Abstract
Objectives
The prevalence of mental health issues has increased at an alarming rate during the COVID-19 pandemic. Furthermore, an exacerbated psychosocial burden in populations with chronic disease is observed. This cross-sectional study evaluated the psychosocial factors of pediatric type 1 diabetes (T1D) during the COVID-19 pandemic.
Methods
During April 2020, 15 min phone interviews were performed for pediatric T1D group (n=100) and healthy comparison group (n=93) to assess psychosocial functioning during the acute lockdown phase of the pandemic. The patient health questionnaire-4 was utilized to assess anxiety and depressive symptoms. An additional questionnaire to assess specific concerns related to T1D and COVID-19 was administered to the T1D group to explore potential causes for increased psychosocial burden.
Results
T1D was associated with a five-times higher risk of anxiety symptoms. Increased anxiety symptoms in T1D group appear to be, at least in part, due to fear of higher risk of severe COVID-19 infection and uncertainty regarding access to diabetes supplies.
Conclusions
This study provides a snapshot of mental well-being in a diverse population of patients with T1D in the acute phase of a crisis and underscores the need for timely, accurate medical information and distribution of medical resources for pediatric T1D population.
Acknowledgments
We would like to thank Angelia Eddington, PhD, for the advice regarding the mental health assessment; Tachele Anderson, Teresa Borcky, Rahul Peravali, and Caitlin Witt for assisting in data collection; Biostats, Epidemiology, and Research Design (BERD) Clinic for data analysis; and Courtney Bricker-Anthony, PhD for editing the draft.
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Research funding: None declared.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Informed consent was obtained from all individuals included in this study.
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Ethical approval: The local Institutional Review Board approved the study.
References
1. Fauci, AS, Lane, HC, Redfield, RR. Covid-19—navigating the uncharted. N Engl J Med 2020;382:1268–9. https://doi.org/10.1056/nejme2002387.Search in Google Scholar PubMed PubMed Central
2. Khubchandani, J, Sharma, S, Webb, FJ, Wiblishauser, MJ, Bowman, SL. Post-lockdown depression and anxiety in the USA during the COVID-19 pandemic. J Public Health 2021;43:246–53. https://doi.org/10.1093/pubmed/fdaa250.Search in Google Scholar PubMed PubMed Central
3. Dubey, S, Biswas, P, Ghosh, R, Chatterjee, S, Dubey, MJ, Chatterjee, S, et al.. Psychosocial impact of COVID-19. Diabetes Metab Syndrome Clin Res Rev 2020;14:779–88. https://doi.org/10.1016/j.dsx.2020.05.035.Search in Google Scholar PubMed PubMed Central
4. Chiang, JL, Maahs, DM, Garvey, KC, Hood, KK, Laffel, LM, Weinzimer, SA, et al.. Type 1 diabetes in children and adolescents: a position statement by the American Diabetes Association. Diabetes Care 2018;41:2026–44. https://doi.org/10.2337/dci18-0023.Search in Google Scholar PubMed PubMed Central
5. Buchberger, B, Huppertz, H, Krabbe, L, Lux, B, Mattivi, JT, Siafarikas, A. Symptoms of depression and anxiety in youth with type 1 diabetes: a systematic review and meta-analysis. Psychoneuroendocrinology 2016;70:70–84. https://doi.org/10.1016/j.psyneuen.2016.04.019.Search in Google Scholar PubMed
6. Delamater, AM, de Wit, M, McDarby, V, Malik, J, Acerini, CL, International Society for, P, et al.. ISPAD Clinical Practice Consensus Guidelines 2014. Psychological care of children and adolescents with type 1 diabetes. Pediatr Diabetes 2014;15(20 Suppl):232–44. https://doi.org/10.1111/pedi.12191.Search in Google Scholar PubMed
7. US Department of Health and Human Services. National diabetes statistics report 2020: estimates of diabetes and its burden in the United States. Atlanta, GA: Centers for Disease Control and Prevention; 2020.Search in Google Scholar
8. Fogel, NR, Weissberg-Benchell, J. Preventing poor psychological and health outcomes in pediatric type 1 diabetes. Curr Diabetes Rep 2010;10:436–43. https://doi.org/10.1007/s11892-010-0145-z.Search in Google Scholar PubMed
9. Kroenke, K, Spitzer, RL, Williams, JB, Lowe, B. An ultra-brief screening scale for anxiety and depression: the PHQ-4. Psychosomatics 2009;50:613–21. https://doi.org/10.1176/appi.psy.50.6.613.Search in Google Scholar PubMed
10. Lowe, B, Wahl, I, Rose, M, Spitzer, C, Glaesmer, H, Wingenfeld, K, et al.. A 4-item measure of depression and anxiety: validation and standardization of the patient health questionnaire-4 (PHQ-4) in the general population. J Affect Disord 2010;122:86–95. https://doi.org/10.1016/j.jad.2009.06.019.Search in Google Scholar PubMed
11. Dayal, D. We urgently need guidelines for managing COVID-19 in children with comorbidities. Acta Paediatr 2020;109:1497–8. https://doi.org/10.1111/apa.15304.Search in Google Scholar PubMed PubMed Central
12. Muniyappa, R, Gubbi, S. COVID-19 pandemic, coronaviruses, and diabetes mellitus. Am J Physiol Endocrinol Metab 2020;318:E736–41. https://doi.org/10.1152/ajpendo.00124.2020.Search in Google Scholar PubMed PubMed Central
13. Tao, B, Pietropaolo, M, Atkinson, M, Schatz, D, Taylor, D. Estimating the cost of type 1 diabetes in the U.S.: a propensity score matching method. PLoS One 2010;5:e11501. https://doi.org/10.1371/journal.pone.0011501.Search in Google Scholar PubMed PubMed Central
