title: Risks of psychiatric disorders and suicide attempts in children and adolescents with type 1 diabetes: a population-based cohort study.
abstract: OBJECTIVE
  To assess the risk of psychiatric disorders and suicide attempts in children with type 1 diabetes and their healthy siblings.
  
  
  METHODS
  We performed a population-based case-cohort study of individuals born in Sweden between 1973 and 2009. Children with type 1 diabetes (n = 17,122) and their healthy siblings (n = 18,847) were identified and followed until their 18th birthday. Their risk of psychiatric disorders was compared with that of matched control subjects.
  
  
  RESULTS
  The risk of psychiatric morbidity in children with type 1 diabetes compared with the general population was tripled within 6 months after the onset of diabetes (hazard ratio [HR] 3.0 [95% CI 2.7-3.4]) and doubled within the total observation period (HR 2.1 [95% CI 2.0-2.2]). An increased risk was noted in suicide attempts (HR 1.7 [95% CI 1.4-2.0]) and in most categories of psychiatric disorders. The risk of psychiatric disorders in probands declined from HR 2.7 (95% CI 2.2-3.3) for those in the cohort born 1973-1986 to 1.9 (95% CI 1.8-2.0) in those born 1997-2009. The risk for any psychiatric disorders among siblings of patients with type 1 diabetes was estimated to be HR 1.1 (95% CI 1.0-1.1), and there was no increased risk in any of the specific category of disorders.
  
  
  CONCLUSIONS
  Children with type 1 diabetes are at high risk of psychiatric disorders, which seems to be a consequence of the disease rather than due to a common familial etiology. The results support recommendations on comprehensive mental health surveillance in children with type 1 diabetes, especially in recently diagnosed children.
authors: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden Department of Child Psychiatry, Medical University of Warsaw, Warsaw, Poland agnieszka.butwicka@ki.se.
authors: Agnieszka
authors: A
authors: Butwicka
authors: Child and Adolescent Psychiatry Research Center, Stockholm, Sweden Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
authors: Louise
authors: L
authors: Frisén
authors: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden Lung and Allergy Unit, Astrid Lindgren Children's Hospital, Stockholm, Sweden.
authors: Catarina
authors: C
authors: Almqvist
authors: Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden Medical Products Agency, Uppsala, Sweden.
authors: Björn
authors: B
authors: Zethelius
authors: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
authors: Paul
authors: P
authors: Lichtenstein
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology / Q000523:psychology*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology*; D035781:Siblings / Q000523:psychology; D013406:Suicide, Attempted / Q000706:statistics & numerical data*; D013548:Sweden / Q000453:epidemiology
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