Research: Diabetic teens should be screened for depression with caution

ANI |
Updated: September 18, 2022 7:27 PM IST

Florida [US]September 18 (ANI): To more effectively identify depression in adolescents with type 1 diabetes mellitus, a new study published in the American Diabetes association magazine Diabetes Care recommended carefully modifying the scores results of the widely used depression screening techniques (T1D).
The study is the first to thoroughly compare the effectiveness of such filters with diagnostic interviews for this demographic. The study was conducted by specialists at Primary Children’s Hospital and Nemours Children’s Health in Jacksonville. When both researchers partnered with the University of Kansas Medical Center, which funded the project, the data was collected in conjunction with Children’s Mercy Kansas City.
Previous studies have shown that adolescents with T1D are more likely to experience depression than their non-diabetic peers. Researchers have found that sadness can also compromise blood glucose control, alter glycemic control, and lead to more frequent hospitalizations. For these reasons, both national and international standards recommend that all adolescents with diabetes be routinely screened for depression.
“Depression Screening is crucial for youth with type 1 diabetes, as treatment for depression is likely to keep them healthier now and in the long term,” said the paper’s lead author, Arwen M. Marker, PhD, a fellow at pediatric psychology at Salt Lake City Primary Children’s Hospital “We need to know what screening tools work best and how to best use them in this population, so that we don’t miss out on identifying depressed children and giving them the support they need.”

Clinical interviews, which are considered the gold standard for diagnosing depression, were completed with each of the 100 young people with type 1 diabetes (ages 12 to 17). Participants were also given five commonly used depression screening measures, each of which took one to three minutes to complete. The results of each selection tool were compared with those of subsequent interviews. They noted that they were surprised that most of the raters’ typical diagnostic cutoff values ​​had to be lowered to increase their sensitivity for adolescent T1D patients.
“We thought we might need to increase the cutoff scores for accuracy with this population, thinking that symptoms common to diabetes and depression would inflate the number of depression diagnoses, suggesting that more people were depressed when in fact symptoms of depression diabetes were the cause,” Marker said. . “However, we generally found the opposite: we needed to lower cut-off scores to more accurately identify youth with depressive symptoms.”
The study’s screening instruments were designed primarily with adults in mind. None have previously been shown to reliably distinguish adolescent depression, and none were created especially for people with type 1 diabetes. The CDI-2 Short, PHQ-9A, and SMFQ, which have been shown to have the highest accuracy in this population, were recommended for use by diabetes care professionals.
A senior research scientist at Nemours Children’s Health in Jacksonville and co-author Susana Patton, PhD, ABPP, CDE, says, “Without the right sensitivity limits, even the best screening tools will miss some adolescents with depression, resulting in not receive mental health services and possibly continue to experience depression. This means that some adolescents with type 1 diabetes may have more difficulty managing their diabetes.
Type 1 diabetes is an autoimmune disease that develops when the body’s immune system accidentally destroys insulin-producing cells in the pancreas. There is currently no known treatment for it, and its origins are unknown. This condition, believed to affect 244,000 children and adolescents in the US, can cause serious health problems both early in life and later in life. (AND ME)