Exploring the early symptoms of depression in children, adolescent and young adults: a review with public patient involvement

Archana Nepal; Binaya Bhattarai

doi:10.1530/endoabs.110.P399

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Endocrine Abstracts (2025) 110 P399 | DOI: 10.1530/endoabs.110.P399

ECEESPE2025 Poster Presentations Diabetes and Insulin (143 abstracts)

Exploring the early symptoms of depression in children, adolescent and young adults: a review with public patient involvement

Archana Nepal ¹ & Binaya Bhattarai ²

Author affiliations

¹Patan Academy of health sciences, Pediatrics, Lalitpur, Nepal; ²HAMS Hospital, Metro hospital, Endocrinology, kathmandu, Nepal

JOINT2622

Background: Type 1 diabetes (T1D) is a chronic condition that significantly impacts both physical and mental health. Depression is prevalent among children, adolescents, and young adults with T1D but often remains underdiagnosed. Identifying early symptoms of depression in this population is crucial for timely intervention and improved disease management.

Objective: This study explores early markers of depression in children, adolescents, and young adults with T1D through a comprehensive literature review and public patient involvement (PPI).

Methods: A two-phase approach was employed. The first phase involved a systematic literature review (2000–2024) focusing on depression prevalence, symptoms, and screening tools in T1D. The second phase incorporated PPI through focus group discussions (FGDs) with patients, guardians, and clinicians to identify and rank early depressive symptoms. The findings were then compared with established depression and diabetes distress screening tools.

Results: Depression prevalence in children and adolescents with T1D varied from 6. 3% to 46. 3%. Commonly used screening tools, such as the Children’s Depression Inventory (CDI), Center for Epidemiological Studies Depression Scale (CES-D), and Patient Health Questionnaire-9 (PHQ-9), effectively captured general depressive symptoms but lacked diabetes-specific emotional burdens. Diabetes distress tools, such as the Problem Areas in Diabetes (PAID) scale and Diabetes Distress Scale (DDS), identified unique stressors but did not comprehensively screen for depression. FGDs highlighted early depression markers, including sadness, social withdrawal, academic decline, diabetes-related distress, and feelings of unfairness about having diabetes.

Conclusion: Early depressive symptoms in children and young adults with T1D encompass both general and diabetes-specific features. Current depression screening tools may not fully capture these nuances. Developing an integrated screening approach that incorporates diabetes-specific distress along with depression screening tools could improve early identification and intervention.

Keywords: Type 1 diabetes, depression, diabetes distress, early symptoms, children, adolescents, screening tools