Behavioral and Emotional Disorders in Young People With Diabetes

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The impact of psychiatric comorbidities on readmissions for diabetes in youth, by M.M. Garrison and colleagues. Diabetes Care 28:2150–2154, 2005.

What is the problem and what is known about it so far?

Several studies have shown that young people with diabetes are more likely to have emotional or behavioral problems than young people who don't have diabetes. And other studies have shown that young people with diabetes who have emotional or behavioral problems have a harder time controlling their diabetes.

It's been shown that adults who have diabetes and emotional/behavioral problems go back to the hospital more often to be treated for diabetes problems and other illnesses. But there haven't been any studies on whether young people with emotional/behavioral problems go back to the hospital more often to be treated for diabetes problems.

Why did the researchers do this particular study?

To see whether young people with diabetes and emotional/behavioral problems are more likely to go back to the hospital to be treated for diabetes problems.

Who was studied?

A total of 4,508 children (between 5 and 12 years of age) and 3,094 adolescents (between 13 and 18 years of age) who had diabetes.

How was the study done?

The researchers looked at records from the Pediatric Health Information System database to see whether any of the children and adolescents had to go back to the hospital for diabetes problems and, if they did, if they had diagnosed emotional or behavioral disorders, such as depression, anxiety, impulsivity, aggression, or hyperactivity. The researchers also took into account whether the patients had type 1 or type 2 diabetes, whether they were on Medicaid, whether they were in the intensive care unit when they were first admitted to the hospital, how long they were in the hospital, and the patients’ age, sex, and race/ethnicity.

What did the researchers find?

Having an emotional or behavioral disorder did not seem to make children with diabetes more likely to have to go back to the hospital to treat diabetes problems. Among adolescents, however, having an "internalizing disorder," like depression or anxiety, seemed to be linked with repeat admissions to the hospital to treat diabetes problems.

What were the limitations of the study?

The researchers weren't able to account for undiagnosed emotional and behavioral disorders.

The researchers looked at records from only one hospital and within a limited time frame.

The researchers weren't able to account for other issues, like family problems and drug abuse.

What are the implications of the study?

More research needs to be done to see why adults and adolescents who have emotional and/or behavioral disorders are more likely to have to go back to the hospital to treat diabetes problems. In the meantime, doctors should screen diabetes patients for emotional and behavioral disorders to find out if they need more care and attention after leaving the hospital.

FOR MORE INFORMATION

Depression

Behavioral and clinical factors associated with depression among individuals with diabetes, by W. Katon and colleagues. Diabetes Care 27:914-920, 2004.

Relationship of depression and diabetes self-care, medication adherence, and preventive care, by E.H. Lin and colleagues. Diabetes Care 27:2154-2160. 2004.

Practical Psychology for Diabetes Clinicians, 2nd ed. (Alexandria, Va., ADA, 2002)