Psychiatric disorders during early adulthood in those with childhood onset type 1 diabetes: Rates and clinical risk factors from population-based follow-up

被引:60
作者
Cooper, M. N. [1 ]
Lin, A. [1 ]
Alvares, G. A. [1 ]
De Klerk, N. H. [1 ,2 ]
Jones, T. W. [1 ,2 ,3 ]
Davis, E. A. [1 ,2 ,3 ]
机构
[1] Univ Western Australia, Telethon Kids Inst, Perth, WA, Australia
[2] Univ Western Australia, Sch Paediat & Child Hlth, Perth, WA, Australia
[3] Princess Margaret Hosp Children, Dept Endocrinol & Diabet, GPO Box D184, Perth, WA 6840, Australia
基金
澳大利亚国家健康与医学研究理事会;
关键词
mental health; morbidity; psychiatric disorders; risk factors; type; 1; diabetes; YOUNG-PEOPLE; EMERGING ADULTS; MENTAL-HEALTH; ADOLESCENTS; CARE; PREVALENCE; TRANSITION; DEPRESSION; COHORT; ADHERENCE;
D O I
10.1111/pedi.12469
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aim: To determine the incidence of and risk factors for psychiatric disorders in early adulthood in patients with childhood onset type 1 diabetes (T1D). Methods: In this retrospective-cohort study, we identified a population-based childhood onset T1D cohort and an age and sex matched (5: 1) non-diabetic comparison cohort. Data linkage was used to access inpatient hospitalization data, mental health support service data, and mortality data to follow-up both cohorts into early adulthood. Results: The mean age of T1D diagnosis was 9.5 years (SD 4.1), with a mean age at end of follow-up of 26.4 years (SD 5.2, max 37.7). The diagnosis of any psychiatric disorder was observed for 187 of 1302 (14.3%) in the T1D cohort and 400 of 6422 (6.2%) in the comparison cohort [ adjusted hazard ratio (HR) 2.3; 95% CI 1.9, 2.7]. Anxiety, eating, mood, and personality and behaviour disorders were observed at higher rates within the T1D cohort. Comorbid psychiatric disorders were more frequent, at the cohort level, within the T1D cohort (2-3 disorders 3.76% vs 1.56%) and service utilization was higher (15+ contacts 6.8% vs 2.8%); though these differences did not remain when restricted to only those individuals diagnosed during followup. A history of poor glycaemic control was associated with an increased risk of anxiety, mood, and 'any' disorder (HR ranging from 1.35 to 1.42 for each 1% increase in mean paediatric HbA1c). Conclusion: Our findings highlight the need for access to mental health support services as part of routine patient care for young adults with T1D, and for better predictive tools to facilitate targeting at-risk patients with early intervention programs.
引用
收藏
页码:599 / 606
页数:8
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