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Diabetes Care. 2015 Mar;38(3):453-9. doi: 10.2337/dc14-0262. Epub 2015 Feb 3.

Risks of psychiatric disorders and suicide attempts in children and adolescents with type 1 diabetes: a population-based cohort study.

Author information

1
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden Department of Child Psychiatry, Medical University of Warsaw, Warsaw, Poland agnieszka.butwicka@ki.se.
2
Child and Adolescent Psychiatry Research Center, Stockholm, Sweden Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
3
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden Lung and Allergy Unit, Astrid Lindgren Children's Hospital, Stockholm, Sweden.
4
Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden Medical Products Agency, Uppsala, Sweden.
5
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.

Abstract

OBJECTIVE:

To assess the risk of psychiatric disorders and suicide attempts in children with type 1 diabetes and their healthy siblings.

RESEARCH DESIGN AND METHODS:

We performed a population-based case-cohort study of individuals born in Sweden between 1973 and 2009. Children with type 1 diabetes (n = 17,122) and their healthy siblings (n = 18,847) were identified and followed until their 18th birthday. Their risk of psychiatric disorders was compared with that of matched control subjects.

RESULTS:

The risk of psychiatric morbidity in children with type 1 diabetes compared with the general population was tripled within 6 months after the onset of diabetes (hazard ratio [HR] 3.0 [95% CI 2.7-3.4]) and doubled within the total observation period (HR 2.1 [95% CI 2.0-2.2]). An increased risk was noted in suicide attempts (HR 1.7 [95% CI 1.4-2.0]) and in most categories of psychiatric disorders. The risk of psychiatric disorders in probands declined from HR 2.7 (95% CI 2.2-3.3) for those in the cohort born 1973-1986 to 1.9 (95% CI 1.8-2.0) in those born 1997-2009. The risk for any psychiatric disorders among siblings of patients with type 1 diabetes was estimated to be HR 1.1 (95% CI 1.0-1.1), and there was no increased risk in any of the specific category of disorders.

CONCLUSIONS:

Children with type 1 diabetes are at high risk of psychiatric disorders, which seems to be a consequence of the disease rather than due to a common familial etiology. The results support recommendations on comprehensive mental health surveillance in children with type 1 diabetes, especially in recently diagnosed children.

PMID:
25650362
PMCID:
PMC4338504
DOI:
10.2337/dc14-0262
[Indexed for MEDLINE]
Free PMC Article

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