title: Psychosocial screening and management of young people aged 18-25 years with diabetes.
abstract: BACKGROUND
  Routine psychosocial screening and management of people with diabetes is recommended.
  
  
  OBJECTIVE
  To profile demographic, medical and psychosocial characteristics of young people with diabetes, and to develop a screening tool and care pathway for routine use.
  
  
  METHODS
  Indices of diabetes control and recorded diabetes complications were complimented by psychosocial screening tools assessing psychological, diabetes specific and perceived stress (Kessler 10, Problem Area in Diabetes, Perceived Stress Scale), well-being (World Health Organization Well Being Index-5), disordered eating (Eating Disorder Risk Inventory-3 Risk Composite), compensatory behaviour questionnaire, social support (Multidimensional Scale of Perceived Social Support), resilience (Connor Davidson Resilience Scale - 2 item) and financial concerns. Service provision and demographic data were also collected. Diabetes and mental health clinicians then identified a subset of measures to use for routine screening along with care pathways.
  
  
  RESULTS
  Psychosocial screening was well accepted. Participants (151) had suboptimal glycaemic control (glycated haemoglobin 8.0 interquartile range 1.8%/64 interquartile range 22 mmol/mol). Severe diabetes-related distress (Problem Area in Diabetes ≥40) was found in 19.4% and 26.0% reported difficulties managing healthcare costs. A mental health disorder was likely in 9.7%, whilst 23.4% had high Kessler 10 scores. Low World Health Organization Well Being Index-5 scores (≤13) were seen in 29.0%. Risk for an eating disorder (Eating Disorder Risk Inventory-3 Risk Composite) was 12.7%, whereas approximately 36.0% had disturbed eating behaviours.
  
  
  CONCLUSIONS
  Psychosocial screening of young adults with diabetes identified complex needs. A brief psychosocial screening tool and associated care pathways were developed for routine use in a young adult tertiary referral diabetes clinic. The tool assesses constructs, such as diabetes distress, depression, anxiety, well-being, hypoglycaemia-unawareness, fear of hypoglycaemia, social support, weight, shape and eating concerns and financial concerns. This will provide a longitudinal data source for further research to inform clinical practice.
authors.affiliation: Queensland Diabetes and Endocrine Centre, University of Queensland, Brisbane, Queensland, Australia.|Mater Research, University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Helen
authors.initials: H
authors.lastname: d'Emden
authors.affiliation: Mater Research, University of Queensland, Brisbane, Queensland, Australia.|College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.
authors.forename: Brett
authors.initials: B
authors.lastname: McDermott
authors.affiliation: Queensland Diabetes and Endocrine Centre, University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Neisha
authors.initials: N
authors.lastname: D'Silva
authors.affiliation: Queensland Diabetes and Endocrine Centre, University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Tom
authors.initials: T
authors.lastname: Dover
authors.affiliation: Young Adult Support Centre, Mater Health, University of Queensland, Brisbane, Queensland, Australia.|School of Medicine, Griffith University, Gold Coast Campus, Gold Coast, Queensland, Australia.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Ewais
authors.affiliation: Mater Research Office, Mater Research, Brisbane, Queensland, Australia.
authors.forename: Kristen
authors.initials: K
authors.lastname: Gibbons
authors.affiliation: Queensland Diabetes and Endocrine Centre, University of Queensland, Brisbane, Queensland, Australia.|Mater Research, University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Trisha
authors.initials: T
authors.lastname: O'Moore-Sullivan
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia; D015190:Blood Glucose Self-Monitoring / Q000523:psychology / Q000706:statistics & numerical data; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D001068:Feeding and Eating Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007003:Hypoglycemia / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology*; D008297:Male; D008403:Mass Screening; D011237:Predictive Value of Tests; D011581:Psychological Tests; D012648:Self Care / Q000523:psychology*; D012944:Social Support; D013315:Stress, Psychological / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D011795:Surveys and Questionnaires; D060305:Transition to Adult Care; D055815:Young Adult
keywords: diabetes mellitus type 1; evidenced-based practice; psychology; young adults