PSYCHOLOGICAL ADJUSTMENT TO IDDM - 10-YEAR FOLLOW-UP OF AN ONSET COHORT OF CHILD AND ADOLESCENT PATIENTS

OBJECTIVE - To evaluate the psychological adjustment of young adults w ith IDDM in comparison with similarly aged individuals without chronic illness. RESEARCH DESIGN AND METHODS - An onset cohort of young adult s (n = 57), ages 19-26 years, who have been followed over a 10-year pe riod since diagnosis, was compared with a similarly aged group of youn g adults identified at the time of a moderately severe, acute illness (n = 54) and followed over the same 10-year period. The groups were as sessed at 10-year follow-up in terms of 1) sociodemographic indices (e .g., schooling, employment, delinquent activities, drug use), 2) psych iatric symptoms, and 3) perceived competence. In addition, IDDM patien ts were examined for longitudinal change in adjustment to diabetes. RE SULTS - The groups differed only minimally in terms of sociodemographi c indices, with similar rates of high school graduation, post-high sch ool education, employment, and drug use. The IDDM group reported fewer criminal convictions and fewer non-diabetes-related illness episodes than the comparison group. There were no differences in psychiatric sy mptoms. However, IDDM patients reported lower perceived competence, wi th specific differences found on the global self-worth, sociability, p hysical appearance, being an adequate provider, and humor subscales. T he IDDM patients reported improving adjustment to their diabetes over the course of the 10-year follow-up. CONCLUSIONS - Overall, the young adults with IDDM appeared to be as psychologically well adjusted as th e young adults without a chronic illness. There were, however, indicat ions of lower self-esteem in the IDDM patients that could either porte nd or predispose them to risk for future depression or other difficult ies in adaptation.