Association of insulin-manipulation and psychiatric disorders : A systematic epidemiological evaluation of adolescents with type 1 diabetes in Austria
© 2018 The Authors. Pediatric Diabetes published by John Wiley & Sons Ltd..
BACKGROUND/OBJECTIVE: The aim of this study was to systematically assess the association of insulin-manipulation (intentional under- and/or overdosing of insulin), psychiatric comorbidity and diabetes complications.
METHODS: Two diagnostic interviews (Diabetes-Self-Management-Patient-Interview and Children's-Diagnostic-Interview for Psychiatric Disorders) were conducted with 241 patients (age 10-22) with type 1 diabetes (T1D) from 21 randomly selected Austrian diabetes care centers. Medical data was derived from medical records.
RESULTS: Psychiatric comorbidity was found in nearly half of the patients with insulin-manipulation (46.3%) compared to a rate of 17.5% in patients, adherent to the prescribed insulin therapy. Depression (18.3% vs 4.9%), specific phobia (21.1% vs 2.9%), social phobia (7.0% vs 0%), and eating disorders (12.7% vs 1.9%) were elevated in patients with insulin-manipulation. Females (37.7%) were more often diagnosed (P = 0.001) with psychiatric disorders than males (18.4%). In females, the percentage of psychiatric comorbidity significantly increased with the level of non-adherence to insulin therapy. Insulin-manipulation had an effect of +0.89% in HbA1c (P = <0.001) compared to patients adherent to insulin therapy, while there was no association of psychiatric comorbidity with metabolic control (HbA1c 8.16% vs 8.12% [65.68 vs 65.25 mmol/mol]). Ketoacidosis, severe hypoglycemia, and frequency of outpatient visits in a diabetes center were highest in patients with insulin-manipulation.
CONCLUSIONS: This is the first study using a systematic approach to assess the prevalence of psychiatric disorders in patients who do or do not manipulate insulin in terms of intentional under- and/or overdosing. Internalizing psychiatric disorders were associated with insulin-manipulation, especially in female patients and insulin-manipulation was associated with deteriorated metabolic control and diabetes complications.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:20 |
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| Enthalten in: |
Pediatric diabetes - 20(2019), 1 vom: 15. Feb., Seite 127-136 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Berger, Gabriele [VerfasserIn] |
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| Links: |
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| Themen: |
Adolescent |
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| Anmerkungen: |
Date Completed 19.08.2019 Date Revised 28.07.2020 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/pedi.12784 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM289032334 |
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| 041 | |a eng | ||
| 100 | 1 | |a Berger, Gabriele |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Association of insulin-manipulation and psychiatric disorders |b A systematic epidemiological evaluation of adolescents with type 1 diabetes in Austria |
| 264 | 1 | |c 2019 | |
| 336 | |a Text |b txt |2 rdacontent | ||
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| 500 | |a Date Completed 19.08.2019 | ||
| 500 | |a Date Revised 28.07.2020 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2018 The Authors. Pediatric Diabetes published by John Wiley & Sons Ltd. | ||
| 520 | |a BACKGROUND/OBJECTIVE: The aim of this study was to systematically assess the association of insulin-manipulation (intentional under- and/or overdosing of insulin), psychiatric comorbidity and diabetes complications | ||
| 520 | |a METHODS: Two diagnostic interviews (Diabetes-Self-Management-Patient-Interview and Children's-Diagnostic-Interview for Psychiatric Disorders) were conducted with 241 patients (age 10-22) with type 1 diabetes (T1D) from 21 randomly selected Austrian diabetes care centers. Medical data was derived from medical records | ||
| 520 | |a RESULTS: Psychiatric comorbidity was found in nearly half of the patients with insulin-manipulation (46.3%) compared to a rate of 17.5% in patients, adherent to the prescribed insulin therapy. Depression (18.3% vs 4.9%), specific phobia (21.1% vs 2.9%), social phobia (7.0% vs 0%), and eating disorders (12.7% vs 1.9%) were elevated in patients with insulin-manipulation. Females (37.7%) were more often diagnosed (P = 0.001) with psychiatric disorders than males (18.4%). In females, the percentage of psychiatric comorbidity significantly increased with the level of non-adherence to insulin therapy. Insulin-manipulation had an effect of +0.89% in HbA1c (P = <0.001) compared to patients adherent to insulin therapy, while there was no association of psychiatric comorbidity with metabolic control (HbA1c 8.16% vs 8.12% [65.68 vs 65.25 mmol/mol]). Ketoacidosis, severe hypoglycemia, and frequency of outpatient visits in a diabetes center were highest in patients with insulin-manipulation | ||
| 520 | |a CONCLUSIONS: This is the first study using a systematic approach to assess the prevalence of psychiatric disorders in patients who do or do not manipulate insulin in terms of intentional under- and/or overdosing. Internalizing psychiatric disorders were associated with insulin-manipulation, especially in female patients and insulin-manipulation was associated with deteriorated metabolic control and diabetes complications | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a adolescent | |
| 650 | 4 | |a diabetes complications | |
| 650 | 4 | |a medication adherence | |
| 650 | 4 | |a mental disorders | |
| 650 | 4 | |a psychology | |
| 650 | 7 | |a Insulin |2 NLM | |
| 700 | 1 | |a Waldhoer, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Barrientos, Irene |e verfasserin |4 aut | |
| 700 | 1 | |a Kunkel, Daniela |e verfasserin |4 aut | |
| 700 | 1 | |a Rami-Merhar, Birgit M |e verfasserin |4 aut | |
| 700 | 1 | |a Schober, Edith |e verfasserin |4 aut | |
| 700 | 1 | |a Karwautz, Andreas |e verfasserin |4 aut | |
| 700 | 1 | |a Wagner, Gudrun |e verfasserin |4 aut | |
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