Depression and anxiety disorders are the most commonly diagnosed psychological ailments in children with type 1 diabetes (CT1). – Research shows that up to 30.4% of them suffer from depression and 32% have anxiety disorders – stresses dr Andrzej Śliwerski from the Institute of Psychology of the University of Lodz. The scientist, along with the research team, is trying to determine to what extent the behaviours of parents and surroundings, including peers, but also the perception of the sick person themselves, affect their mental state.
CT1 is an autoimmune disease that results in the destruction of pancreatic islet beta cells that produce insulin. Lack of insulin prevents body cells from taking glucose from the blood, which provokes severe metabolic disorders that, untreated, lead to death. CT1 cannot be cured. People suffering from it require constant delivery of insulin to the body in the form of subcutaneous injections, which both young patients and their parents are involved in. The onset of the disease in most cases occurs in early childhood and in young adulthood, with an average age of 8 years.
Dr Andrzej Śliwerski says:
Every year we observe a steady increase in patients with CT1. In the world, 9.5% of the population suffers from type 1 diabetes. Over the past eight years, the number of cases has increased by 21%, making it now one of the most common chronic diseases in children and adolescents.
Depression, anxiety, fear of contracting a disease… how do you deal with it?
Type 1 diabetes in children is accompanied by ailments of psychological nature – most often depression and anxiety disorders.
Dr Andrzej Śliwerski describes the problem:
The relationship between depression and anxiety and diabetes control is bidirectional emotional disorders affect glycemia control. At the same time, recurrent hypoglycemia (low blood sugar levels) and hyperglycemia (high blood sugar levels) cause a higher risk of depression and anxiety. Since anxiety and depressive disorders worsen the metabolic correction of diabetes, increasing the risk of acute and chronic complications of the disease, knowledge of the factors that determine their occurrence may contribute to the development of preventive and educational programmes that improve mental health condition of children suffering from type 1 diabetes. As a consequence, this will lead to better self-control of diabetes.
Researchers assume that children who tend to direct attention to negative stimuli and have a bad vision of themselves, the world and the future are more susceptible to emotional disturbances. These risks may be increased by parents who also draw attention and memory to negative stimuli and over control their children.
The research project carried out with the participation of dr Andrzej Śliwerski is of an interdisciplinary nature. Psychologists from the Institute of Psychology of the University of Lodz and diabetologists and psychologist from the Clinic of Pediatrics, Diabetology, Endocrinology and Nephrology of the Medical University of Lodz are working on it.
What determines depressive and anxiety disorders?
In the studies of the international Cognitive Vulnerability to Depression project, cognitive factors such as biased attention, memory and negative self-vision have been shown to be an important element shaping susceptibility to emotional disturbances. This model has also been verified in the Polish population, but in relation to depression and suicidal tendencies as well as mood disorders associated with fluctuations in hormone levels.
Dr Andrzej Śliwerski explains:
We will now verify to what extent the same factors account for susceptibility to depressive and anxiety disorders in children with CT1, taking into account the way their families function. It is worth emphasizing that on a daily basis they live in specific, difficult conditions, taking into account the obligation of parents to permanently control children’s sugar levels. Children with diabetes and their mothers will have two computer tasks to do where they will have to remember words and count faces expressing emotions. These tasks will make it possible to verify if they memorize and direct their attention to negative stimuli more easily.
And he adds:
The constant risk of endangering the child’s life, resulting from an excessive decrease in sugar levels and the risk of severe health complications due to too high levels, provokes anxiety and excessive need to control its functioning in many parents. This leads to a decrease in the child’s self-esteem. In some cases, this can be worsened by a lack of parental acceptance of the disease. On the other hand, research shows that positive attitudes of parents can meaningfully lower the risk of depression — for example, by engaging and helping children adapt to the disease.
Researchers admit that both over-protective and over-demanding style, and increased control are essential elements shaping cognitive vulnerability. The introduced solutions may contribute to the creation of programmes that will help cope with the difficult aspects of the disease, giving the necessary support to the young patient and their family.
Dr Andrzej Śliwerski concludes:
Children with type 1 diabetes along with their families have mandatory diabetology training before leaving hospital. The topics of insulin therapy, diet and daily functioning are addressed during it. A psychologist from the diabetology department is taking part in our study, so we will use the study results in training addressed to parents on support and ways of taking care of children with CT1.
UL IDUB Grants
The Excellence Initiative – UL Research University – grant competitions under which the University of Lodz funds research ideas of its scientists and doctoral students. By supporting them in conducting high quality research, the university implements a strategy of striving for research excellence in all fields and disciplines. The competitions also serve the purpose of internationalisation – developing and strengthening the university’s cooperation with international researchers. As part of grants addressed to scientists from outside the university, experienced and young researchers join the UL team. This favours the fusion of experiences and increasing the university’s scientific potential, supports networking and employee mobility.
The grants are financed as part of the subsidy increased by 2% for the universities that joined the IDUB competition in 2019. University of Lodz will receive additional funding for research until 2026. Internal grant competitions have been implemented since 2020.
Currently, in the 2nd edition, over PLN 3 million was used to finance young, experienced researchers and doctoral students in such grant competitions as: UL IDUB “Grants for young and experienced researchers” and “Doctoral research grants”.
Source: dr Andrzej Śliwerski, Institute of Psychology, Faculty of Educational Sciences, University of Lodz
Edit: Promotion Centre of the Univesrsity of Lodz