Recurrent depression relates to worse outcomes than single episode depression among Hispanic adolescents with diabetes

Resumen

Adolescents with type 1 diabetes (T1D) are at increased risk for depression. A history of recurrent depression (HRD) may relate to worse health outcomes than single episode depression. However, no study has explored this issue among T1D adolescents. We examined differences in psychosocial and diabetes-related outcomes among T1D adolescents with (G1; n = 33) and without (G2; n = 18) HRD. Participants were 51 youths (aged 12-17 years) enrolled in a depression treatment study (IRB#1112-005). Youths and one caregiver each completed several measures. Using MANOVA, followed by individual ANOVAs, and Chi-square tests, we compared groups in continuous and categorical variables, respectively. MANOVA results were significant, F(7, 43) = 3.97, p = .002. Adolescents from G1 obtained higher scores than youths in G2 in self-esteem/guilt problems, cognitive alterations, and sadness due to T1D. Their caregivers reported more burden, and rated their offspring as having more internalizing problems, facing more barriers to comply with T1D treatment, and using a medical ID less frequently than their counterparts did. A higher percentage of G1 participants reported having met criteria for major depression, presented clinical levels of anxiety, and showed inadequate glycemic control. According to caregivers, a higher proportion of G1 participants had experienced multiple diabetes-related hospitalizations and non-compliance with insulin treatment. Our study documents important differences in outcomes between T1D adolescents with vs. without HRD. Clinicians may need an intensive and integrative approach to treat mental and physical aspects of health among these patients. Funded by NIDDK (R03DK092547).