Diabetes Mellitus in Children and Its Effect on Caregivers' Mental Health

Abstract

IntroductionCaring for a child with diabetes often has a negative effect on the mental health of caregivers and other family members. The goal of this study was to determine the effect of caring for children with diabetes on the mental health of caregivers.Materials and methodsThis case-control study was conducted in the National Institute of Child Health from October to November 2017 to compare the mental health effects associated with caring for children with diabetes as against caring for children without diabetes. The case group consisted of the caregivers of 60 children with diabetes, and the control group consisted of the caregivers of 60 children without diabetes. A validated questionnaire with two scales was used. Frequencies, percentages, confidence intervals, and p-values were reported for the categorical variables. The variables were analyzed using Patient Health Questionnaire 9 (PHQ-9) and Generalized Anxiety Disorder 7 (GAD-7) scales to determine associations.ResultsIn the case group, most caregivers were mothers, 60% had consanguineous marriages, 21.7% were employed, and 21.7% were suffering from a long-term illness. Of those reporting a disease, 13.3% reported a change in their disease. Most caregivers (71.7%) received family support, and 78.3% of caregivers had social support. Most caregivers in the case group had mild depression, and 35% had mild anxiety. In the control group, most caregivers were mothers, 5% were employed, and 35% had disease(s). Of those reporting a disease, 15% reported a change in their health. Most of the caregivers in the control group (93.3%) had family support, and 85% had social support. Most (62%) were found to have mild depression, and more than half had no anxiety. Most children in the control group were under five years old, and most children in the case group were over 10 years old. Nearly half of the children in the case group had a positive family history of thalassemia, and 68.3% of them have insulin administered once daily. Strong variables that affect caregiver mental health were caregiver age, health changes, and consanguinity.ConclusionThe caregivers of children with diabetes have a higher incidence of anxiety compared with the caregivers of children without diabetes; depression was similar for both groups. Health care providers should be aware of the differences in parenting stress related to caring for children with long-term illnesses and should consider ways to help improve the well-being of these caregivers.

Families with pediatric type 1 diabetes: A comparison with the general population on child well‐being, parental distress, and parenting behavior

“…As hypothesized, mothers of children having T1D experienced more stress, anxiety symptoms and depressive symptoms as compared to controls. Increased maternal anxiety symptoms were present regardless of child glycemic control, which is in line with previous research . Interestingly, higher symptoms of stress and depression were only observed in mothers of children with suboptimal HbA1c.…”

“…The majority of parents of newly diagnosed children experience clinically significant depression (61%) and anxiety (59%), and symptoms of depression and anxiety are higher in those parents compared to controls . However, studies examining differences at a later stage of T1D found similar levels of depressive symptoms in caregivers as compared to other parents . With regard to anxiety, many parents, and mothers especially, fear hypoglycemia in their child .…”

“…Concerns about long‐term health consequences and access to daycare are also regularly reported by mothers . Two studies that evaluated anxiety levels confirm that caregivers of children with T1D experience significantly more anxiety than controls . However, almost all studies evaluating distress in parents of children with T1D examined mainly mothers, leaving fathers largely understudied.…”

“…Additionally, we examined whether differences between families with and without pediatric T1D were present for children with suboptimal (HbA1c ≥7.5% [58 mmol/mol]) vs optimal glycemic control (HbA1c <7.5%) . Based upon previous research, we hypothesized that children with T1D would experience more adjustment difficulties and lower QoL than children without T1D, and that parents of children with T1D would report more stress, anxiety symptoms, and possibly more depressive symptoms, compared to controls. Furthermore, we expected that parents of children with T1D would engage in more protective behaviors, provide less autonomy support, and less responsiveness as compared to controls.…”

Self-reported psychological disorders among the mothers of children with an autism spectrum disorder, type 1 diabetes mellitus, and typically developed children

“…Studies that addressed the prevalence of depression, anxiety, and stress among mothers of children with diabetes were not conclusive and revealed mixed results. Parents of children with type-1 diabetes have a higher expression of anxiety and depressive feelings compared with parents of children without diabetes (9,10,11,12). All subjects in the above studies included both parents.…”