Psychosocial Well-Being and Functional Outcomes in Youth With Type 1 Diabetes 12 years After Disease Onset
Psychosocial Well-Being and Functional Outcomes in Youth With Type 1 Diabetes 12 years After Disease Onset
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DOI：
10.2337/dc09-2232
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发表时间：
2010-07-01
期刊：
影响因子：
16.2
通讯作者：
Cameron, Fergus J.
中科院分区：
文献类型：
--
作者：
Northam, Elisabeth A.;Lin, Ashleigh;Cameron, Fergus J.
目的 - 比较青少年和社区对照中 1 型糖尿病的功能结果。检查诊断时心理社会变量与 12 年后功能结果之间的关系。 研究设计和方法 - 参与者为 1 型糖尿病受试者（n = 110，平均年龄 20.7 岁，SD 4.3）和对照受试者（n = 76，平均年龄 20.8 岁，SD 4.0）。使用的措施包括青少年自我报告和年轻人自我报告以及功能结果的半结构化访谈。 1 型糖尿病参与者还提供了有关当前糖尿病护理和诊断后代谢控制的信息。 结果 - 1 型糖尿病参与者和对照组报告了相似的当前健康水平，但对于患有 1 型糖尿病的青少年来说，过去 12 年的心理健康转诊率高出 19%，学业完成率低 17%。超过三分之一的临床参与者目前没有接受专科护理，该群体过去的心理健康服务使用率较高（61% vs. 33%），但目前的社会心理健康状况较低。在 1 型糖尿病组中，诊断时的行为问题、高活动量和低家庭凝聚力预示着当前的健康状况较低，但与代谢控制史无关。较差的代谢控制与较高的心理健康服务使用率相关。 结论 - 1 型糖尿病参与者报告的当前社会心理健康水平与对照受试者相似，但诊断后的精神发病率较高，学业完成率较低。精神疾病发病率与代谢控制不佳和未能过渡到三级成人糖尿病护理有关。
OBJECTIVE - Type 1 diabetes in youth and community controls were compared on functional outcomes. Relationships were examined between psychosocial variables at diagnosis and functional outcome 12 years later.RESEARCH DESIGN AND METHODS - Participants were subjects with type 1 diabetes (n = 110, mean age 20.7 years, SD 4.3) and control subjects (n = 76, mean age 20.8 years, SD 4.0). The measures used included the Youth Self-Report and Young Adult Self-Report and a semi-structured interview of functional outcomes. Type 1 diabetes participants also provided information about current diabetes care and metabolic control from diagnosis.RESULTS - Type 1 diabetes participants and control subjects reported similar levels of current well-being but for the youth with type 1 diabetes, the mental health referral rates over the previous 12 years were higher by 19% and school completion rates were lower by 17%. Over one-third of clinical participants were not currently receiving specialist care and this group had higher mental health service usage in the past (61 vs. 33%) and lower current psychosocial wellbeing. Within the type 1 diabetes group, behavior problems, high activity, and low family cohesion at diagnosis predicted lower current well-being, but were not associated with metabolic control history. Poorer metabolic control was associated with higher mental health service usage.CONCLUSIONS - Type 1 diabetes participants report similar levels of current psychosocial well-being compared with control subjects, but higher levels of psychiatric morbidity since diagnosis and lower school completion rates. Psychiatric morbidity was associated with poor metabolic control and failure to transition to tertiary adult diabetes care.