Emotional, behavioral and social difficulties among children with type 1 diabetes mellitus

 
 
 
  • Abstract
  • Keywords
  • References
  • PDF
  • Abstract


    Background: Children and adolescents with diabetes are at a greater risk for emotional and behavioral problems.

    Aim of the study was to assess behavioral, emotional and social difficulties of diabetic children and examine the association of these difficulties with demographic and disease related variables.

    Subjects and method: A cross sectional study of 423 diabetic children attended Sidy Galal health insurance outpatient clinic in Assuit city – Egypt was conducted. A similar number of healthy children matched for age, sex and socioeconomic status were included in the study as a control group used for comparison. Strength and Difficulty Questionnaire (SDQ) was used as a screening tool. The SDQ is a screening instrument consisting of five separate 5-item subscales for emotional symptoms, conduct problems, hyperactivity-inattention, peer problems, and prosocial behavior.

    Results: Most of diabetic children (92.9%) were in the abnormal group of the total score compared to 20.6% of the controls. In all SDQ subscales except prosocial, diabetic children had significantly higher percentages of abnormal indices than in controls (p value <0.001). Emotional, hyperactivity and conduct problems were significantly associated with age and sex of the child. Prolonged duration of illness was significantly associated with peer relationship problems. Glycemic control was not a significant risk factor for any problem.

    Conclusion: Many of diabetic children had behavioral and psychosocial problems. Age and sex of the child and duration of the disease were important determinants for these problems.

    Recommendation: Diabetic children need to be screened by psychologist and social worker to identify and manage any behavioral or emotional problems.


  • Keywords


    Behavioral; Children; Emotional; Social; Type 1 Diabetes.

  • References


      [1] Abd El-Tawb (1998): Socio-economic scale, Faculty of Education, Assiut University.

      [2] ADA (American Diabetes Association): Children and Adolescents, Diabetes Care 2016;39(Suppl. 1):S86 S93 https://doi.org/10.2337/dc16-S014 .

      [3] Al-Khurinej, A. (2007), Emotional and Behavioral Problems among Diabetic Children. Digest of Middle East Studies, 16 (1): 1–11. https://doi.org/10.1111/j.1949-3606.2007.tb00061.x.

      [4] Almaqrami, M., Shuwail, A. (2004). “Validity of the Self-report Version of the Strengths and Difficulties Questionnaire in Yemen”. Saudi Medical Journal, 25(5); 592-601.

      [5] Bearman KJ, LaGreca AM. Assessing friend support of adolescents' diabetes care: The Diabetes Social Support Questionnaire- friends version, J Pediatr Psychol 2002; 27: 417- 28. https://doi.org/10.1093/jpepsy/27.5.417.

      [6] Blanz B, Rensch-Riemann B, Fritz-Sigmund D & Schmidt M. Iddm Is A Risk Factor For Adolescent Psychiatric Disorders. Diabetes Care 1993: 16: 1579–1587. https://doi.org/10.2337/diacare.16.12.1579.

      [7] Canadian Diabetes Association, Clinical Practice Guidelines Expert Committee. Canadian Diabetes Association 2003 clinical practice guidelines for the prevention and management of diabetes in Canada. Can J Diabetes 2003; 27(Suppl 2):S50-2, 84-90.

      [8] Chisholm, V. (2003). “The Adjustment to Diabetes of School-age Children with Psychological Adjustment Problems”. British Journal of Health Psychology, 8; 335-358. https://doi.org/10.1348/135910703322370897.

      [9] Cho E, Shin SH, Eun SH, Kim JY, Nam HK, et al. (2013) Psychological characteristics of Korean children and adolescents with type 1 diabetes mellitus. Ann Pediatr Endocrinol Metab 18: 122-127. https://doi.org/10.6065/apem.2013.18.3.122.

      [10] Davidson M. Effect of nurse-directed diabetes care in a minority population. Diabetes Care 2003; 26(8): 2281-87. https://doi.org/10.2337/diacare.26.8.2281.

      [11] Gaudieri AP & GREER TF (2008): Cognitive Function in Children with Type 1Diabetes. Diabetes Care, 31(9):1892-1897. https://doi.org/10.2337/dc07-2132.

