher body mass index (BMI) (P=0. 048), presence of diabetic-related complications (P = 0. 049), greater number of hospital admissions related to poor diabetic control (P = 0. 003), poor family dynamics with parental marital conflicts (P = 0. 002) and parent-child relationship problems (P < 0. 001), known psychological or behavioural problems (P < 0. 001) were identified as factors associated with increased risk for developing depressive symptoms. Patients who used continuous glucose monitoring system (CGMS) (P = 0. 014) and had more frequent blood sugar monitoring (P = 0. 002) were associated with less risk for developing depressive symptoms. A higher haemoglobin A1c (HbA1c) value (P = 0. 023) was found to be positively related to depressive symptoms in the subgroup analysis for patients with type 1 diabetes mellitus but not type 2.

Conclusion: Depressive symptoms are common in youths with diabetes mellitus. Regular mental health screening by using a validated self-reported questionnaire is a cost-effective and reliable method that should be advocated in all eligible patients.