P-24: Comprehensive in-clinic psychosocial screening for adolescents with type 1 diabetes in the Republic of Ireland
E Moran, E Somers, V McDarby, F Dolan, C Speight, A Beegan, J Thompson, C Betz, D Fahy, D Cody, L V Mali, A Delamater, M O’GradyAbstract
Introduction
Psychosocial concerns such as anxiety and depression in addition to family conflict are impediments to effective type 1 diabetes self-care management. Routine screening of adolescents for such concerns is recommended by ISPAD
Objectives
Implementation of screening for psychosocial concerns in adolescents aged 12-18 years with type 1 diabetes in the Republic of Ireland. Furthermore, we aimed to describe the prevalence of psychosocial concerns in this population and examine interactions between various psychosocial concerns and glycaemic control (HbA1c).
Methods
Adolescents completed the screening measures on tablet devices on the waiting area prior to their multidisciplinary team review. Proportions of adolescents screening positive for each measure were assessed and regression analyses evaluated how psychosocial variables accounted for variances in glycaemic outcomes.
Results
Preliminary data from the 88 adolescents (63% male) with a mean (SD) age of 14.8 (1.5) years who have participated to date. Mean HbA1c was 54.4 (10.5) mmol/mol. Psychosocial concerns were common and included prevalences as follows; family conflict 9%, suicide risk 11.4%, fear of hypoglycaemia and disordered eating (both 13.6%) and diabetes stress 21.6%. Elevated scores for depression were observed in 60.3% (45.5% mild and 14.8% moderate) and anxiety in 52.3% (39.8% mild, 12.5% moderate). Glycaemic control was negatively associated with the mean score on the Diabetes Management Questionnaire (DMQ) (p=0.011), Collaborative Parent Involvement Scale (p=0.025) and the Multidimensional Support scale (p<0.001). Our preliminary data did not identify significant associations between HbA1c and other measures.
Conclusions
Prevalence of psychosocial concerns in Irish adolescents are similar to those reported elsewhere in the literature and psychosocial screening can be effectively implemented as part of routine care processes and identify those in need of additional supports.