      [12] Goodman R. The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry.1997; 38:581–586. https://doi.org/10.1111/j.1469-7610.1997.tb01545.x.

      [13] Goodman R (2001) Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry 40: 1337–1345. https://doi.org/10.1097/00004583-200111000-00015.

      [14] Grey M, Cameron ME, Lipman TH, Thurber FW (1994) Initial adaptation in children with newly diagnosed diabetes and healthy children. Pediatr Nurs 20: 17–22.

      [15] Guthrie DW, Bartsocas C, Jarosz-Chabot P, Konstantinova M. Psychosocial issues for children and adolescents with diabetes: Overview and recommendations. Diabetes Spectr 2003; 16:7-12. https://doi.org/10.2337/diaspect.16.1.7.

      [16] Helgeson VS, Snyder PR, Escobar O, Siminerio L, Becker D (2007) Comparison of adolescents with and without diabetes on indices of psychosocial functioning for three years. J Pediatr Psychol 32: 794–806. https://doi.org/10.1093/jpepsy/jsm020.

      [17] Hamilton, J. & Daneman, D. (2002) 'Deteriorating Diabetes Control during Adolescence: Physiological or Psychosocial?' Journal of Pediatric Endocrinology & Metabolism [online] 15, (2) 115-126. https://doi.org/10.1515/JPEM.2002.15.2.115.

      [18] Hawes, D.J., Dadds, M.R. (2004). “Australian Data and Psychometric Properties of the Strengths and Difficulties Questionnaire”. Australian and New Zealand Journal of Psychiatry, 38; 644-651. https://doi.org/10.1080/j.1440-1614.2004.01427.x.

      [19] Hood KK, Huestis S, Maher A, Butler D, Volkening L, et al. (2006) Depressive Symptoms in Children and Adolescents with Type 1 Diabetes: Association with diabetes-specific characteristics. Diabetes Care 29: 1389–139 https://doi.org/10.2337/dc06-0087.

      [20] Hysing M, Elgen I, Gillberg C, Lie SA, Lundervold AJ (2007) Chronic physical illness and mental health in children. Results from a large-scale population study. J Child Psychol Psychiatry 48: 785–792. https://doi.org/10.1111/j.1469-7610.2007.01755.x.

      [21] Hysing ME, Elgen I, Gillberg c, Lum-dervold A. (2009): Emotional and behavioral problems in subgroups of children with chronic illness: results from a large – scale population study. Child care, Health and development, 35 (4); 527 -533. https://doi.org/10.1111/j.1365-2214.2009.00967.x.

      [22] International Diabetes Federation (2013) IDF Diabetes Atlas 6th Edition. Available at: http://www.idf.org/sites/default/ files/EN_6E_Atlas_Full_0.pdf (accessed 8 October 2014).

      [23] Kakleas K, Kandyla B, Karayianni C, Karavanaki K. Psychosocial problems in adolescents with type 1 diabetes mellitus. Diabetes Metab. 2009; 35:339–50. https://doi.org/10.1016/j.diabet.2009.05.002.

      [24] Kerry AR, Vicki SH (2011) Children with diabetes compared to peers: depressed? Distressed? A meta-analytic review. Ann Behav Med 42: 29-41 https://doi.org/10.1007/s12160-011-9262-4.

      [25] kim W, Hong JP, and Ho Yoo J::(2015): Emotional and Behavioral Problems and Glycemic Control in Adolescents with Type 1 and Type 2 Diabetes. Journal of Psychiatry, 18 (2):1-5.

      [26] Kristensen LJ, Birkebaek NH, Mose AH, Hohwu¨ L, Thastum M (2014) Symptoms of Emotional, Behavioral, and Social Difficulties in the Danish Population of Children and Adolescents with Type 1 Diabetes – Results of a National Survey. PLoS ONE 9(5): e97543. https://doi.org/10.1371/journal.pone.0097543.

      [27] McCarthy, A., Lindgren, S., Mengeling, M., Tsalikian, E., and Engvall, J. (2002). “Effects of Diabetes on Learning in Children”. Pediatrics, 109(1); E9. https://doi.org/10.1542/peds.109.1.e9.

