Psychosocial well-being and functional outcomes in youth with type 1 diabetes 12 years after disease onset

  1. Fergus J Cameron, MD3,5
  1. Department of Psychology, Royal Children's Hospital1
  2. Department of Psychology, University of Melbourne2
  3. Murdoch Childrens Research Institute3
  4. Statistical Consulting Centre, University of Melbourne4
  5. Department of Endocrinology and Diabetes, Royal Children's Hospital5; Melbourne, Australia

Abstract

Objective- Type 1 diabetes youth and community controls were compared on functional outcomes. Relationships were examined between psychosocial variables at diagnosis and functional outcome 12 years later.

Research Design and Methods - Participants: Type 1 diabetes (N = 110, mean age 20.7 yrs, SD 4.3) and controls (N = 76, mean age 20.8 yrs, SD 4.0). Measures: Youth/Young Adult Self Report and a semi-structured interview about functional outcomes. Type 1 diabetes participants also provided information about current diabetes care and metabolic control from diagnosis.

Results - Type 1 diabetes participants and controls reported similar levels of current well-being, but mental health referral rates over the previous 12 years were higher by 19%, and school completion rates were lower by 17% in youth with type 1 diabetes. Over one third were not currently receiving specialist diabetes care and this group had higher mental health service usage in the past (61% vs 33%) and lower current psychosocial well-being. Within the type 1 diabetes group, behaviour problems, high activity and low family cohesion at diagnosis predicted lower current well-being, but were not associated with metabolic control history. Poorer metabolic control was associated with higher mental health service usage.

Conclusions - Type 1 diabetes participants report similar levels of current psychosocial well-being to controls, but higher levels of psychiatric morbidity since diagnosis and lower school completion. Psychiatric morbidity was associated with poor metabolic control and failure to transition to tertiary adult diabetes care.

Footnotes

    • Received December 7, 2009.
    • Accepted March 13, 2010.