Psychiatric disorders during early adulthood in those with childhood onset type 1 diabetes: Rates and clinical risk factors from population-based follow-up

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Abstract

Aim: To determine the incidence of and risk factors for psychiatric disorders in early adulthood in patients with childhood onset type 1 diabetes (T1D). Methods: In this retrospective-cohort study, we identified a population-based childhood onset T1D cohort and an age and sex matched (5:1) non-diabetic comparison cohort. Data linkage was used to access inpatient hospitalization data, mental health support service data, and mortality data to follow-up both cohorts into early adulthood. Results: The mean age of T1D diagnosis was 9.5 years (SD 4.1), with a mean age at end of follow-up of 26.4 years (SD 5.2, max 37.7). The diagnosis of any psychiatric disorder was observed for 187 of 1302 (14.3%) in the T1D cohort and 400 of 6422 (6.2%) in the comparison cohort [adjusted hazard ratio (HR) 2.3; 95% CI 1.9, 2.7]. Anxiety, eating, mood, and personality and behaviour disorders were observed at higher rates within the T1D cohort. Comorbid psychiatric disorders were more frequent, at the cohort level, within the T1D cohort (2-3 disorders 3.76% vs 1.56%) and service utilization was higher (15+ contacts 6.8% vs 2.8%); though these differences did not remain when restricted to only those individuals diagnosed during follow-up. A history of poor glycaemic control was associated with an increased risk of anxiety, mood, and ‘any’ disorder (HR ranging from 1.35 to 1.42 for each 1% increase in mean paediatric HbA1c). Conclusion: Our findings highlight the need for access to mental health support services as part of routine patient care for young adults with T1D, and for better predictive tools to facilitate targeting at-risk patients with early intervention programs.

Original languageEnglish
Pages (from-to)599-606
Number of pages8
JournalPediatric Diabetes
Volume18
Issue number7
DOIs
Publication statusPublished - 1 Nov 2017

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Type 1 Diabetes Mellitus
Psychiatry
Population
Mental Health Services
Mood Disorders
Mental Disorders
Anxiety
Information Storage and Retrieval
Personality Disorders
Inpatients
Young Adult
Patient Care
Hospitalization
Cohort Studies
Retrospective Studies
Eating
Pediatrics
Mortality
Incidence

Cite this

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title = "Psychiatric disorders during early adulthood in those with childhood onset type 1 diabetes: Rates and clinical risk factors from population-based follow-up",
abstract = "Aim: To determine the incidence of and risk factors for psychiatric disorders in early adulthood in patients with childhood onset type 1 diabetes (T1D). Methods: In this retrospective-cohort study, we identified a population-based childhood onset T1D cohort and an age and sex matched (5:1) non-diabetic comparison cohort. Data linkage was used to access inpatient hospitalization data, mental health support service data, and mortality data to follow-up both cohorts into early adulthood. Results: The mean age of T1D diagnosis was 9.5 years (SD 4.1), with a mean age at end of follow-up of 26.4 years (SD 5.2, max 37.7). The diagnosis of any psychiatric disorder was observed for 187 of 1302 (14.3{\%}) in the T1D cohort and 400 of 6422 (6.2{\%}) in the comparison cohort [adjusted hazard ratio (HR) 2.3; 95{\%} CI 1.9, 2.7]. Anxiety, eating, mood, and personality and behaviour disorders were observed at higher rates within the T1D cohort. Comorbid psychiatric disorders were more frequent, at the cohort level, within the T1D cohort (2-3 disorders 3.76{\%} vs 1.56{\%}) and service utilization was higher (15+ contacts 6.8{\%} vs 2.8{\%}); though these differences did not remain when restricted to only those individuals diagnosed during follow-up. A history of poor glycaemic control was associated with an increased risk of anxiety, mood, and ‘any’ disorder (HR ranging from 1.35 to 1.42 for each 1{\%} increase in mean paediatric HbA1c). Conclusion: Our findings highlight the need for access to mental health support services as part of routine patient care for young adults with T1D, and for better predictive tools to facilitate targeting at-risk patients with early intervention programs.",
keywords = "mental health, morbidity, psychiatric disorders, risk factors, type 1 diabetes",
author = "Cooper, {M. N.} and A. Lin and Alvares, {G. A.} and {de Klerk}, {N. H.} and Jones, {T. W.} and Davis, {E. A.}",
year = "2017",
month = "11",
day = "1",
doi = "10.1111/pedi.12469",
language = "English",
volume = "18",
pages = "599--606",
journal = "Pediatric Diabetes",
issn = "1399-543X",
publisher = "John Wiley & Sons",
number = "7",

}

TY - JOUR

T1 - Psychiatric disorders during early adulthood in those with childhood onset type 1 diabetes

T2 - Rates and clinical risk factors from population-based follow-up

AU - Cooper, M. N.

