Psychological and behavioral complications in children and adolescents with type 1 diabetes mellitus in Sohag

Type 1 diabetes mellitus is a chronic disease mainly diagnosed in children and adolescents. It has multiple psychiatric comorbidities. Our aim in this study was to determine the prevalence of psychological and behavioral problems in children and adolescents diagnosed with type 1 diabetes and to find if there is a strong correlation between these problems and different epidemiological- and disease-related factors such as age of the child, duration of diabetes, and other risk factors. We conducted a cross-sectional study and compared between 564 children diagnosed with diabetes mellitus type 1 (who attended Specialized Health Insurance Clinic in Sohag City, Upper Egypt, during the year 2018/2020) and 564 non-diabetic children matched with the diabetic children for age, sex, and socio-economic status. We used “Strengths and Difficulties Questionnaire (SDQ)” to screen for behavioral, social, and emotional problems in diabetic and control children. “SDQ” is a 25-item brief behavioral screening questionnaire that consists of five subscales which are emotional problems, hyperactivity-inattention problems, conduct problems, peer problems, and prosocial behavior subscales. It generates total score and individual score for each subscale. In our study, we found that diabetic children had significantly higher prevalence of emotional and behavioral problems than control children (92.37% of diabetic children versus 20.2% of control children had abnormal total SDQ score with P value < 0.001). All subscales of SDQ except prosocial subscale were significantly affected in children with type 1 diabetes mellitus than control children with P value < 0.001. Certain factors were significantly associated with impaired subscales of SDQ scale. We found a positive correlation between age and emotional, hyperactivity and conduct problems as these problems were more frequent in older children. Female children had more hyperactivity and conduct problems than male children (68.6%, 71.7% vs. 58.0%, 62.0%, P 0.002 and 0.003, respectively) while male children were more affected by emotional problems than female children (68% vs. 57.4%, P 0.003). Peer problems were more prevalent in children of parents with higher educational level. Children with positive family history of diabetes were less affected by emotional problems than children with negative family history (50% vs.64.3%, P 0.04). Longer duration of disease was associated with increased prevalence of peer and emotional problems. Poor control of diabetes increased the prevalence of conduct and emotional problems (P 0.007 and 0.022, respectively). Children with type 1 diabetes mellitus have more emotional, hyperactivity, conduct, and peer problems than non-diabetic children. These findings indicate a need to screen diabetic children and adolescents for behavioral and emotional problems and treat these problems if found.