      [28] Mounir GM, Abolfotouh MA. Psychosocial characteristics of diabetic students at sporting student hospital in Alexandria. J Egypt Public Health Assoc. 2005; 80:475–93.

      [29] Muris, P., Meesters, C., van den Berg, F. (2003). “The Strengths and Difficulties Questionnaire (SDQ): Further Evidence for its Reliability and Validity in a Community Sample of Dutch Children and Adolescents”. European Child and Adolescent Psychiatry, 12; 1-8. https://doi.org/10.1007/s00787-003-0298-2.

      [30] Niclasen J, Teasdale TW, Andersen AM, Skovgaard AM, Elberling H, et al. (2012) Psychometric properties of the Danish Strength and Difficulties Questionnaire: the SDQ assessed for more than 70,000 raters in four different cohorts. PLoS One 7: e32025. https://doi.org/10.1371/journal.pone.0032025.

      [31] Obel C, Heiervang E, Rodriguez A, Heyerdahl S, Smedje H, et al. (2004) The Strengths and Difficulties Questionnaire in the Nordic countries. Eur Child Adolesc Psychiatry 13 Suppl 2: II32–II39. https://doi.org/10.1007/s00787-004-2006-2.

      [32] Orsillo, S. M., & Roemer, L. (Eds.). (2005). Acceptance and mindfulness-based approaches to anxiety: New directions in conceptualization and treatment. New York: Kluwer Academic/Plenum (Springer). https://doi.org/10.1007/b136521.

      [33] Pendley JS, Kasmen LJ, Miller DL, Donze J, Swenson C, Reeves G. Peer and family support in children and adolescents with type I diabetes. J Pediatr Psychol 2002; 27: 429- 38. https://doi.org/10.1093/jpepsy/27.5.429.

      [34] Pinquart M, Shen Y (2011) Depressive Symptoms in Children and Adolescents with Chronic Physical Illness: An Updated Meta-Analysis. J Pediatr Psychol 36: 375–384. https://doi.org/10.1093/jpepsy/jsq104.

      [35] Reynolds KA, Helgeson VS (2011) Children with diabetes compared to peers: depressed? Distressed? A meta-analytic review. Ann Behav Med 42: 29–41. https://doi.org/10.1007/s12160-011-9262-4.

      [36] Rubio Zarzuela E, San Gregorio AP, Conde Hernamdez J. (2010): behavioral and emotional differences in groups of child and juvenile chronic patients. Annuary of clinical and health psychology, 6: 21- 31.

      [37] Schaaijk MN, Roeleveld-Versteegh BA, Odink RR and van Baar LA (2013): Behavioral Problems and Depressive Symptoms in Adolescents with Type 1 Diabetes Mellitus: Self and Parent Reports. Diabetes Mellitus – Insights and Perspectives. This is an open access chapter distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/3.0), 47-58. https://doi.org/10.5772/50667.

      [38] Soltesz G, Patterson C, Dahlquist G. Global trends in childhood type 1 diabetes. IDF Diabetes Atlas, 4 th ed.; 2010. p. 1-36. Available from: Http://www.idf.org/sites/default/files/Diabetes_in_the_Young.pdf [Last accessed on 2012 Mar 7].

      [39] Wherrett D, Huot C, Mitchell B et al. Type 1 Diabetes in Children and Adolescents. Canadian Journal of Diabetes; 37 (2013) S153- S162. https://doi.org/10.1016/j.jcjd.2013.01.042.

      [40] WINKLEYK, LANDAUS, EISLERI, ISMAILK. Psychological interventions to improve glycaemic control in patients with type 1 diabetes: systematic review and meta-analysis of randomized controlled trials. BMJ 2006: 333: 65 – 68. https://doi.org/10.1136/bmj.38874.652569.55.

      [41] Yousef, J. (1993). “Meeting the Counseling needs of Children with Diabetes”. International Journal for the Advancement of Counseling, 16; 29-36. https://doi.org/10.1007/BF01418181.


 

View

Download

Article ID: 6947
 
DOI: 10.14419/ijans.v5i2.6947




Copyright © 2012-2015 Science Publishing Corporation Inc. All rights reserved.