14. Don, BP, Chong, A, Biehle, SN, Gordon, A, Mickelson, KD. Anxiety across the transition to parenthood: change trajectories among low-risk parents. Anxiety Stress Coping 2014;27:633–49. https://doi.org/10.1080/10615806.2014.903473.Search in Google Scholar PubMed
© 2022 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Review Article
- Impact of Obesity on Bone Metabolism in Children
- Mini Review
- Late sequelae of drug reaction with eosinophilia and systemic symptoms (DRESS) cause thyroid dysfunction and thyroiditis: review of literature
- Original Articles
- Moderating effect of bone maturation on the relationship between body fat and insulin resistance
- Prevalence of nephropathy in Indian children and youth with type 1 diabetes mellitus
- Initial neutrophil/lymphocyte and lymphocyte/monocyte ratios can predict future insulin need in newly diagnosed type 1 diabetes mellitus
- Subcutaneous adipose tissue is a positive predictor for bone mineral density in prepubertal children with Prader–Willi syndrome independent of lean mass
- The attitudes, experiences, and self-competencies of pediatric endocrinology fellows and attending physicians regarding diabetes technology: the Turkey experience
- Adiposity measures in screening for metabolic syndrome among Chinese children and adolescents
- Increased anxiety symptoms in pediatric type 1 diabetes during the acute phase of COVID-19 lockdown
- Pediatric adrenal insufficiency: thirty years experience at a Portuguese hospital
- Spectrum of PAH gene mutations and genotype–phenotype correlation in patients with phenylalanine hydroxylase deficiency from Turkey
- Serum spexin levels are not associated with size at birth but are associated with metabolic syndrome components in prepubertal children born at term
- Familial early-onset obesity in Turkish children: variants and polymorphisms in the melanocortin-4 receptor (MC4R) gene
- An update of the mutation spectrum of phenylalanine hydroxylase (PAH) gene in the population of Turkey
- Primary hypertriglyceridemia induced pancreatitis in a cohort of Pakistani children
- Investigation of the relationship between serum sclerostin and dickkopf-1 protein levels with bone turnover in children and adolescents with type-1 diabetes mellitus
- Case Reports
- Diagnostic value of plasma lysosphingolipids levels in a Niemann–Pick disease type C patient with transient neonatal cholestasis
- A 7-year-old boy with central diabetes insipidus presenting with thickened pituitary stalk and anti-rabphilin-3A antibody positivity
- Homozygous missense variant of PTH (c.166C>T, p.(Arg56Cys)) as the cause of familial isolated hypoparathyroidism in a three-year-old child
- Long-term follow-up of transient neonatal diabetes mellitus due to a novel homozygous c.7734C>T (p.R228C) mutation in ZFP57 gene: relapse at prepubertal age
Articles in the same Issue
- Frontmatter
- Review Article
- Impact of Obesity on Bone Metabolism in Children
- Mini Review
- Late sequelae of drug reaction with eosinophilia and systemic symptoms (DRESS) cause thyroid dysfunction and thyroiditis: review of literature
- Original Articles
- Moderating effect of bone maturation on the relationship between body fat and insulin resistance
- Prevalence of nephropathy in Indian children and youth with type 1 diabetes mellitus
- Initial neutrophil/lymphocyte and lymphocyte/monocyte ratios can predict future insulin need in newly diagnosed type 1 diabetes mellitus
- Subcutaneous adipose tissue is a positive predictor for bone mineral density in prepubertal children with Prader–Willi syndrome independent of lean mass
- The attitudes, experiences, and self-competencies of pediatric endocrinology fellows and attending physicians regarding diabetes technology: the Turkey experience
- Adiposity measures in screening for metabolic syndrome among Chinese children and adolescents
- Increased anxiety symptoms in pediatric type 1 diabetes during the acute phase of COVID-19 lockdown
- Pediatric adrenal insufficiency: thirty years experience at a Portuguese hospital
- Spectrum of PAH gene mutations and genotype–phenotype correlation in patients with phenylalanine hydroxylase deficiency from Turkey
- Serum spexin levels are not associated with size at birth but are associated with metabolic syndrome components in prepubertal children born at term
- Familial early-onset obesity in Turkish children: variants and polymorphisms in the melanocortin-4 receptor (MC4R) gene
- An update of the mutation spectrum of phenylalanine hydroxylase (PAH) gene in the population of Turkey
- Primary hypertriglyceridemia induced pancreatitis in a cohort of Pakistani children
- Investigation of the relationship between serum sclerostin and dickkopf-1 protein levels with bone turnover in children and adolescents with type-1 diabetes mellitus
- Case Reports
- Diagnostic value of plasma lysosphingolipids levels in a Niemann–Pick disease type C patient with transient neonatal cholestasis
- A 7-year-old boy with central diabetes insipidus presenting with thickened pituitary stalk and anti-rabphilin-3A antibody positivity
- Homozygous missense variant of PTH (c.166C>T, p.(Arg56Cys)) as the cause of familial isolated hypoparathyroidism in a three-year-old child
- Long-term follow-up of transient neonatal diabetes mellitus due to a novel homozygous c.7734C>T (p.R228C) mutation in ZFP57 gene: relapse at prepubertal age