Child-onset diabetes linked to high risk for mental health disorders later in life

Key takeaways:

• Individuals who develop type 1 diabetes as children faced greater risks for anxiety, depression and eating disorders.
• Findings show the importance of prevention and monitoring of mental health in youth with diabetes.

Individuals who develop type 1 diabetes during childhood experienced greater risk for several mental health conditions later in life, including anxiety disorders and substance use disorders, study results showed.

Prior studies have highlighted ties between mental health and diabetes across various age groups. Healio previously reported that adults with diabetes were more likely to report emotional distress, while another study suggested that incorporating psychosocial screening in diabetes clinics may be crucial.

“However, existing research has focused mostly on broadly defined psychiatric disorders and had only limited ambitions to ascertain whether the observed associations are best explained by the impacts of living with the condition and its treatment, or whether underlying common biological mechanisms may be implicated,” Tomá Formánek, a PhD student in the department of psychiatry at the University of Cambridge in England, and colleagues wrote in Nature Mental Health.

Researchers analyzed a cohort of 4,556 youth with type 1 diabetes aged 14 years or younger between 1994 and 2007 included in a Czech national registry of all-cause hospitalizations. They matched each youth with type 1 diabetes with 10 counterparts without type 1 diabetes, according to sex, age, discharge year and month (mean age for both groups, 8.66 years; 52.8% males).

During follow-up of 10 to 24 years, investigators accounted for competing risk for mortality and used stratified Cox proportional hazards models to assess risk for six psychiatric diagnostic groups and 21 specific or closely associated psychiatric disorders.

Results showed that compared with those without childhood onset type 1 diabetes, children and adolescents with type 1 diabetes were more likely to develop substance use disorders (HR = 1.39; 95% CI, 1.23-1.58), anxiety disorders (HR = 1.61; 95% CI, 1.4-1.85), mood disorders (HR = 2.32; 95% CI, 1.82-2.96), behavioral syndromes associated with physiological disturbances and physical factors (HR = 4.18; 95% CI, 3.24-5.39) and personality and behavioral disorders (HR = 1.39; 95% CI, 1.09-1.77).

However, youth with type 1 diabetes experienced lower risk for developing schizophrenia vs. those without type 1 diabetes (HR = 0.55; 95% CI, 0.33-0.91).

When the researchers examined specific or closely related psychiatric disorders, children and adolescents with type 1 diabetes experienced greater risk for conditions like alcohol use disorders (HR = 1.54; 95% CI, 1.32-1.8), drug use disorders (HR = 1.21; 95% CI, 1.02-1.44), depression (HR = 2.61; 95% CI, 2.02-3.38) and other anxiety disorders (HR = 1.7; 95% CI, 1.27-2.27).

Researchers additionally used Mendelian Randomization to determine links between the several psychiatric disorders and type 1 diabetes.

“Although we found a concerning increase in the risk of mental health problems among people living with type 1 diabetes, our study — and others before it — suggest this is unlikely to be the result of common biological mechanisms,” Formánek said in a press release. “This emphasizes the importance of prevention and sustained attention to the mental health needs of children and young people with type 1 diabetes.”

References:

• ‘Diabetes distress’ increases risk of mental health problems among young people living with type 1 diabetes. Available at https://www.eurekalert.org/news-releases/1051189. Published July 17, 2024. Accessed July 17, 2024.
• Formánek T, et al. Nat Mental Health. 2024;doi:10.1038/s44220-024-00280-8.