233-LB: Depressive Symptom Trajectories among Youth and Young Adults with Type 1 Diabetes

Purpose: To characterize the burden of depressive symptoms over time in youth and young adults (YYA) with type 1 diabetes (T1D) by identifying subgroups that have similar trajectories of depressive symptoms and assessing baseline demographic predictors of these trajectories.

Methods: YYA diagnosed with T1D between 2002-2005, ages 10.0 to 20.6 years, who were enrolled in the SEARCH for Diabetes in Youth Study baseline were included (n = 879, 47.6% female, 76.3% non-Hispanic white). Participants provided a baseline and at least one follow-up measure of depressive symptoms using the Center for Epidemiologic Studies - Depression (CES-D) scale over a five-year period. Group-based trajectory modeling was used to assign individuals to the most likely depressive symptom trajectory class, and multinomial logistic regression was used to assess predictors of trajectories. Depressive symptoms were interpreted based on established CES-D cut-offs for adolescents: minimal (0-15), mild (16-23), and moderate/severe (24-60).

Results: Five depressive symptom trajectory classes were identified: little to no symptoms (63.2%), persistent minimal (22.2%), increasing from mild to moderate (4.6%), decreasing from mild to minimal (6.7%), and chronic moderate (3.3%). There were no significant differences in age at baseline among the groups. Significant demographic predictors of trajectories included sex, race/ethnicity, parental education, family income, and health insurance status. For example, the increasing mild to moderate trajectory had a greater proportion of Hispanic participants, public health insurance, and lower parental education compared to the little to no symptoms trajectory.

Conclusion: Among YYA with T1D, unique trajectories of depressive symptoms show meaningful differences in demographic characteristics. These results provide insight into the identification of high-risk groups and potential target populations for prevention of chronic depressive symptoms.