Maternal expressed emotion and metabolic control of children and adolescents with diabetes mellitus

Background: The objectives of this study of children and adolescents with d iabetes were to: (1) examine whether maternal expressed emotion (EE), in th e form of critical comments (CC), hostility and emotional over-involvement (EOI), is related to metabolic control; (2) determine if CC and EOI are sep arately related to poor metabolic control, and (3) ascertain whether high E E is related to psychopathology in these children. Methods: The Present Epi sode version of the Schedule for Affective Disorders and Schizophrenia for School-Age Children (Kiddie-SADS-P/K-SADS-P) interview was administered to 55 children and adolescents with diabetes and the parental EE instrument, t he 5-min speech sample, to 55 mothers. The same instruments were utilized w ith the 54 controls and their mothers. Glycosylated hemoglobin A1 values we re used as a measure of metabolic control. Results: More than half of the c hildren with diabetes (58.2%) had mild to moderate symptoms of anxiety depr ession as compared to 9.3% of the controls. High EE was exhibited by 70.9% of the index group mothers in contrast to only 29.6% of the control group m others. High maternal EE was not related to the psychopathology of children with diabetes. High maternal EE and in particular its EOI component and ex cessive detail (a subcategory of EOI) were related to poor metabolic contro l of the index children. Conclusions: Maternal EE is related to metabolic c ontrol in childhood diabetes; maternal EOI in particular is related to poor metabolic control. Mental health professionals should work with mothers of children with diabetes in an effort to modify such attitudes and emotions. Copyright (C) 2001 S. Karger AG, Basel.