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Acta Diabetologica
Published in: Acta Diabetologica 1/2020

01-01-2020 | Mood Disorders | Original Article

Depressive symptoms and glycaemic control in adults with type 1 diabetes: an exploratory study on the role of family functioning

Authors: Liliana Indelicato, Vincenzo Calvo, Marco Dauriz, Arianna Negri, Carlo Negri, Maddalena Trombetta, Enzo Bonora

Published in: Acta Diabetologica | Issue 1/2020

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Abstract

Aims

Psychological distress and family functioning have a considerable impact on diabetes self-management and glycaemic control in individuals with type 1 diabetes (T1D). However, the influence of both individual and family factors on glycaemic control has not been adequately investigated yet. This study aimed at examining the relationship between perceived family functioning and depressive symptoms with the frequency of capillary self-monitoring of blood glucose (SMBG) and glycaemic control (HbA1c) in a large sample of adults with T1D.

Methods

In a cross-sectional study design, we consecutively enrolled 90 adults with T1D diagnosis from at least 1 year and currently living in their family of origin or conjugal family from at least 1 year before the enrolment. Questionnaires were administered to assess family functioning and depressive symptoms. The SMBG frequency over the past 3 months and the most recent HbA1c measurement were also collected in each individual. Correlation and mediation analyses were carried out.

Results

Glycaemic control showed a positive relationship with depressive symptoms and family balanced cohesion, while SMBG frequency was correlated with family balanced flexibility and rigidity, but not with depressive symptoms. Mediation analyses showed that family rigidity mediates the effect of depressive symptoms on glycaemic control.

