Type 1 diabetes raises risks for depression, anxiety for children, adolescents
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Children with type 1 diabetes have elevated risks for developing depression, anxiety and stress-related disorders, according to study data.
Shared familial factors may contribute to these heightened risks, according to Shengxin Liu, a doctoral student, and Agnieszka Butwicka, MD, PhD, assistant professor, both in the department of medical epidemiology and biostatistics at the Karolinska Institute in Solna, Sweden.
Liu, Butwicka and colleagues aimed to investigate the association and familial coaggregation of childhood-onset type 1 diabetes with depression, anxiety and stress-related disorders.
The population-based cohort study featured data from Swedish nationwide registers. Researchers linked approximately 3.5 million individuals born in Sweden from 1973 to 2007 to their biological parents, full siblings, half-siblings and cousins. They used Cox models to estimate the association and familial coaggregation of type 1 diabetes with depression, anxiety and stress-related disorders.
Compared with individuals without type 1 diabetes, those diagnosed with childhood-onset type 1 diabetes (n = 20,005; 0.6%) were at greater risk for all outcomes; these included any psychiatric diagnosis (adjusted HR = 1.66; 95% CI, 1.59-1.72) or specific diagnoses of depression (aHR = 1.85; 95% CI, 1.76-1.94), anxiety (aHR = 1.41; 95% CI, 1.33-1.5) and stress-related disorders (aHR = 1.75; 95% CI, 1.62-1.89), along with the use of antidepressants or anxiolytics (aHR = 1.3; 95%, 1.26-1.34).
In addition, relatives of those with type 1 diabetes demonstrated increased risks for developing these outcomes, with the highest risks observed for parents (aHRs = 1.18 to 1.25), followed by full siblings (aHRs = 1.05 to 1.2) with greater risks for those more closely related, the researchers noted.
“Many clinicians assume intuitively that diabetes in a child negatively affects the mental health of both the patient and the family members. The answer seems not that simple, as our study indicates that there could also be a genetic component behind this association,” Liu and Butwicka told Healio.
They added that clinical vigilance and therapeutical intervention should also involve close family members, not just people with diabetes.
“More studies are needed to fully understand the underlying genetic and environmental contributions driving psychiatric disorders in type 1 diabetes,” Liu and Butwicka said.
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