PEDIATRICS Vol. 117 No. 4 April 2006, pp. 1348-1358 (doi:10.1542/peds.2005-1398)
Prevalence and Correlates of Depressed Mood Among Youth With Diabetes: The SEARCH for Diabetes in Youth Study
a Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California
b Children's Hospital Medical Center, Cincinnati, Ohio
c Children's Hospital and Regional Medical Center, Seattle, Washington
d Barbara Davis Center for Childhood Diabetes, University of Colorado Health Sciences Center, Denver, Colorado
e Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
f Department of Public Health Sciences, Wake Forest University Health Sciences, Winston-Salem, North Carolina
g Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
h Pacific Health Research Institute, Honolulu, Hawaii
OBJECTIVE.The objective of this study was to determine if depressed mood among youth with diabetes was associated with type and duration of diabetes, mean glycosylated hemoglobin (HbA1c) level, and the frequency of diabetic ketoacidosis (DKA) and hypoglycemic episodes, hospitalizations, and emergency department (ED) visits.
METHODS.A total of 2672 youth (aged 10–21 years) who had diabetes for a mean duration of 5 years completed a SEARCH study visit, in which their HbA1c was measured and information about their demographic characteristics, diabetes type and duration, and episodes of DKA, hypoglycemia, hospitalizations, and ED visits over the previous 6 months was collected. Their level of depressed mood was measured using the Center for Epidemiologic Studies Depression Scale (CES-D).
RESULTS.Among these youth, 14% had mildly (CES-D 16–23) and 8.6% had moderately or severely (CES-D 
24) depressed mood. Females had a higher mean CES-D score than males. After adjusting for demographic factors, and duration of diabetes, we found the prevalence of depressed mood to be higher among males with type 2 diabetes than those with type 1 diabetes and to be higher among females with comorbidities than those without comorbidities. Higher mean HbA1c and frequency of ED visits were associated with depressed mood. The prevalence of depressed mood among youth with diabetes was similar to that of published estimates of depressed mood among youth without diabetes.
CONCLUSIONS.Physicians and other health care professionals should consider screening youth with diabetes for depressed mood in clinical settings, particularly youth with poor glycemic control, those with a history of frequent ED visits, males with type 2 diabetes, and females with comorbidities.
Key Words: adolescent depression • diabetes type 1 • diabetes type 2 • health service utilization
Abbreviations: HbA1c—mean glycosylated hemoglobin • DKA—diabetic ketoacidosis • ED—emergency department • CES-D—Center for Epidemiologic Studies Depression • MODY—maturity-onset diabetes of youth • CDC—Centers for Disease Control and Prevention • ORs—odds ratios • CIs—confidence intervals
Accepted Sep 27, 2005.
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