Published online May 2, 2005
PEDIATRICS Vol. 115 No. 5 May 2005, pp. 1315-1319 (doi:10.1542/peds.2004-1717)
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Depressive Symptoms Predict Hospitalization for Adolescents With Type 1 Diabetes Mellitus

Sunita M. Stewart, PhD*, Uma Rao, MD*, Graham J. Emslie, MD*, Diane Klein, MSW{ddagger} and Perrin C. White, MD§

* Department of Psychiatry
§ Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas
{ddagger} Department of Social Work, Children's Medical Center, Dallas, Texas

Objective. To examine the role of self-reported depressive symptoms in predicting hospitalization for complications of diabetes mellitus over a period of up to 2 years.

Study Design. Two hundred thirty-one adolescent outpatients (age range: 11–18 years) with type 1 diabetes completed the Center for Epidemiological Studies Depression Scale, a self-report measure of depressive symptoms. Glycosylated hemoglobin levels were also assessed, to account for this known predictor of hospitalization. With survival analysis methods, hospitalizations for medical complications that occurred up to 2 years after this assessment were recorded.

Results. After controlling for age, gender, socioeconomic status, and glycosylated hemoglobin levels at baseline, the odds ratio for prediction offered by Center for Epidemiological Studies Depression Scale scores above the cutoff point (12 for boys and 22 for girls) was 2.58 (95% confidence interval: 1.12–5.98).

Conclusions. Young people with type 1 diabetes who show high levels of depressive symptoms are at increased risk for hospitalization for disease complications. Interventions aimed at improving their depressive symptoms may result in positive health outcomes, as well as improved quality of life.

Key Words: depression • type 1 diabetes mellitus • hospitalization • adolescent

Abbreviations: MDD, major depressive disorder • CES-D, Center for Epidemiological Studies Depression Scale • HbA1c, hemoglobin A1c

Accepted Sep 28, 2004.


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