Symptoms of depression are important to psychological adaptation and metabolic control in children with diabetes mellitus

Aims. Sixty-two children (37 girls, 25 boys) between 9 and 18 years of age were enrolled to investigate: (1) the relationship between adaptation to di abetes mellitus (DM) and psychological functioning; (2) if adaptation or ps ychological functioning was related to metabolic control; and (3) if the pa tients' ability to cope with diabetes as assessed by physicians, was correl ated to adaptation or psychological functioning. Methods. Psychological functioning was measured by three general psychologi cal instruments for depressive symptoms, self-esteem and fear. Diabetes ada ptation was evaluated by questionnaires and coping with diabetes by an asse ssment of the physicians. Metabolic control was expressed by the individual HbA(1C) measured during the last year. Results. Adaptation to diabetes correlated to psychological functioning (de pression, P < 0.001; self-esteem, P < 0.01; and fear, P < 0.01). Multiple r egression analyses showed that metabolic control was predicted by adaptatio n (P = 0.0013) with monitoring of diabetes as the only significant aspect o f the adaptation (P less than or equal to 0.0001). In turn, adaptation was predicted by symptoms of depression and metabolic control (P < 0.0001). In support of this observation, a depressed (n = 9) and a non depressed (n = 5 3) group showed significant differences in metabolic control (P less than o r equal to 0.01), adaptation (P less than or equal to 0.001) and self-estee m (P less than or equal to 0.001). The only significant variable for the ph ysicians assessment was metabolic control, which explained 35% of the varia nce (P < 0.001). Conclusions. The major conclusion is that symptoms of depression affect bot h adaptation and metabolic control. It should be of concern to identify pat ients with depressive symptoms, offer treatment for their emotional difficu lties and increase the support for taking care of their diabetes.