title: Psychosocial Illness in Children with Type 1 Diabetes Mellitus: Prevalence, Pattern and Risk Factors.
abstract: BACKGROUND
  Type 1 Diabetes Mellitus (T1DM) and psychosocial illness influence each other in multiple ways. The extent of psychosocial disorders in children with T1DM remains largely unstudied in India.
  
  
  OBJECTIVE
  To assess the prevalence, severity, pattern and variables affecting psychosocial illness in children with type 1 diabetes mellitus.
  
  
  METHODS
  This observational study included 84 children (6-14 years of age) having T1DM at least for 1 year and 100 non diabetic children for comparison. "DSM-5 parent/guardian-Rated Level 1 & 2 Cross-Cutting Symptom Measure -Child age 6-17" was used to assess psychosocial illness, specific domains and severity. Socio-demographic variables were studied and HbA1c levels were measured.
  
  
  RESULTS
  Significantly higher prevalence of psychosocial illness was observed in children with T1DM as compared with non diabetic group (55.95% vs 20%; p<0.0001). The prevalence for mild, moderate and severe psychosocial illness was 8.33%, 27.38% and 20.24% respectively in diabetic children. Most common psychosocial abnormality was irritation (38.1%), followed by depression (36.9%) and anxiety (32.1%). The prevalence of psychosocial illness was significantly higher in T1DM patients with poorer metabolic control (HbA1c>7.5, p=0.014). Significant association of psychosocial illness was also noticed with poor dietary compliance (p=0.021) and higher mean HbA1c level (p<0.001).
  
  
  CONCLUSIONS
  This study established T1DM as a risk factor for development of psychosocial illness. Irritation, depression and anxiety were most common abnormalities. Significant association of psychosocial illness with poor dietary compliance and poor metabolic control was observed. Psychosocial assessment of every diabetic child is suggested for optimal management.
authors: 3rd Year Resident, Department of Paediatrics, S.P. Medical College , Bikaner, Rajasthan, India .
authors: Shikha
authors: S
authors: Khandelwal
authors: Professor, Department of Paediatrics, S.P. Medical College , Bikaner, Rajasthan, India .
authors: Ghanshyam Singh
authors: GS
authors: Sengar
authors: 3rd Year Resident, Department of Paediatrics, S.P. Medical College , Bikaner, Rajasthan, India .
authors: Monika
authors: M
authors: Sharma
authors: Senior Resident, Department of Paediatrics, S.N. Medical College , Jodhpur, Rajasthan, India.
authors: Shyama
authors: S
authors: Choudhary
authors: 3rd Year Resident, Department of Paediatrics, S.P. Medical College , Bikaner, Rajasthan, India .
authors: Niranjan
authors: N
authors: Nagaraj
keywords: DSM-5; Dietary compliance; Irritation; Metabolic control