title: Symptoms of depression are important to psychological adaptation and metabolic control in children with diabetes mellitus.
abstract: OBJECTIVE
  Sixty-two children (37 girls, 25 boys) between 9 and 18 years of age were enrolled to investigate: (1) the relationship between adaptation to diabetes mellitus (DM) and psychological functioning; (2) if adaptation or psychological functioning was related to metabolic control; and (3) if the patients' ability to cope with diabetes as assessed by physicians, was correlated to adaptation or psychological functioning.
  
  
  METHODS
  Psychological functioning was measured by three general psychological instruments for depressive symptoms, self-esteem and fear. Diabetes adaptation was evaluated by questionnaires and coping with diabetes by an assessment of the physicians. Metabolic control was expressed by the individual HbA1c measured during the last year.
  
  
  RESULTS
  Adaptation to diabetes correlated to psychological functioning (depression, P<0.001; self-esteem, P<0.01; and fear, P<0.01). Multiple regression analyses showed that metabolic control was predicted by adaptation (P=0.0013) with monitoring of diabetes as the only significant aspect of the adaptation (P < or = 0.0001). In turn, adaptation was predicted by symptoms of depression and metabolic control (P<0.0001). In support of this observation, a depressed (n = 9) and a non depressed (n= 53) group showed significant differences in metabolic control (P < or = 0.01), adaptation (P < or = 0.001) and self-esteem (P < or = 0.001). The only significant variable for the physicians assessment was metabolic control, which explained 35 % of the variance (P < 0.001).
  
  
  CONCLUSIONS
  The major conclusion is that symptoms of depression affect both adaptation and metabolic control. It should be of concern to identify patients with depressive symptoms, offer treatment for their emotional difficulties and increase the support for taking care of their diabetes.
authors.affiliation: Department of Woman and Child Health, Karolinska Institute, Sweden. blern@u.washington.edu
authors.forename: B
authors.initials: B
authors.lastname: Lernmark
authors.forename: B
authors.initials: B
authors.lastname: Persson
authors.forename: L
authors.initials: L
authors.lastname: Fisher
authors.forename: P A
authors.initials: PA
authors.lastname: Rydelius
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D002648:Child; D003863:Depression / Q000378:metabolism*; D003920:Diabetes Mellitus / Q000378:metabolism / Q000523:psychology*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male