Research shows that children and adolescents with type 1 diabetes are at increased risk of mental health problems such as depression, anxiety, and stress-related disorders, and that these comorbidities can impede optimal care. Current guidelines from the International Society of Pediatric and Adolescent Diabetes (ISPAD) recommend screening for mental health problems in children with type 1 diabetes, but do not adequately address the needs of family members, who are also at increased risk of mental health problems. Furthermore, the reasons behind the association between family mental health problems and type 1 diabetes are not fully understood. “Many clinicians intuitively assume that diabetes in a child negatively affects the mental health of both the patient and family members,” says Agnieszka Butwicka, assistant professor at Karolinska Institutet’s Department of Medical Epidemiology and Biostatistics and the latest senior author of of study. “But we think the answer is not so simple. Our study shows that there could also be a genetic component behind this association.” The study linked about 3.5 million people born in Sweden between 1973 and 2007 with their biological parents, full and half siblings and cousins. More than 20,000 people were diagnosed with childhood type 1 diabetes and found to have almost twice the risk of depression and about 1.6 times the risk of anxiety and stress disorders compared to those without the disease. Their parents and full siblings also had somewhat increased risks for anxiety and stress disorders, although to a lesser degree, while their half-siblings and cousins had no or marginally higher risk for some conditions. “These results are of high clinical importance, because they mean that therapeutic intervention should also include close family members, not only patients,” says Agnieszka Butwicka. Since parent-child and full siblings share more genetic material (about 50 percent) than half-siblings (about 25 percent) and cousins (less than 12.5 percent), the researchers say the result supports the idea that genes may contribute to mental health problems in type 1 diabetes. However, since this is only an observational study, they cannot say for sure what is causing the associations.
More studies are needed to fully understand the underlying genetic and environmental contributions to psychiatric disorders in type 1 diabetes.”
Shengxin Liu, PhD at Karolinska Institutet and corresponding author of the study
Source: Journal Reference: Liu, S., et al. (2022) Association and Familial Aggregation of Childhood Type 1 Diabetes with Depression, Anxiety, and Anxiety-Related Disorders: A Population-Based Cohort Study. Diabetes Care. doi.org/10.2337/dc21-1347.
