PSYCHIATRIC-DISORDERS IN YOUTHS WITH IDDM - RATES AND RISK-FACTORS

OBJECTIVE - To determine prevalence rates, associated features, and ri sk factors for psychiatric disorders subsequent to the diagnosis of ID DM in youths. RESEARCH DESIGN AND METHODS - Using a longitudinal, natu ralistic deign, 92 youths from 8 to 13 years old at onset of IDDM were followed from their diagnosis. They were repeatedly assessed by semis tructured interview and diagnosed by operational criteria. RESULTS - B y the 10th year of IDDM and the mean age of 20 years, an estimated 47. 6% of the sample developed psychiatric disorder. Major depressive, con duct, and generalized anxiety disorders were the most prevalent, and m ajor depression had a significantly higher estimated rate (27.5%) than each other disorder. The highest incidence rates were during the 1st year of the medical condition. Initial maternal psychopathology increa sed the risk of psychiatric disorder in the subjects, and maternal dep ression was a specific risk factor for depression in the subjects. Ear lier psychiatric disorder in the subjects also increased the risk of l ater disorder. CONCLUSIONS - The results converge with findings from o ther studies, suggesting elevated psychiatric morbidity in contemporar y samples of young people with IDDM. The morbidity partly reflects the high incidence of major depression in adolescence and generalized anx iety disorder in young adulthood. Monitoring the psychological status of young patients and their mothers may help to identify diabetic chil dren at risk for psychiatric disorder and facilitate prevention or tre atment efforts. Monitoring may be particularly beneficial during the 1 st year of the IDDM.