AU - Lin, A.

AU - Alvares, G. A.

AU - de Klerk, N. H.

AU - Jones, T. W.

AU - Davis, E. A.

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Aim: To determine the incidence of and risk factors for psychiatric disorders in early adulthood in patients with childhood onset type 1 diabetes (T1D). Methods: In this retrospective-cohort study, we identified a population-based childhood onset T1D cohort and an age and sex matched (5:1) non-diabetic comparison cohort. Data linkage was used to access inpatient hospitalization data, mental health support service data, and mortality data to follow-up both cohorts into early adulthood. Results: The mean age of T1D diagnosis was 9.5 years (SD 4.1), with a mean age at end of follow-up of 26.4 years (SD 5.2, max 37.7). The diagnosis of any psychiatric disorder was observed for 187 of 1302 (14.3%) in the T1D cohort and 400 of 6422 (6.2%) in the comparison cohort [adjusted hazard ratio (HR) 2.3; 95% CI 1.9, 2.7]. Anxiety, eating, mood, and personality and behaviour disorders were observed at higher rates within the T1D cohort. Comorbid psychiatric disorders were more frequent, at the cohort level, within the T1D cohort (2-3 disorders 3.76% vs 1.56%) and service utilization was higher (15+ contacts 6.8% vs 2.8%); though these differences did not remain when restricted to only those individuals diagnosed during follow-up. A history of poor glycaemic control was associated with an increased risk of anxiety, mood, and ‘any’ disorder (HR ranging from 1.35 to 1.42 for each 1% increase in mean paediatric HbA1c). Conclusion: Our findings highlight the need for access to mental health support services as part of routine patient care for young adults with T1D, and for better predictive tools to facilitate targeting at-risk patients with early intervention programs.

AB - Aim: To determine the incidence of and risk factors for psychiatric disorders in early adulthood in patients with childhood onset type 1 diabetes (T1D). Methods: In this retrospective-cohort study, we identified a population-based childhood onset T1D cohort and an age and sex matched (5:1) non-diabetic comparison cohort. Data linkage was used to access inpatient hospitalization data, mental health support service data, and mortality data to follow-up both cohorts into early adulthood. Results: The mean age of T1D diagnosis was 9.5 years (SD 4.1), with a mean age at end of follow-up of 26.4 years (SD 5.2, max 37.7). The diagnosis of any psychiatric disorder was observed for 187 of 1302 (14.3%) in the T1D cohort and 400 of 6422 (6.2%) in the comparison cohort [adjusted hazard ratio (HR) 2.3; 95% CI 1.9, 2.7]. Anxiety, eating, mood, and personality and behaviour disorders were observed at higher rates within the T1D cohort. Comorbid psychiatric disorders were more frequent, at the cohort level, within the T1D cohort (2-3 disorders 3.76% vs 1.56%) and service utilization was higher (15+ contacts 6.8% vs 2.8%); though these differences did not remain when restricted to only those individuals diagnosed during follow-up. A history of poor glycaemic control was associated with an increased risk of anxiety, mood, and ‘any’ disorder (HR ranging from 1.35 to 1.42 for each 1% increase in mean paediatric HbA1c). Conclusion: Our findings highlight the need for access to mental health support services as part of routine patient care for young adults with T1D, and for better predictive tools to facilitate targeting at-risk patients with early intervention programs.

KW - mental health

KW - morbidity

KW - psychiatric disorders

KW - risk factors

KW - type 1 diabetes

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U2 - 10.1111/pedi.12469

DO - 10.1111/pedi.12469

M3 - Article

VL - 18

SP - 599

EP - 606

JO - Pediatric Diabetes

JF - Pediatric Diabetes

SN - 1399-543X

IS - 7

ER -