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McVoy M, Hardin H, Fulchiero E, Caforio K, Briggs F, Neudecker M, Sajatovic M. Mental health comorbidity and youth onset type 2 diabetes: A systematic review of the literature. Int J Psychiatry Med 2023; 58:37-55. [PMID: 35026126 DOI: 10.1177/00912174211067335] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Type 2 diabetes (T2D) is a burgeoning epidemic in children and adolescents. Adult T2D doubles the risk of depression and mental health comorbidity, makes it more difficult to make the lifestyle, medication adherence and health behavior changes needed to optimize outcomes. There is limited research on the impact of depression and depressive symptoms on youth T2D. METHODS A search of the literature in the last 10 years regarding youth with depression and T2D was conducted. Abstracts were screened by 2 randomly assigned authors for inclusion, and disagreement was resolved by a third author. Selected full-text articles were divided among all authors for review. RESULTS 13 publications from 8 studies (N=2244, age 6-17) were included. 6 of 13 publications utilized Treatment Options for Type 2 Diabetes in Youth (TODAY) study data. While studies included evaluation of depressive symptoms, most did not formally assess for major depressive disorder (MDD) and excluded participants with a previous diagnosis of MDD. Depressive symptoms were common in this population and were associated with negative T2D outcomes. CONCLUSIONS While there is a growing body of adult literature highlighting the extensive relationship between T2D and mental health, there is a dearth of data in youth. Future studies are needed that include, 1.) youth with diagnosed MDD, 2.) treatment studies of both T2D and MDD, 3.) larger, more racially diverse samples of youth with T2D, and 4.) studies that evaluate the impact of social determinants of health, including mental health comorbidity on outcomes of T2D.
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Affiliation(s)
- Molly McVoy
- Department of Psychiatry, 24575University Hospitals Cleveland Medical Center, Cleveland, OH, USA.,12304Case Western Reserve University School of Medicine, Cleveland, OH, USA.,Neurological and Behavioral Outcomes Center, 24575University Hospitals Cleveland Medical Center, Cleveland, OH, USA.,Division of Child and Adolescent Psychiatry, Cleveland, OH, USA
| | - Heather Hardin
- Frances Payne Bolton School of Nursing, 15735Case Western Reserve University, Cleveland, OH, USA
| | - Erin Fulchiero
- Department of Psychiatry, 24575University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Kate Caforio
- 2546Case Western Reserve University, Cleveland, OH, USA
| | - Farren Briggs
- Neurological and Behavioral Outcomes Center, 24575University Hospitals Cleveland Medical Center, Cleveland, OH, USA.,Division of Child and Adolescent Psychiatry, Cleveland, OH, USA
| | - Mandy Neudecker
- University Hospitals Cleveland Medical Center, 159284Rainbow Babies and Children's Hospital, Cleveland, OH, USA
| | - Martha Sajatovic
- Department of Psychiatry, 24575University Hospitals Cleveland Medical Center, Cleveland, OH, USA.,Neurological and Behavioral Outcomes Center, 24575University Hospitals Cleveland Medical Center, Cleveland, OH, USA.,Division of Child and Adolescent Psychiatry, Cleveland, OH, USA.,Department of Neurology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
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Prevalence of depression and anxiety among children with type 1 and type 2 diabetes: a systematic review and meta-analysis. World J Pediatr 2022; 18:16-26. [PMID: 34807367 DOI: 10.1007/s12519-021-00485-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 11/02/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Evaluation of psychiatric disorders in children is essential in timely treatment. Despite individual studies, there is no information on the exact status of psychiatric disorders in children. The present study was conducted to determine the prevalence of depression among children with type 1 and type 2 diabetes. METHODS This meta-analysis is registered with PROSPERO (CRD42021231491). Several databases (Web of Science, Scopus, and PubMed) were searched from January 1, 2000 to December 15, 2020. The key words included: depression, anxiety, children, and diabetes. The steps of search, comprising screening, risk of bias, and extraction of study data, were performed separately by two researchers. RESULTS It was found that a total of 109 studies had been conducted involving 52,493 children with type 1 and type 2 diabetes. These studies were included in the present review study. The prevalence of depression, anxiety among children with type 1 diabetes were 22.2% [95% confidence interval (CI) 19.2-25.2], and 17.7% (95% CI 15.2-20.1), respectively. The prevalence of depression was higher among girls (29.7%) than boys (19.7%). The prevalence of depression was higher in lower-middle-income countries at 29.3% (95% CI 18.6-40.0). The prevalence of depression among children with type 2 diabetes was 22.7% (95% CI 17.3-28.0). CONCLUSION The results of the present study indicate the importance of paying attention to extensive periodic screening and appropriate activities to reduce pediatric depression.
