title: Symptoms of Eating Disorders and Depression in Emerging Adults with Early-Onset, Long-Duration Type 1 Diabetes and Their Association with Metabolic Control.
abstract: BACKGROUND
  This study analyzed the prevalence of and association between symptoms of eating disorders and depression in female and male emerging adults with early-onset, long-duration type 1 diabetes and investigated how these symptoms are associated with metabolic control.
  
  
  METHODS
  In a nationwide population-based survey, 211 type 1 diabetes patients aged 18-21 years completed standardized questionnaires, including the SCOFF questionnaire for eating disorder symptoms and the Patient Health Questionnaire (PHQ-9) for symptoms of depression and severity of depressive symptoms (PHQ-9 score). Multiple linear and logistic regression models were used to analyze the association between eating disorder and depressive symptoms and their associations with HbA1c.
  
  
  RESULTS
  A total of 30.2% of the women and 9.5% of the men were screening positive for eating disorders. The mean PHQ-9 score (standard deviation) was 5.3 (4.4) among women and 3.9 (3.6) among men. Screening positive for an eating disorder was associated with more severe depressive symptoms among women (βwomen 3.8, p<0.001). However, neither eating disorder symptoms nor severity of depressive symptoms were associated with HbA1c among women, while HbA1c increased with the severity of depressive symptoms among men (βmen 0.14, p=0.006).
  
  
  CONCLUSIONS
  Because of the high prevalence of eating disorder and depressive symptoms, their interrelationship, and their associations with metabolic control, particularly among men, regular mental health screening is recommended for young adults with type 1 diabetes.
authors.affiliation: German Diabetes Center, Institute for Biometrics and Epidemiology, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany.
authors.forename: Christina
authors.initials: C
authors.lastname: Bächle
authors.affiliation: Hannover Medical School, Department of Medical Psychology, Hannover, Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Lange
authors.affiliation: German Diabetes Center, Institute for Biometrics and Epidemiology, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany.
authors.forename: Anna
authors.initials: A
authors.lastname: Stahl-Pehe
authors.affiliation: German Diabetes Center, Institute for Biometrics and Epidemiology, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany.
authors.forename: Katty
authors.initials: K
authors.lastname: Castillo
authors.affiliation: German Center for Diabetes Research (DZD), Neuherberg, Germany; University of Ulm, Institute of Epidemiology and Medical Biometry, ZIBMT, Ulm, Germany.
authors.forename: Nicole
authors.initials: N
authors.lastname: Scheuing
authors.affiliation: German Center for Diabetes Research (DZD), Neuherberg, Germany; University of Ulm, Institute of Epidemiology and Medical Biometry, ZIBMT, Ulm, Germany.
authors.forename: Reinhard W
authors.initials: RW
authors.lastname: Holl
authors.affiliation: German Diabetes Center, Institute for Biometrics and Epidemiology, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany.
authors.forename: Guido
authors.initials: G
authors.lastname: Giani
authors.affiliation: German Diabetes Center, Institute for Biometrics and Epidemiology, Düsseldorf, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Rosenbauer
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D016022:Case-Control Studies; D002648:Child; D003863:Depression / Q000150:complications*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000378:metabolism*; D001068:Feeding and Eating Disorders / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D016014:Linear Models; D008297:Male; D008403:Mass Screening; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin