Depression and anxiety in adolescents with type 1 diabetes and their parents

Linh A Nguyen; Frans Pouwer; Paul Lodder; Esther Hartman; Per Winterdijk; Henk-Jan Aanstoot; Giesje Nefs

doi:10.1038/s41390-021-01392-y

Depression and anxiety in adolescents with type 1 diabetes and their parents

Pediatr Res. 2022 Jan;91(1):188-196. doi: 10.1038/s41390-021-01392-y. Epub 2021 Mar 4.

Authors

Linh A Nguyen^{1

2}, Frans Pouwer^{3

4

5}, Paul Lodder^{1

6}, Esther Hartman¹, Per Winterdijk⁷, Henk-Jan Aanstoot⁷, Giesje Nefs^{8

9

10}

Affiliations

¹ Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic disorders (CoRPS), Tilburg University, Tilburg, The Netherlands.
² Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
³ Department of Psychology, University of Southern Denmark, Odense, Denmark.
⁴ STENO Diabetes Center Odense, Odense, Denmark.
⁵ School of Psychology, Deakin University, Geelong, VIC, Australia.
⁶ Department of Methodology and Statistics, Tilburg University, Tilburg, The Netherlands.
⁷ National Treatment and Research Center for Children, Adolescents and Adults with Type 1 Diabetes, Rotterdam, The Netherlands.
⁸ Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic disorders (CoRPS), Tilburg University, Tilburg, The Netherlands. giesje.nefs@radboudumc.nl.
⁹ Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands. giesje.nefs@radboudumc.nl.
¹⁰ National Treatment and Research Center for Children, Adolescents and Adults with Type 1 Diabetes, Rotterdam, The Netherlands. giesje.nefs@radboudumc.nl.

PMID: 33664478
DOI: 10.1038/s41390-021-01392-y

Abstract

Background: Longitudinal studies including parental distress when examining adverse health outcomes in adolescents with type 1 diabetes are lacking. This study examined whether parental depression and anxiety predict adolescent emotional distress and glycated hemoglobin A_1c (HbA_1c) 1 year later and whether a relation between parental distress and HbA_1c is mediated by the level of parental involvement in diabetes care and by treatment behaviors.

Methods: Longitudinal path modeling was applied to data from 154 adolescents and parents from diabetes centers participating in the Longitudinal study of Emotional problems in Adolescents with type 1 diabetes and their Parents/caregivers (Diabetes LEAP). At baseline and 1-year follow-up, participants completed measures of depression and anxiety. HbA_1c was extracted from medical charts. Responsibility and treatment behavior questionnaires were completed by adolescents at baseline.

Results: Baseline parental depressive and anxiety symptoms were not associated with 1-year adolescent depressive symptoms, anxiety symptoms, and HbA_1c. Responsibility division and treatment behaviors did not mediate associations between parental emotional distress and 1-year HbA_1c.

Conclusions: Parental depressive and anxiety symptoms did not predict adolescent health outcomes 1 year later. Future studies may determine whether the link is present in case of mood/anxiety disorders or severe diabetes-specific distress, or whether adolescents are resilient in the face of parental distress.

Impact: Adolescents with T1D are a vulnerable group in terms of psychological and health outcomes. Whether parental emotional distress (i.e., depressive and anxiety symptoms) is prospectively associated with adolescent emotional distress and/or HbA_1c has been understudied. Our results show that parental distress was not related to adolescent distress or HbA_1c 1 year later. Responsibility division and treatment behaviors did not mediate associations between parental emotional distress and 1-year HbA_1c. Future studies could determine whether these links are present in case of mood/anxiety disorders or severe diabetes-specific distress, or whether adolescents are resilient in the face of parental distress.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Anxiety / complications*
Depression / complications*
Diabetes Mellitus, Type 1 / complications*
Female
Glycated Hemoglobin / analysis
Humans
Longitudinal Studies
Male
Parents / psychology*

Substances

Glycated Hemoglobin A
hemoglobin A1c protein, human