Conclusions

This exploratory study highlighted the significance of a cohesive family context to facilitate the achievement of individual glycaemic goals in individuals with T1D. These observations, if confirmed in larger data sets, would timely call for a comprehensive family care assessment as part of the evaluations routinely carried out in the ambulatory care of these individuals.
Literature
1.
Silverstein J, Klingensmith G, Copeland K, Plotnick L, Kaufman F, Laffel L et al (2005) Care of children and adolescents with type 1 diabetes: a statement of the American diabetes association. Diabetes Care 28:186–212PubMed
2.
3.
4.
Gonder-Frederick LA, Cox DJ, Ritterband LM (2002) Diabetes and behavioral medicine: the second decade. J Consult Clin Psychol 70:611–625PubMed
5.
Caruso R, Rebora P, Dellafiore F, Fabrizi D, Riegel B, Ausili D et al (2019) Clinical and socio-demographic determinants of inadequate self-care in adults with type 1 diabetes mellitus: the leading role of self-care confidence. Acta Diabetol 56:151–161PubMed
6.
Lewin AB, Heidgerken AD, Geffken GR, Williams LB, Storch EA, Gelfand KM et al (2006) The relation between family factors and metabolic control: the role of diabetes adherence. J Pediatr Psychol 31:174–183PubMed
7.
Williams LB, Laffel LM, Hood KK (2009) Diabetes-specific family conflict and psychological distress in paediatric type 1 diabetes. Diabet Med 26:908–914PubMedPubMedCentral
8.
Weissberg-Benchell J, Nansel T, Holmbeck G, Chen R, Anderson B, Wysocki T et al (2009) Generic and diabetes-specific parent-child behaviors and quality of life among youth with type 1 diabetes. J Pediatr Psychol 34:977–988PubMedPubMedCentral
9.
Hilliard ME, Guilfoyle SM, Dolan LM, Hood KK (2011) Prediction of adolescents’ glycemic control 1 year after diabetes-specific family conflict: the mediating role of blood glucose monitoring adherence. Arch Pediatr Adolesc Med 165:624–629PubMedPubMedCentral
10.
Ingerski LM, Anderson BJ, Dolan LM, Hood KK (2010) Blood glucose monitoring and glycemic control in adolescence: contribution of diabetes-specific responsibility and family conflict. J Adolesc Health 47:191–197PubMedPubMedCentral
11.
Moore SM, Hackworth NJ, Hamilton VE, Northam EP, Cameron FJ (2013) Adolescents with type 1 diabetes: parental perceptions of child health and family functioning and their relationship to adolescent metabolic control. Health Qual Life Outcomes 11:50PubMedPubMedCentral
12.
Rosenberg T, Shields CG (2009) The role of parent-adolescent attachment in the glycemic control of adolescents with type 1 diabetes: a pilot study. Fam Syst Health 27:237–248PubMed
13.
Berg CA, Butler JM, Osborn P, King G, Palmer DL, Butner J et al (2008) Role of parental monitoring in understanding the benefits of parental acceptance on adolescent adherence and metabolic control of type 1 diabetes. Diabetes Care 31:678–683PubMed
14.
Northam EA, Lin A, Finch S, Werther GA, Cameron FJ (2010) Psychosocial well-being and functional outcomes in youth with type 1 diabetes 12 years after disease onset. Diabetes Care 33:1430–1437PubMedPubMedCentral
15.
Dantzer C, Swendsen J, Maurice-Tison S, Salamon R (2003) Anxiety and depression in juvenile diabetes: a critical review. Clin Psychol Rev 23:787–800PubMed
16.
McGrady ME, Laffel L, Drotar D, Repaske D, Hood KK (2009) Depressive symptoms and glycemic control in adolescents with type 1 diabetes: mediational role of blood glucose monitoring. Diabetes Care 32:804–806PubMedPubMedCentral
17.
McGrady ME, Hood KK (2010) Depressive symptoms in adolescents with type 1 diabetes: associations with longitudinal outcomes. Diabetes Res Clin Pract 88:e35–e37PubMedPubMedCentral
18.
Keeler AR, Siegel JT (2016) Depression, help-seeking perceptions, and perceived family functioning among Spanish-dominant Hispanics and non-Hispanic whites. J Affect Disord 202:236–246PubMed
19.
20.
Olson DH (1988) Circumplex model of family systems: VIII. Family assessment and intervention. J Psychother Fam 4:42
21.
Olson D (2011) FACES IV and the circumplex model: validation study. J Marital Fam Ther 37:64–80PubMed
22.
Guilfoyle SM, Crimmins NA, Hood KK (2011) Blood glucose monitoring and glycemic control in adolescents with type 1 diabetes: meter downloads versus self-report. Pediatr Diabetes 12:560–566PubMed
23.
Kroenke K, Spitzer RL, Williams JB (2001) The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 16:606–613PubMedPubMedCentral
24.
van Steenbergen-Weijenburg KM, de Vroege L, Ploeger RR, Brals JW, Vloedbeld MG, Veneman TF et al (2010) Validation of the PHQ-9 as a screening instrument for depression in diabetes patients in specialized outpatient clinics. BMC Health Serv Res 10:235PubMedPubMedCentral
25.
Sanderson J, Kosutic I, Garcia M, Melendez T, Donoghue J, Perumbilly S et al (2009) The measurement of outcome variables in couple and family therapy research. Am J Fam Ther 37:239–257
26.
Hamilton E, Carr A (2016) Systematic review of self-report family assessment measures. Fam Process 55:16–30PubMed
27.
Place M, Whitehead AL, Reynolds J (2017) Living with type 1 diabetes: the influence of the child’s gender on family functioning. Int J Diabetes Endocrinol 2:43–49
28.
Faul F, Erdfelder E, Buchner A, Lang AG (2009) Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods 41:1149–1160PubMed
29.
Baron RM, Kenny DA (1986) The moderator–mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Personal Soc Psychol 51:1173–1182
30.
Hayes AF, Preacher KJ (2014) Statistical mediation analysis with a multicategorical independent variable. Br J Math Stat Psychol 67:451–470PubMed
31.
Preacher KJ, Hayes AF (2008) Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods 40:879–891PubMed
32.
Fritz MS, Mackinnon DP (2007) Required sample size to detect the mediated effect. Psychol Sci 18:233–239PubMed
33.
Ellis DA, Podolski CL, Frey M, Naar-King S, Wang B, Moltz K (2007) The role of parental monitoring in adolescent health outcomes: impact on regimen adherence in youth with type 1 diabetes. J Pediatr Psychol 32:907–917PubMed
34.
Wysocki T, Nansel TR, Holmbeck GN, Chen R, Laffel L, Anderson BJ et al (2009) Collaborative involvement of primary and secondary caregivers: associations with youths’ diabetes outcomes. J Pediatr Psychol 34:869–881PubMed
35.
Whittemore R, Liberti L, Jeon S, Chao A, Jaser SS, Grey M (2014) Self-management as a mediator of family functioning and depressive symptoms with health outcomes in youth with type 1 diabetes. West J Nurs Res 36:1254–1271PubMed
36.
Baiocco R, Cacioppo M, Laghi F, Tafà M (2013) Factorial and construct validity of FACES IV among Italian adolescents. J Child Fam Stud 22:962–970
37.
Everri M, Mancini T, Fruggeri L (2016) The role of rigidity in adaptive and maladaptive families assessed by FACES IV: the points of view of adolescents. J Child Fam Stud 25:2987–2997PubMedPubMedCentral
38.
Kerr M, Stattin H, Ozdemir M (2012) Perceived parenting style and adolescent adjustment: revisiting directions of effects and the role of parental knowledge. Dev Psychol 48:1540–1553PubMed
39.
Hood KK, Huestis S, Maher A, Butler D, Volkening L, Laffel LM (2006) Depressive symptoms in children and adolescents with type 1 diabetes: association with diabetes-specific characteristics. Diabetes Care 29:1389–1391PubMed
40.
Stewart SM, Rao U, Emslie GJ, Klein D, White PC (2005) Depressive symptoms predict hospitalization for adolescents with type 1 diabetes mellitus. Pediatrics 115:1315–1319PubMed
41.
Gonzalez JS, Peyrot M, McCarl LA, Collins EM, Serpa L, Mimiaga MJ et al (2008) Depression and diabetes treatment nonadherence: a meta-analysis. Diabetes Care 31:2398–2403PubMedPubMedCentral
42.
Wu YP, Hilliard ME, Rausch J, Dolan LM, Hood KK (2013) Family involvement with the diabetes regimen in young people: the role of adolescent depressive symptoms. Diabet Med 30:596–602PubMedPubMedCentral
43.
Wysocki T, Harris MA, Buckloh LM, Mertlich D, Lochrie AS, Mauras N et al (2007) Randomized trial of behavioral family systems therapy for diabetes: maintenance of effects on diabetes outcomes in adolescents. Diabetes Care 30:555–560PubMed
Metadata
Title
Depressive symptoms and glycaemic control in adults with type 1 diabetes: an exploratory study on the role of family functioning
Authors
Liliana Indelicato
Vincenzo Calvo
Marco Dauriz
Arianna Negri
Carlo Negri
Maddalena Trombetta
Enzo Bonora
Publication date
01-01-2020
Publisher
Springer Milan
Published in
Acta Diabetologica / Issue 1/2020
Print ISSN: 0940-5429
Electronic ISSN: 1432-5233
DOI
https://doi.org/10.1007/s00592-019-01356-z

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