Identifying Pediatric Diabetic Patients at High Risk for Mental Health Issues

With childhood diabetes on the rise, there is an increasing need for psychological intervention to help these people deal with the challenges that accompany the diagnosis. “Currently, there are over 150,000 people under the age of 20 in the United States with Type 1 diabetes, the most common form of diabetes in children,” said pediatric psychologists, David D. Schwartz, Marni E. Axelrad and Barbara J. Anderson from Baylor College of Medicine and Texas Children’s Hospital. “Yet, there is little information in the literature to help practitioners determine which children are more likely to develop problems with coping or illness management and who, therefore, are more likely to need preventive intervention.” Research has shown that people who receive a childhood diagnoses of diabetes have a fifty percent chance of developing a psychological problem within the first ten years.

The psychologists were approached by the head of their endocrinology department and asked to develop an appropriate screening tool that would identify which newly diagnosed children were at highest risk for psychological problems. The team designed a tool to address coping skills, psychological education and follow-up treatment and applied it to 121 children and their caregivers over a period of nine months. They discovered that children at highest risk for psychological problems were two to three times more likely to miss scheduled clinical appointments.

“Our findings suggest that these are children who tend to cope with stress by reacting emotionally, avoiding problems, or not seeking help, and they are more likely to have behavior problems,” said the team. “Assessing child coping and behavior should be a priority for psychologists seeing these children.” They hope that their assessment program can be expanded and adapted for psychologists in various settings. They added, “Children who reported significant symptoms of depression at diagnosis were more likely to miss subsequent diabetes clinic appointments. Early identification of these children is therefore critical.”

Schwartz, David D., Marni E. Axelrad, Virginia Depp Cline, and Barbara J. Anderson. “A Model Psychosocial Screening Program for Children and Youth with Newly Diagnosed Type 1 Diabetes: Implications for Psychologists across Contexts of Care.”Professional Psychology: Research and Practice 42.4 (2011): 324-30. Print.

© Copyright 2011 by By John Smith, therapist in Bellingham, Washington. All Rights Reserved. Permission to publish granted to

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Granger


    August 30th, 2011 at 4:18 AM

    Encouraging children from a very young age, even when they do not have quite the right words to express what thet are feeling, is so beneficial for them. Art can be a way to communicate, or even through music. But giving them that outlet to voice their fears is going to be so good for them in the future. While it saddens me to know that this is a diagnosis that they will have to always live with and manage, learning and talking from an early age can help to alleviate some of those fears that could pop up later on.

  • Fred


    August 30th, 2011 at 8:02 AM

    Having a disorder that is not too usual for someone of your age does have its low points I’d imagine…But to push you into depression?Come on,diabetes is not the end of the world…Try to keep it under control and you’re gonna be fine,young’uns.

  • jo


    August 30th, 2011 at 11:58 AM

    Oh Fred, you clearly are not a type 1 diabetic. I have been for 30+ years and believe me, it affects ALL areas of your life and it requires a kind of micro-management that few can imagine. I ignored the emotional impact of this disease for most of my life.

  • Nurse Shannon

    Nurse Shannon

    August 30th, 2011 at 3:57 PM

    As a pediatric nurse I have seen quite a few young patients get the diagnosis of having diabetes. There is fear and there is a scariness to this diagnosis but I always try to reassure the family that this is something manageable and something that the kids can help to control. The best thing that we can do for the patients and the families is to provide them with the ebst education available so that they can ease some of those fears. Sometimes they are afraid of what they do not know, and sometimes it is the things that they do know about the disease that can be so telling. But one thing that must happen is that the doctors and the family have to communicate about the treatment plan so that they can feel in control, and not let the diagnosis control them.

  • RR


    August 30th, 2011 at 11:49 PM

    its very important that kids do not grow up to have their disorders or conditions dominate them and affect every part of their life.Something like diabetes can be controlled and even brought down.So telling these kids there is not a lot to worry about sounds like a good idea.

  • Patricia W

    Patricia W

    September 18th, 2011 at 8:12 AM

    I’ve always felt for these children with type 1 diabetes. When I was young it was because of the constant insulin shots and finger pricks but I realize now that this is probably the least of their problems. The doctors visits, the constraints of what they can eat and knowing that it isn’t their fault that they have diabetes is what makes having type 1 diabetes so miserable I assume.

    If you can stay strong and not slump into depression with all this on your shoulders I am very impressed. These kids need to be reminded that if they ever find themselves feeling in the dumps that it is okay to seek help.

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