Endocrine Abstracts

JOINT289

Introduction: An increased prevalence of mental health impairments has been reported for adolescents with type 1 diabetes (T1D). Although psychosocial factors bear the potential to have a detrimental impact on glycemic control, health professionals are insufficiently trained to recognize and accommodate problems in this field.

Objectives: We aimed to determine the prevalence and the type of mental health impairment in adolescents in our outpatient diabetes clinic and to assess the relationship between mental health problems and glycemic control.

Methods: YSR11-18R assesses the scales: anxious/depressive, regressive/depressive, physical complaints, social problems, thinking, and repetitive problems, attention problems, rule-breaking and aggressive behaviour and measures socially desirable behaviours. Student’s t tests were used to compare the results in two groups, patients with good (HbA1c < 7.7%), and less good glycemic control (HbA1c > 7.7%).

Results: In 29 adolescent patients (15 girls, 14 boys), aged 14.9 years (range: 13-18), median HbA1c was 7.8% (range 6.1-14.3%). In 3 questionnaires manifest psychiatric comorbidities were detected, while 3 showed less severe psychopathologies, thus 10 percent of YSR tests in our cohort were abnormal. The individual problem scales showed that highest T-values (means ± SD) were achieved in the fields regressive/depressive (T 55.7 ± 9), anxious/depressive (T 55.79 ± 9) and attention problems (T 55.6 ± 6.4). HbA1c < 7.7% was associated with significantly less (P = 0.03) physical complaints; adolescents with HbA1c > 7.7 had a tendency towards rule-breaking behaviour (P = 0.08). High scores were obtained in the socially desirable responses (Highest score 2, mean 1.53 ± 0.30 SD). Good glycaemic management was associated with fewer physical complaints, while adolescents with impaired glycemic control showed a tendency towards rule-breaking behaviour.

Conclusions: There is an increased prevalence of psychosocial impairment in T1D adolescents but poor glycemic control is mainly associated with physical complaints. YSR testing allows for detection of psychologic problems in adolescents with T1D and thus could allow for targeted interventions.