Background: We have studied a group of children and adolescents with IDDM to evaluate their personality features and family relationship to point out elements of psychopathological risk or evident mental disorders. Our study group is composed of 30 subjects (age range 7-19 years) with IDDM for at least one year.
Methods: The methods employed were interviews to patients and their parents for the attitude towards the illness (done separately), Rutter scale for parents, an anxiety scale for children and adolescents (Busnelli) and a questionnaire about knowledge of diabetes (GISED). In the interviews with parents anamnestic data were collected with particular attention to early symptoms of mental disorder. Metabolic control was tested by the HbA1c measure using high pressure column chromatography, in the same laboratory.
Results and conclusions: On the basis of different results we divide our study group into three subgroups. The first (30%) present no mental disorder or at least reactive or transient disorder. The second subgroup (57%) show mild mental disorder. The third subgroup (13%) present severe mental disorder. In the first subgroup the adaptation to the illness was good, because of a normal personality, absence of past psychological disorders and good family relations. The second subgroup show a wider variability of symptomatology and 65% of these patients had some behaviour disorder in their past, which became more evident after diabetes onset. In the third subgroup diabetes seems to worsen pre-existing status of mental disorder. Metabolic control is better in the first subgroup than in the other two subgroups which do not differ too much one from the other. In conclusion, the better family relationship and personality history a patient had, the better adaptation to illness and metabolic control he had (1st Subgroup). The 2nd subgroup seems to be particularly at risk because it shows behaviour disorders and risk for future personality disorder. In the 3rd subgroup mental illness was already present even if not diagnosed at the onset of diabetes and needs to be treated anyway. As a matter of fact, it seems possible that the chronic illness points out and fixes perhaps pathological characteristics already present, which did not emerge until the traumatic onset of diabetes.