title: Psychological screening in adolescents with type 1 diabetes predicts outcomes one year later.
abstract: OBJECTIVE
  Adolescents with type 1 diabetes are at increased risk for depression and anxiety, which can adversely affect diabetes management, glycemic control, and quality of life (QOL). However, systematic psychological screening is rarely employed. We hypothesized that higher depression and anxiety screener scores would predict higher HbA1c, less frequent blood glucose monitoring (BGM), and poorer QOL one year later. Raw screener scores were expected to be more robust predictors than cutoff scores.
  
  
  METHODS
  150 adolescents age 13-18 with type 1 diabetes completed depression and anxiety screeners. One year later, blood glucose meters were downloaded to assess BGM frequency, HbA1c values were obtained, and caregivers rated the participants' QOL. Separate regressions were conducted for each outcome, including demographic and medical covariates.
  
  
  RESULTS
  Higher depression scores predicted less frequent BGM (b=-0.05, p<.05) and poorer QOL (b=-0.71, p<.01), and higher state anxiety scores predicted higher HbA1c (b=0.07, p<.05). Continuous screener scores identified risk for 12-month outcomes more robustly than clinical cut-off scores.
  
  
  CONCLUSIONS
  Psychological screeners predict diabetes outcomes one year later. Future clinical research studies should explore whether psychological screening and referral for appropriate intervention can prevent deteriorations in diabetes management and control commonly seen during adolescence.
authors.affiliation: Division of Behavioral Medicine and Clinical Psychology, Center for the Promotion of Treatment Adherence and Self-Management, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
authors.forename: Marisa E
authors.initials: ME
authors.lastname: Hilliard
authors.forename: Michele
authors.initials: M
authors.lastname: Herzer
authors.forename: Lawrence M
authors.initials: LM
authors.lastname: Dolan
authors.forename: Korey K
authors.initials: KK
authors.lastname: Hood
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000097:blood / Q000503:physiopathology; D001786:Blood Glucose / Q000378:metabolism; D003863:Depression / Q000097:blood / Q000503:physiopathology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D011788:Quality of Life
chemical_list: D001786:Blood Glucose