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Abstract
PURPOSE OF REVIEW The current review summarizes extant knowledge regarding the prevalence of depression in youth-onset type 2 diabetes (T2D) and how depression might impact glycemic control through stress-related behavioral and physiological mechanisms. The current review also discusses depression intervention studies in adult-onset T2D, as there are no such studies in youth-onset T2D, and provides recommendations for clinical research. RECENT FINDINGS The prevalence of elevated depression symptoms in youth-onset T2D is approximately 20%. Some studies suggest depression may negatively impact glycemic control through inadequate medication adherence and disordered eating, but there is a dearth of studies investigating associations with depression and physical activity/sedentary time, sleep, and stress-related physiological mechanisms. In adult-onset T2D, evidence-based behavioral interventions tailored to address diabetes-related issues have shown positive effects for depression and glycemic control. Future research is needed to characterize the epidemiology of depression in youth-onset T2D and test interventions to improve depression, glycemic control, and health outcomes in this specific pediatric population.
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Affiliation(s)
- Lauren D Gulley
- Department of Human Development and Family Studies, College of Health and Human Sciences, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523, USA.
- Section of Endocrinology, Department of Pediatrics, University of Colorado School of Medicine/Anschutz Medical Campus and Children's Hospital Colorado, 13123 E 16th Avenue, B265, Aurora, CO, 80045, USA.
| | - Lauren B Shomaker
- Department of Human Development and Family Studies, College of Health and Human Sciences, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523, USA
- Section of Endocrinology, Department of Pediatrics, University of Colorado School of Medicine/Anschutz Medical Campus and Children's Hospital Colorado, 13123 E 16th Avenue, B265, Aurora, CO, 80045, USA
- Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, CO, USA
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Peleg O, Hadar E, Cohen A. Individuals With Type 2 Diabetes: An Exploratory Study of Their Experience of Family Relationships and Coping With the Illness. DIABETES EDUCATOR 2019; 46:83-93. [PMID: 31729932 DOI: 10.1177/0145721719888625] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The purpose of this qualitative study is to explore familial patterns that may be related to type 2 diabetes (T2DM) and to patients' ways of coping with the illness. METHODS A purposive sample of 32 Israeli Jewish (n = 12) and Arab (n = 20) individuals with T2DM were recruited from a community population and interviewed about their familial experiences and their illness. Interview data were analyzed using Colaizzi's phenomenological method. RESULTS Many participants, particularly from the Arab society, reported familial patterns that suggest fused relationships and emotional cutoff. They described highly close and positive family relationships, on one hand, but demonstrated unwillingness to share their difficulties with their family members, on the other hand. Precipitating stressful or traumatic events and day-to-day stress appeared as leading perceived causes of the illness. Maintaining an appropriate lifestyle, stress reduction, and family support were the main coping strategies with the illness. CONCLUSIONS The findings suggest a possible avenue in which fusion with family members and inability to attenuate emotional distress by sharing difficulties with others may contribute to the development of T2DM. Assessment of such family dynamics and ways of coping with stress could lead to more appropriately nuanced treatment for individuals with T2DM and prediabetes.
