Pediatric type 1 diabetes treatment should incorporate evaluation of suicide risk
Click Here to Manage Email Alerts
Young people with type 1 diabetes should be screened for suicidal thoughts, as suicide had been attempted by 16.3% of individuals in a cohort of young people with type 1 diabetes who had such thoughts, according to findings published in Diabetes Care.
“This research is incredibly important because it raises awareness about suicide and demonstrates that people with type 1 diabetes think about it,” Kimberly A. Driscoll, PhD, an associate professor of clinical and health psychology, joint associate professor of pediatrics and director of behavioral science research at the Diabetes Institute at the University of Florida, told Healio. “We hope that the results of this study get type 1 diabetes providers to ask their patients if they think about suicide. You can only do something about it if you know it’s a problem.”
Driscoll and colleagues screened 550 individuals aged 10 to 24 years (mean age, 15.2 years; 47.5% female) with type 1 diabetes for major depressive disorder via the Patient Health Questionnaire-9, which included questions about suicidal thoughts. There were 49 individuals (mean age, 14.9 years; 75.5% female) who said they had suicidal thoughts and were further evaluated by a suicide risk assessment team that collected information on the length of time thoughts persisted, the number of times they were present and whether a participant had attempted self-harm or died by suicide. The researchers also evaluated participants’ stress, feelings about family and interpersonal relationships, “intent to kill” and “feelings of hopelessness.”
Suicide had been attempted by 16.3% of the cohort with suicidal thoughts and had been planned for by nine participants, including three who “devised prior plans to attempt suicide by overdosing on insulin.” In addition, self-harm behaviors such as cutting were noted for 46.9% of the population with suicidal thoughts.
“In addition to being a researcher, I am a licensed clinical psychologist and I see people with type 1 diabetes for therapy, so I was not surprised about our findings. I was surprised, however, about how little attention suicide has gotten in people of all ages with type 1 diabetes,” Driscoll said. “Clinically, we know it’s a concern, but very little research has been conducted with people with type 1 diabetes especially because they have access to a lethal method for suicide — insulin.”
The stress an individual felt they caused for family members was cited as a motivator for suicidal thoughts by 64.7% of the cohort, “with type 1 diabetes being a common reason provided.”
“Many youth and young adults expressed that they experienced suicidal ideations in relation to wanting to relieve the burden of type 1 diabetes from their families,” the researchers wrote. “This finding further highlights an urgent need to routinely assess for suicidal ideations in youth and young adults with type 1 diabetes.”
Suicide risk was determined to be moderate to severe for 4.1% of the cohort with suicidal thoughts and moderate for 12.2% of the population. The remaining participants were either at low risk (79.6%) or low to moderate risk (4.1%).
“I’ve heard type 1 diabetes providers say they don’t inquire about it because they are afraid it will ‘plant the seed’ about suicide, and that simply is not true. Asking has actually been shown to be protective,” Driscoll said. “Type 1 diabetes providers need the training to ask the questions and the time and resources to help in situations when suicidal thoughts are expressed, because immediate hospitalization is not always needed, which our study demonstrated. As a field, we also need to figure out how to integrate more clinical psychologists as standard members of the type 1 diabetes team.” – by Phil Neuffer
For more information:
Kimberly A. Driscoll, PhD , can be reached at k.driscoll@phhp.ufl.edu.
Disclosures: The authors report no relevant financial disclosures.
Read more about
Click Here to Manage Email Alerts