Maternal depressive symptoms predict acute hospitalization among children with type 1 diabetes.
OBJECTIVE
The aim of this study is to examine the impact of a mother's depressive symptoms on the risk of hospital admission of her child due to severe hypoglycemia or diabetic ketoacidosis.


METHODS
One hundred sixty-six mothers of children with type 1 diabetes (T1DM) were evaluated using the Hamilton Depression Rating Scale (HDRS). All of the children were studied prospectively for acute diabetic complications. The optimal thresholds of HDRS mother's scores for prediction of the risk of child hospitalization were identified using the Receiver Operating Characteristic curve analysis. The time to hospital admissions were compared using the log-rank test for univariate and Cox's proportional hazard models for multivariate analysis of risk factors for hospitalization.


RESULTS
At study entry age, diabetes duration and glycated hemoglobin (HbA1c) of the children equaled 13.5 ± 2.6 years, 4.1 ± 1.9 years and 7.8 ± 1.7%, respectively. Throughout the observation period 56 patients required at least one hospitalization due to acute complications. Median time of observation and time to the hospital admission were 46.3 [interquartile range (IQR) 32.2-57.7] and 13.2 (IQR 6.6-20.0) months, respectively. The best cutoff value of maternal depression in HDRS predictive for the risk of child hospitalization was above 12 points. The hazard ratio for hospitalization offered by the cutoff score for mother's depressive symptoms above threshold was 2.73 (95% confidence interval: 1.39-5.36).


CONCLUSIONS
Children with T1DM whose mothers show high level of depressive symptoms are at an elevated risk for hospitalization due to acute diabetic complication.
Department of Child Psychiatry, Medical University of Warsaw, Warsaw, Poland.
Agnieszka
A
Butwicka
Adam
A
Zalepa
Wojciech
W
Fendler
Agnieszka
A
Szadkowska
Wojciech
W
Mlynarski
D000293:Adolescent; D000328:Adult; D017028:Caregivers / Q000523:psychology*; D002648:Child; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology*; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D016883:Diabetic Ketoacidosis; D005190:Family; D005260:Female; D006760:Hospitalization; D006801:Humans; D007003:Hypoglycemia; D007332:Insulin Infusion Systems; D008137:Longitudinal Studies; D008297:Male; D009035:Mothers / Q000523:psychology*; D011044:Poland / Q000453:epidemiology; D012307:Risk Factors