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Affiliation(s)
- Ora Peleg
- Departments of Counseling and Education, The Max Stern Yezreel Valley College, Emek Yezreel, Israel
| | - Efrat Hadar
- Departments of Counseling and Education, The Max Stern Yezreel Valley College, Emek Yezreel, Israel
| | - Ami Cohen
- Department of Psychology, The Max Stern Yezreel Valley College, Emek Yezreel, Israel
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Wang X, He L, Zhu K, Zhang S, Xin L, Xu W, Guan Y. An integrated model to evaluate the impact of social support on improving self-management of type 2 diabetes mellitus. BMC Med Inform Decis Mak 2019; 19:197. [PMID: 31640691 PMCID: PMC6805520 DOI: 10.1186/s12911-019-0914-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 09/10/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Type 2 Diabetes Mellitus (T2DM) is a chronic disease closely related to personal life style. Therefore, achieving effective self-management is one of the most important ways to control it. There is evidence that social support can help to improve the self-management ability of patients with T2DM, but which social support is more effective has been rarely explored. The purpose of this study is to construct an integrated model to analyze which social support has more significant impact on self-management of T2DM, and provide reasonable suggestions to health care providers on how to effectively play the role of social support. METHODS We established a social support indicator evaluation system and proposed an integrated model that combines ANP (Analytical Network Process) and CRITIC (CRiteria Importance through Intercriteria Correlation) methods to evaluate the impact of social support on T2DM self-management from both subjective and objective perspectives. The weights calculated by the model will serve as the basis for us to judge the importance of different social support indicators. RESULTS Informational support (weighting 49.26%) is the most important criteria, followed by tangible support (weighting 39.24%) and emotional support (weighting 11.51%). Among 11 sub-criteria, guidance (weighting 23.05%) and feedback (weighting 14.68%) are two most relevant with T2DM self-management. This result provides ideas and evidence for health care providers on how to offer more effective social support. CONCLUSION To our knowledge, this is the first study in which Multi-Criteria Decision Making (MCDM) tools, specifically ANP and CRITIC, are used to evaluate the impact of social support on improving self-management of type 2 diabetes. The study suggests that incorporating two sub-indicators of guidance and feedback into the diabetes care programs may have great potential to improve T2DM self-management and further control patient blood glucose and reduce complications.
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Affiliation(s)
- Xiaojia Wang
- Department of Information Management, School of Management, Hefei University of Technology, Mailbox 270, No. 193, Tunxi Road, Hefei, 230009 An Hui Province China
| | - Linglan He
- Department of Information Management, School of Management, Hefei University of Technology, Mailbox 270, No. 193, Tunxi Road, Hefei, 230009 An Hui Province China
| | - Keyu Zhu
- Department of Information Management, School of Management, Hefei University of Technology, Mailbox 270, No. 193, Tunxi Road, Hefei, 230009 An Hui Province China
| | - Shanshan Zhang
- Department of Clinical Teaching, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, 230031 Anhui China
- The National Chinese Medicine Clinical Research Base- Key Disease of Diabetes Mellitus Study, Hefei, 230031 Anhui China
| | - Ling Xin
- The National Chinese Medicine Clinical Research Base- Key Disease of Diabetes Mellitus Study, Hefei, 230031 Anhui China
- Healthcare and Public health Information Center, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, 230031 Anhui China
| | - Weiqun Xu
- The National Chinese Medicine Clinical Research Base- Key Disease of Diabetes Mellitus Study, Hefei, 230031 Anhui China
- Department of Endocrinology, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, 230031 Anhui China
| | - Yuxiang Guan
- The National Chinese Medicine Clinical Research Base- Key Disease of Diabetes Mellitus Study, Hefei, 230031 Anhui China
- Department of Endocrinology, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, 230031 Anhui China
