title: Differentiating disordered affect in children and adolescents with type 1 diabetes.
abstract: BACKGROUND
  There is evidence for increased risk of affective disorders (AD) in adults with type 1 diabetes however, the prevalence and characteristics of AD in young people with the condition is unclear. Comorbid AD in type 1 diabetes is associated with deleterious self-management, sub-optimal clinical indicators, reduced quality of life, poorer physical health, increased complications, increased high risk behaviours in adolescence and young adulthood, and earlier mortality. The present study investigated the prevalence and character of AD in young people with type 1 diabetes.
  
  
  METHODS
  The self-report PH-PANAS-C was employed in a cross-sectional, case-control design to identify and differentiate full-syndrome (FS) and subthreshold (St) levels of AD in 53 participants with type 1 diabetes (case) and 54 age-balanced controls (N=107; 7-18 yrs).
  
  
  RESULTS
  Case participants reported greater AD than controls. When differentiated, only anxiety was significantly more prevalent. Case participants reported less positive affect, and greater negative affect and autonomic arousal. Further, 1:3 case participants presented with St symptoms of AD.
  
  
  CONCLUSIONS
  Self-report measures are known to produce moderated responses therefore symptoms may be more severe than reported. There has been some suggestion that responses to somatic items in the PH-PANAS-C may relate to diabetes-specific states rather than affect-related symptoms however, recent evidence has refuted this argument.
  
  
  CONCLUSIONS
  AD, particularly anxiety, represents a significant clinical concern in young people with type 1 diabetes both as a disorder in its own right and as a major impediment to primary care and management of the diabetes. The significant dominance of anxiety-related symptoms and prevalence of subthreshold presentation warrant further investigation.
authors.affiliation: Department of Psychiatry and Psychiatric Neuroscience, School of Medicine and Dentistry, James Cook University, Angus Smith Drive, Townsville, QLD, Australia. grantsinnamon@bigpond.com
authors.forename: Grant C B
authors.initials: GC
authors.lastname: Sinnamon
authors.forename: Marie
authors.initials: M
authors.lastname: Caltabiano
authors.forename: Bernhard T
authors.initials: BT
authors.lastname: Baune
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000453:epidemiology; D016022:Case-Control Studies; D002648:Child; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000453:epidemiology*; D015995:Prevalence; D057566:Self Report