Psychological impact of type-1 diabetes mellitus on parents: an exploratory study from North India

Abstract

Due to its early age of onset, type-1 diabetes mellitus (T1DM) poses major burden of care on to the family members, especially parents. To study the psychological morbidity, social support, coping strategies, level of dysfunction and quality of life in parents of subjects with type-1 diabetes mellitus. This study was carried out in a tertiary care hospital with cross sectional design. Fifty parents of 50 subjects with T1DM were assessed by General Health Questionnaire (GHQ-12), Social support Questionnaire, Coping strategy check list, Dysfunction Analysis Questionnaire and WHO Quality of Life-Bref Scale. Those with GHQ score ≥2 were interviewed in detail by a psychiatrist to determine the presence/absence of the psychiatric illness. Mean (±SD) age of the children was 14.09±5.43 years at the time of assessment and the age (mean±SD) at diagnosis was 10.3±5.16 years. Age (mean±SD) of parents was 43.2±8.73 years. Mothers (N=27) outnumbered fathers (N=23). Nearly two-third of parents (64%) had psychological morbidity. Of the 32 parents found to be GHQ positive, more than half (N=17) had diagnosable psychiatric disorder. Parents who more frequently used internalization and externalization as a coping mechanism to overcome the stress of chronic illness in their children suffered from psychological morbidity. Parents with psychological morbidity had more dysfunction in social, personal and cognitive domains and also had significantly poorer quality of life in the physical health, psychological health and general well being domains. Hence, it can be concluded that T1DM in children and adolescents leads to poor parental mental health.

Adolescents with Type 1 Diabetes: parental perceptions of child health and family functioning and their relationship to adolescent metabolic control

“…DeWit et al however note that their sample is atypical of previous studies showing higher depression rates in adolescents with Type 1 diabetes [29-31]. Their findings may also reflect between-country differences (for example in family resources or service provision), given that researchers from India [16] and the US (e.g., [10,17]) have found higher than normative rates of family stress (for example reflected by high rates of parental depression and anxiety) in families where an adolescent has TID.…”

“…Rosenberg and Shields’ [15] finding that stronger parental attachment was related to better metabolic control among 31 adolescents with T1D provides additional evidence for the importance of positive family dynamics as a background for young people learning self-management of chronic disease. That maintaining such positive dynamics is not an easy task is reflected in an Indian study of 50 parents of adolescents with T1D [16]. Scores on the General Health Questionnaire (GHQ) showed 17 out of the 50 parents had a diagnosable psychiatric disorder, and nearly two-thirds showed tendencies toward psychological dysfunction.…”

Coping and caregiving experience of parents of children and adolescents with type-1 diabetes: An exploratory study

“…[ 15 ] A previous study from our center showed that nearly two-third of parents (64%) of patients with Type-1 diabetes have psychological morbidity, and about one-third were diagnosed to have a psychiatric disorder. [ 16 ] Parents who more frequently used internalization and externalization as a coping mechanism to overcome the stress of chronic illness suffered from psychological morbidity. Parents with psychological morbidity had more dysfunction in social, personal and cognitive domains and also had significantly poorer quality of life in the domains of physical health, psychological health and general well-being domains.…”

“…Parents with psychological morbidity had more dysfunction in social, personal and cognitive domains and also had significantly poorer quality of life in the domains of physical health, psychological health and general well-being domains. [ 16 ] Taken together, all these observations suggest that the parents of children and adolescent with diabetes are vulnerable to psychological stress and morbidity. Studies have shown that maternal psychological adjustment problems (i.e.…”

Reasons for the overly optimistic beliefs of parents of children with diabetes

“…Caring for a chronically ill child places immense demands on parents . For children with type 1 diabetes mellitus (T1DM), parents are exposed to enormous demands that may lead to emotional distress, such as constant management of the child's glucose levels and the subsequent medical concomitants of diabetes such as episodes of hypoglycaemia, hospitalisations and the potential for shortened life expectancy . With T1DM on the increase both in Australia (AIHW) and around the world (WHO), the impact of T1DM is an area of great importance.…”