Exploring the Mediating Role of Parental Anxiety in the Link between Children's Mental Health and Glycemic Control in Type 1 Diabetes.

Pediatric diabetes type 1 diabetes mellitus (T1D), as a chronic, incurable disease, is associated with psychoemotional and socioeconomic burden for the whole family. Disease outcomes are determined by the metabolic compensation of diabetes, characterized by the level of glycated hemoglobin (HbA1c). The caregivers play a critical role in the metabolic control of children with T1D. The aim of this study was to investigate which environmental factors may explain the relationship between diabetes compensation and anxiety and depression of a child. The cross-sectional interdisciplinary study recruited dyads from adolescents and their parents (N = 251). Adolescent and parent groups were screened for anxiety and depression. General linear model (GLM) mediation analysis was performed to determine the potential mediating effect of surrounding factors on the relationship between dependent variables (glycated hemoglobin) and independent variables (the child's anxiety and depression symptoms). The study revealed that the relationship between HbA1c and the child's anxiety and depression is fully mediated (B = 0.366, z = 4.31, p < 0.001) by parental anxiety. Diabetes metabolic control in adolescents with T1D is related to adolescents' mental health via parents' anxiety. This means that parents' anxiety plays a more significant role in the level of HbA1c than the anxiety and depression of the adolescent.

Prevalence of anxiety and depression symptoms in adolescents with Type 1 diabetes (T1D) and their parents.

BACKGROUND: Chronic somatic diseases are significant risk factors for the development of depression. Fourteen studies identified symptoms of depression and anxiety in children and adolescents with type 1 diabetes mellitus. The overall prevalence of the symptoms of depression in the study population was 30.04%. METHODS: The study population has been divided into two sub-groups: the target group consisting of adolescents with T1D aged 12-18 and their parents (N = 64), and the control group consisting of somatic healthy adolescents and their parents (N = 36). Anxiety symptoms have been evaluated applying the Generalized Anxiety Disorder 7-item (GAD-7) scale. Depression symptoms have been evaluated using the Patient Health Questionnaire 9 (PHQ-9) scale. 100 respondents were eligible for screening. RESULTS: Severe, generalised anxiety was detected in 13% adolescents suffering from T1D and 47% of their parents. In contrast, no severe anxiety was detected in the control group by any of the respondents. In adolescents with T1D, 9% of cases experienced symptoms of severe depression, 16% experiencing symptoms of moderate depression. Moderate and severe anxiety and depression symptoms were seen significantly more frequently in the study group than in the control group, both in the child and in the parent subgroups. CONCLUSIONS: (1) Adolescents with Type 1 diabetes and their parents are more predisposed to anxiety and depression symptoms than somatic healthy children and their parents. (2) Further multiprofessional research is necessary for children with T1D and their families, in order to avoid the development of stress-related mental health disorders.