title: Routine behavioral and mental health screening in young children with type 1 diabetes mellitus.
abstract: BACKGROUND
  The American Diabetes Association and International Society for Pediatric and Adolescent Diabetes recommend that providers of diabetes care receive training in the recognition of psychosocial problems related to diabetes.
  
  
  OBJECTIVE
  To report the results of routine behavioral/mental health screening for children with type 1 diabetes mellitus (T1D) seen in a multidisciplinary pediatric diabetes program.
  
  
  METHODS
  This was a cross-sectional study of children with T1D ages 4-11 years, who underwent behavioral/mental health screening as part of their diabetes care. Screening utilized the Strengths and Difficulties Questionnaire (SDQ) Parent Proxy Version, and scores were reviewed by a social worker. SDQ scale and total difficulties scores were compared by gender, visit type, age, T1D duration, and HbA1c. Scores were also compared to age-appropriate normative data for children in United States of America (US).
  
  
  RESULTS
  SDQ Parent Proxy Version total difficulties and scale scores did not differ by patient or visit characteristics. Compared with normative data for US children, a greater proportion of children with T1D ages 4-7 and 8-10 years had borderline/abnormal scores on the emotional symptoms scale (p = 0.01 and p = 0.03, respectively), suggesting risk for psychological disorders, such as anxiety and depression.
  
  
  CONCLUSIONS
  Our findings suggest that children less than 11 years old with T1D may have greater emotional symptoms as compared to their age-matched healthy peers. Pediatric diabetes care providers, with access to mental health services, should consider incorporating routine behavioral/mental health screening for children less than 12 years old in their practice.
authors.affiliation: Division of Endocrinology, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
authors.forename: Ian Spencer
authors.initials: IS
authors.lastname: Zenlea
authors.forename: Lauren
authors.initials: L
authors.lastname: Mednick
authors.forename: Jennifer
authors.initials: J
authors.lastname: Rein
authors.forename: Maryanne
authors.initials: M
authors.lastname: Quinn
authors.forename: Joseph
authors.initials: J
authors.lastname: Wolfsdorf
authors.forename: Erinn T
authors.initials: ET
authors.lastname: Rhodes
mesh_terms: D002648:Child; D002652:Child Behavior / Q000523:psychology; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology*; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008603:Mental Health; D011795:Surveys and Questionnaires; D014481:United States
keywords: behavior; children; diabetes mellitus, type 1; mental health; screening