title: Symptoms of depression and anxiety in youth with type 1 diabetes: A systematic review and meta-analysis.
abstract: The interaction between psychosocial factors and type 1 diabetes is complex and screening for psychosocial risk factors from diagnosis of type 1 diabetes has been recommended. This is a systematic review and meta-analysis to address the following questions: (1) How prevalent are symptoms of depression and anxiety in children and adolescents with type 1 diabetes? (2) Is there an association of symptoms of depression and anxiety with diabetes management and glycemic control?
  
  
  
  We searched EMBASE, MEDLINE, The Cochrane Library, and PsycINFO in April 2014 with an update in May 2015. When possible, data were pooled to estimate summary effects.
  
  
  
  14 studies investigated symptoms of depression and anxiety in children and adolescents with type 1 diabetes. The pooled prevalence of depressive symptoms was 30.04%, 95% CI [16.33; 43.74]. There were correlations between symptom levels and glycemic control as well as three-way interactions between HbA1c, blood glucose monitoring frequency or diabetes-specific stress and depression. Symptoms of anxiety were reported for up to 32% of patients. A negative impact on glycemic control was demonstrated.
  
  
  
  Our analyses confirmed a high prevalence of symptoms of depression and anxiety in youth with type 1 diabetes that potentially compromise diabetes management and glycemic control. In our opinion these findings support recommendations for early screening for psychological comorbidity and regular psychosocial assessment from diagnosis. Future prospective studies are warranted to further explore the interaction of symptoms of depression and anxiety with type 1 diabetes and develop evidence-based treatment models.
authors.affiliation: Research Unit Health Technology Assessment and Systematic Reviews, Institute for Health Care Management and Research, Faculty of Economics and Business Administration, University of Duisburg-Essen, Thea-Leymann-Straße 9, 45127 Essen, Germany. Electronic address: barbara.buchberger@medman.uni-due.de.
authors.forename: Barbara
authors.initials: B
authors.lastname: Buchberger
authors.affiliation: Research Unit Health Technology Assessment and Systematic Reviews, Institute for Health Care Management and Research, Faculty of Economics and Business Administration, University of Duisburg-Essen, Thea-Leymann-Straße 9, 45127 Essen, Germany.
authors.forename: Hendrik
authors.initials: H
authors.lastname: Huppertz
authors.affiliation: Research Unit Health Technology Assessment and Systematic Reviews, Institute for Health Care Management and Research, Faculty of Economics and Business Administration, University of Duisburg-Essen, Thea-Leymann-Straße 9, 45127 Essen, Germany.
authors.forename: Laura
authors.initials: L
authors.lastname: Krabbe
authors.affiliation: Research Unit Health Technology Assessment and Systematic Reviews, Institute for Health Care Management and Research, Faculty of Economics and Business Administration, University of Duisburg-Essen, Thea-Leymann-Straße 9, 45127 Essen, Germany.
authors.forename: Beate
authors.initials: B
authors.lastname: Lux
authors.affiliation: Research Unit Health Technology Assessment and Systematic Reviews, Institute for Health Care Management and Research, Faculty of Economics and Business Administration, University of Duisburg-Essen, Thea-Leymann-Straße 9, 45127 Essen, Germany.
authors.forename: Jessica T
authors.initials: JT
authors.lastname: Mattivi
authors.affiliation: Department of Endocrinology and Diabetes, Princess Margaret Hospital, Roberts Rd, Subiaco WA 6008, Perth, Australia; School of Paediatrics and Child Health, University of Western Australia, 35 Stirling Hwy, Crawley, WA 6009, Nedlands, Australia; Institute for Health Research, University of Notre Dame, Fremantle, 32 Mouat St., Fremantle WA 6959, Australia.
authors.forename: Aris
authors.initials: A
authors.lastname: Siafarikas
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000209:etiology / Q000523:psychology* / Q000628:therapy; D001008:Anxiety Disorders / Q000209:etiology / Q000523:psychology / Q000628:therapy; D002648:Child; D015928:Cognitive Behavioral Therapy; D003863:Depression / Q000209:etiology / Q000523:psychology* / Q000628:therapy; D003866:Depressive Disorder / Q000209:etiology / Q000523:psychology / Q000628:therapy; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology*; D006801:Humans; D011446:Prospective Studies; D011613:Psychotherapy
keywords: Adolescent; Anxiety; Depression; Diabetes management; Systematic review; Type 1 diabetes