Predictors of Depressive Symptoms in a Clinical Sample of Individuals with Type 1 Diabetes

Background: Depression screening during routine type 1 diabetes (T1D) clinical care is increasing, but no studies have examined predictors of symptoms in a clinical sample of those with T1D.

Methods: Individuals with T1D ages 10-25 years completed the Patient Health Questionnaire-9 (PHQ-9) during routine T1D clinic visits. PHQ-9 scores range from 0-27 with higher scores reflecting more depressive symptoms. Demographic and T1D-specific characteristics were also collected.

Results: A total of 609 individuals with T1D were screened: 49% female; mean 15.2±3.1 years; 76% Caucasian; 11% Hispanic; 70% private insurance; mean A1C = 9.2±2.2%, mean T1D duration = 5.9±4.4 years; 49% insulin pump (CSII); 26% continuous glucose monitor (CGM). Average PHQ-9 score was 4.0±4.6 (range = 0-24; 67% minimal, 22% mild, 7% moderate, 3% moderately severe, 1% severe). Linear regression analyses revealed female sex, having public insurance and higher A1Cs, and lack of CGM use were significantly associated with higher depressive symptoms (Table). Older age and lack of CSII trended towards significance.

Conclusions: The results of this study demonstrate the importance of screening for depressive symptoms as part of routine T1D clinical care. Results further support potentially targeting individuals with specific characteristics (e.g., females, high A1Cs) for screening when clinic resources to implement screening are limited.