Emotional and behavioural problems

Jacobson et al, 199456661 patients enrolled within 12 months of diagnosis
Aged 9–16 years
Boston, USA
Mothers also interviewed
Family Environment Scale (FES)
Children with the least open, expressive families had greater deterioration in glycaemic control (maternal report <capitaldelta>R2= 0.12, p ≤ 0.01; child report <capitaldelta>R2= 0.15, p ≤ 0.006)
Boys from less cohesive and more conflicted families showed deterioration in glycaemic control (p ≤ 0.01)
Worsened over the 4-years (mean 11.1% to 12%)
Frequency of visits varied4-year study period; routine visits every 2–4 months in first 2 years and then 1 every 4–6 monthsIIb
Close et al, 198656760 children and young people (aged 9–18 years), Manchester Children’s Hospital
30 boys, mean age 14.1 ± 2.3 years
Rutter Parental Screening Questionnaire
Birleson Depression Inventory
Lipsitt Self-Esteem Scale
Locus control scale
Mean HbA1c
28% of children had ‘appreciable emotional/behavioural difficulties’
12% reported possible depression; all had values of HbA1c below 10% (p < 0.01)
No significant relation of HbA1c with other psychosocial measures
Landolt et al, 2002569Parents (37 mothers and 36 fathers) of 38 children with type 1 diabetes in 4 hospitals of German-speaking cantons in Switzerland, within the first 6 weeks of diagnosis
14 girls, mean age 10.5 ± 2.5 years
Post-traumatic stress disorder (PTSD)24% of mothers and 22% of fathers met full DSM-IV PTSD criteria, only 2 families showed full PTSD at the same timeCross-sectional surveyIII
Hatton et al, 199557182 parent families with an infant or toddler with diabetes (minimum duration 2 months) from the provincial clinic register of British Columbia
Age range of children at diabetes diagnosis: 5 weeks to 29 months
Parents’ perceptions of caring
Diagnosis, hospitalisation
Coping strategies
No numbers were given; descriptive and verbatim passagesData subjected to ‘phenomenological’ analytical proceduresQualitative study consisting of a series of 14 audio-taped interviewsIII
Blankfeld et al, 199657052 mothers of children with type 1 diabetes participating in a paediatric diabetes management programme
Mean age of children 11.3 ± 3.2 years, 24 boys, mean duration of diabetes 2.65 years
Family support showed an indirect relationship to mothers’ depressive symptomsFamily Support (FES)
Maternal % approach coping (Coping Responses Inventory)
Depressive symptoms (Health and Daily Living Form)
Family support significantly related to % approach coping, and % approach coping significantly associated with depressive symptom (p < 0.05 level)Tested predictive framework using a LISREL modelCross-sectionalIII

From: Evidence tables

Cover of Type 1 Diabetes
Type 1 Diabetes: Diagnosis and Management of Type 1 Diabetes in Children and Young People.
NICE Clinical Guidelines, No. 15.2.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2004 Sep.
Copyright © 2004, National Collaborating Centre for Women’s and Children’s Health.

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