Psychiatric Disorders and Health Related Quality of Life in Children With Type 1 Diabetes Mellitus.
BACKGROUND Type 1 diabetes mellitus (T1DM) is a chronic condition with major effect on health related quality of life (HRQoL) and mental health. In 1990s, high rates of psychiatric disorders were reported among children with T1DM. Little is known, however, about current prevalence of psychiatric disorders in children with T1DM and the relation between psychiatric diagnosis and HRQoL. OBJECTIVE The aim of the study was to determine the prevalence of Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision) psychiatric disorders and the association between psychiatric comorbidity and HRQoL in the pediatric population with T1DM. METHODS We conducted a cross sectional study of 207 children, aged 8 18 years, diagnosed with T1DM. The presence of psychiatric disorders has been assessed by the standard diagnostic interview according to Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision) criteria. HRQoL was measured by the general and diabetes mellitus specific modules of the Paediatric Quality of Life Inventory. RESULTS Of the evaluated patients, 26.6% (N 55) met the criteria for psychiatric disorders at the time of evaluation. The most common diagnoses were anxiety (N 32; 15.5% and mood disorders (N 8; 3.9% One third of the patients (N 66, 31.9% met the criteria for at least 1 psychiatric diagnosis in their lifetime. The presence of psychiatric disorders was related to an elevated hemoglobin A1c level (8.6% vs 7.6% and a lowered HRQoL level in the general pediatric quality of life inventory. In the diabetes mellitus specific pediatric quality of life inventory, children with psychiatric disorders revealed more symptoms of diabetes mellitus, treatment barriers, and lower adherence than children without psychiatric disorders. CONCLUSIONS T1DM in children is associated with a very high prevalence of psychiatric comorbidity, which is related to elevated hemoglobin A1c and lower HRQoL levels.
Psychosomatics