title: Maternal depressive symptoms predict adolescent healthcare utilization and charges in youth with type 1 diabetes (T1D).
abstract: OBJECTIVE
  To examine whether maternal depressive symptoms predict diabetes-related health care utilization and charges in adolescents with Type 1 diabetes.
  
  
  METHODS
  Mothers of adolescents ages 11-18 with Type 1 diabetes completed the Center for Epidemiological Studies Depression Scale at enrollment and at 12-month follow-up. Demographic and disease-related variables, including HbA1c, were also assessed. Health care utilization data and charges for diabetes-related care (i.e., endocrine clinic visits, emergency room visits, and hospitalizations) for the period of 12 and 24 months following enrollment were assessed.
  
  
  RESULTS
  Maternal depressive symptoms at enrollment predicted higher utilization/charges at 12- and 24-month follow-up, after controlling for demographic and disease-related variables and adolescent depressive symptoms. High maternal depressive symptoms at baseline were associated with $8,405 additional charges over the next 2 years. Adolescents of mothers with high depressive symptoms were twice as likely to have an emergency room visit and three times as likely to have a hospitalization.
  
  
  CONCLUSIONS
  Maternal depressive symptoms are an independent predictor of health care utilization and charges in adolescents with Type 1 diabetes. Interventions aimed at identifying and treating depressive symptoms in mothers could not only enhance caregiver quality of life but could also be economically advantageous for payers and providers.
authors.affiliation: Department of Psychiatry, University of Texas Southwestern Medical Center and Children’s Medical Center of Dallas, Texas, USA.
authors.forename: Kyle M
authors.initials: KM
authors.lastname: Clayton
authors.forename: Sunita M
authors.initials: SM
authors.lastname: Stewart
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Wiebe
authors.forename: Charles E
authors.initials: CE
authors.lastname: McConnel
authors.forename: Carroll W
authors.initials: CW
authors.lastname: Hughes
authors.forename: Perrin C
authors.initials: PC
authors.lastname: White
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D000328:Adult; D002648:Child; D003863:Depression / Q000175:diagnosis*; D003922:Diabetes Mellitus, Type 1 / Q000191:economics* / Q000628:therapy*; D005249:Fees and Charges / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human