title: Psychological distress of children with early-onset type 1 diabetes and their mothers' well-being.
abstract: OBJECTIVE
  Few studies have focused on the psychological adjustment of pre-adolescent children with type 1 diabetes. This study examined psychosocial functioning in nine- and 10-year-old children with early-onset type 1 diabetes, and their mothers, and associations between psychosocial functioning and diabetes management.
  
  
  METHODS
  The mothers of 63 children with early-onset diabetes and 86 healthy children evaluated their own psychosocial functioning, and their child's, with standardised rating scales. We used general linear models to analyse the children's behaviour problems and the mothers' well-being. Associations between the children's behaviour problems, diabetes-related measures and the mothers' well-being were studied with partial correlations.
  
  
  RESULTS
  Children with diabetes had more internalising problems than the controls (p = 0.001), and these were associated with poor glycaemic control at the early stage of the illness (p = 0.033) and the use of insulin pumps in girls (p = 0.004). Mothers in the diabetes group had more child-related stress than the controls (p < 0.001), and poorer well-being was associated with the children's behavioural problems (p < 0.024).
  
  
  CONCLUSIONS
  Children with early-onset diabetes faced an increased risk of internalising problems in middle childhood. The mothers' psychological distress was associated with children's behaviour problems rather than their diabetes.
authors.affiliation: Department of Child Neurology, Carea - Kymenlaakso Social and Health Services, Kotka, Finland.
authors.forename: Riitta
authors.initials: R
authors.lastname: Hannonen
authors.affiliation: Department of Psychology, University of Jyväskylä, Jyväskylä, Finland.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Eklund
authors.affiliation: Department of Psychology, University of Jyväskylä, Jyväskylä, Finland.
authors.forename: Asko
authors.initials: A
authors.lastname: Tolvanen
authors.affiliation: Finnish Medical Society Duodecim, Helsinki, Finland.
authors.forename: Jorma
authors.initials: J
authors.lastname: Komulainen
authors.affiliation: Children's Hospital, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Raili
authors.initials: R
authors.lastname: Riikonen
authors.affiliation: Department of Pediatrics, Miller School of Medicine, University of Miami, Miami, FL, USA.
authors.forename: Alan M
authors.initials: AM
authors.lastname: Delamater
authors.affiliation: Department of Psychology, University of Jyväskylä, Jyväskylä, Finland.
authors.forename: Timo
authors.initials: T
authors.lastname: Ahonen
mesh_terms: D002648:Child; D002653:Child Behavior Disorders / Q000209:etiology; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D009035:Mothers / Q000523:psychology*; D013315:Stress, Psychological / Q000209:etiology*
keywords: Behavioural problems; Childhood; Mother; Psychosocial functioning; Type 1 diabetes