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Leustek J, Theiss JA. Features of Illness Versus Features of Romantic Relationships as Predictors of Cognitive and Behavioral Coping Among Individuals with Type 2 Diabetes. HEALTH COMMUNICATION 2018; 33:1549-1559. [PMID: 29068699 DOI: 10.1080/10410236.2017.1384346] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
For individuals with a chronic illness, such as type 2 diabetes, a multitude of factors may influence the ways people cope with their condition. This study compares characteristics of the illness and characteristics of a patient's romantic relationship as factors that predict coping behaviors for individuals with type 2 diabetes. Specifically, we identify illness uncertainty as a feature of chronic illness, as well as relational uncertainty and interference from partners as relationship characteristics that are associated with coping behaviors. Using Amazon Mechanical Turk, we recruited 500 participants who were diagnosed with type 2 diabetes and involved in a romantic relationship to complete an online survey about the ways they manage their illness in the context of their relationship. Structural equation model results showed that relational uncertainty and partner interference were both positively associated with the perceived threat of discussing the illness, whereas the effect for illness uncertainty was nonsignificant; thus, relationship characteristics were a more robust predictor of perceived threat than illness characteristics. In turn, the perceived threat of discussing the illness was negatively associated with treatment compliance and positively associated with topic avoidance about the illness. Treatment compliance was also negatively associated with topic avoidance. Implications for health and relationships are discussed.
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Affiliation(s)
- John Leustek
- a Department of Communication Studies , The College of New Jersey
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Glick BA, Hong KMC, Obrynba K, Kamboj MK, Hoffman RP. Identifying depressive symptoms among diabetes type and the impact on hemoglobin A1c. J Pediatr Endocrinol Metab 2018; 31:39-44. [PMID: 29303779 DOI: 10.1515/jpem-2017-0241] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 11/10/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND This study was designed to determine the effects of diabetes type and gender on depression risk determined by a highly sensitive screening questionnaire in adolescents. Glycemic control and counseling affect were also studied. METHODS A retrospective chart review of patients seen between 2013 and 2015 was performed. Five hundred and thirty adolescents with type 1 (T1DM) or 2 (T2DM) diabetes mellitus completed the Patient Health Questionnaire-9 (PHQ-9) to identify depressive symptoms. Hemoglobin A1c (HbA1c) was measured when the PHQ-9 was given, and at 1 year. Patients with increased depression risk were referred for counseling and comparisons were made between those who did and did not attend. RESULTS Females with T2DM, but not males, had increased depression compared to T1DM. Females had increased depression compared to males in T1DM (p = 0.046) and a near significant increase in T2DM (p = 0.069). In T1DM, but not T2DM, HbA1c levels were increased in high and moderate, compared to low, risk depression risk groups (p = 0.007). Follow-up HbA1c was unchanged 1 year later and there were no differences between those involved in counseling and those who refused to attend. Sex and type of diabetes had no effect on response to counseling. CONCLUSIONS These results demonstrate increased depression in adolescents with T2DM compared to T1DM and in females compared to controls. Glycemic control did not change in adolescents who reported moderate to severe symptoms of depression and received counseling intervention compared to adolescents who declined counseling.
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Affiliation(s)
- Bethany A Glick
- Nationwide Children's Hospital, Pediatric Endocrinology, 700 Children's Drive, Columbus, OH, USA
| | - K Ming Chan Hong
- Nationwide Children's Hospital, Pediatric Endocrinology, 700 Children's Drive, Columbus, OH, USA
| | - Kathryn Obrynba
- Nationwide Children's Hospital, Pediatric Endocrinology, 700 Children's Drive, Columbus, OH, USA
| | - Manmohan K Kamboj
- Nationwide Children's Hospital, Pediatric Endocrinology, 700 Children's Drive, Columbus, OH, USA
| | - Robert P Hoffman
- Nationwide Children's Hospital, Pediatric Endocrinology, 700 Children's Drive, Columbus, OH, USA
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