Differentiating disordered affect in children and adolescents with type 1 diabetes

• Published in: Journal of affective disorders Vol. 147; no. 1; pp. 51 - 58
• Main Authors: Sinnamon, Grant C.B, Caltabiano, Marie, Baune, Bernhard T
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier B.V 01.05.2013; Elsevier
• Subjects: Adolescent; Adolescents; Adult and adolescent clinical studies; Affective disorders; Anxiety; Anxiety Disorders - epidemiology; Biological and medical sciences; Case-Control Studies; Child; Comorbidity; Cross-Sectional Studies; Depression; Diabetes mellitus type 1; Diabetes Mellitus, Type 1 - epidemiology; Diabetes Mellitus, Type 1 - psychology; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Humans; Male; Medical sciences; Mood disorders; Mood Disorders - epidemiology; Prevalence; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Self Report; Selfreport; Symptoms; Tripartite model; Type 1 diabetes mellitus; Young people; Depression; Anxiety; Affective disorders; Tripartite model; Comorbidity; Diabetes mellitus type 1; Endocrinopathy; Human; Mood disorder; Affect affectivity; Immunopathology; Autoimmune disease; Affective disorder; Concomitant disease; Type 1 diabetes; Adolescent; Models; Child
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2012.10.006

Abstract Background There is evidence for increased risk of affective disorders (AD) in adults with type 1 diabetes however, the prevalence and characteristics of AD in young people with the condition is unclear. Comorbid AD in type 1 diabetes is associated with deleterious self-management, sub-optimal clinical indicators, reduced quality of life, poorer physical health, increased complications, increased high risk behaviours in adolescence and young adulthood, and earlier mortality. The present study investigated the prevalence and character of AD in young people with type 1 diabetes. Methods The self-report PH-PANAS-C was employed in a cross-sectional, case-control design to identify and differentiate full-syndrome (FS) and subthreshold (St) levels of AD in 53 participants with type 1 diabetes (case) and 54 age-balanced controls ( N =107; 7–18 yrs). Results Case participants reported greater AD than controls. When differentiated, only anxiety was significantly more prevalent. Case participants reported less positive affect, and greater negative affect and autonomic arousal. Further, 1:3 case participants presented with St symptoms of AD. Limitations Self-report measures are known to produce moderated responses therefore symptoms may be more severe than reported. There has been some suggestion that responses to somatic items in the PH-PANAS-C may relate to diabetes-specific states rather than affect-related symptoms however, recent evidence has refuted this argument. Conclusions AD, particularly anxiety, represents a significant clinical concern in young people with type 1 diabetes both as a disorder in its own right and as a major impediment to primary care and management of the diabetes. The significant dominance of anxiety-related symptoms and prevalence of subthreshold presentation warrant further investigation.