Depressive Symptom And Overall Satisfaction Of Quality Of Life Among Children And Adolescents With Type 1 Diabetes In Hunan

Objective:1.To describe the status of depressive symptom among children and adolescents with type 1 diabetes mellitus(T1DM) in Hunan Province and explore the related factors.2.To explore the related factors of overall satisfaction of quality of life among children and adolescents with T1DM in Hunan Province.3. To identify the relationship between depressive symptom and overall satisfaction of quality of life(QoL).4. To find out the differences in parent-child relationship, peer relationship, development status, fasting blood sugar(FBS), body mass index(BMI) and overall satisfaction of QoL between patients with depressive symptom and patients without depressive symptom.Methods:It was a multi-plot cross-sectional survey. The target population was patients with T1DM aged from 8 to 19 in Hunan Province. The investigation was carried out from July 2009 to September 2010.136 subjects who met inclusion criteria were recruited, including 81 cases from Diabetes Center of Central South University,45 cases from first class of the third grade hospitals in Changsha and the tertiary hospitals in 13 Prefecture-Level cities and 1 Autonomous Prefecture in Hunan Province,10 cases from other ways. The questionnaire included four parts, General Information Questionnaire(collecting the general information of subjects), Depression Self-Rating Scale of Children(DSRS, evaluating depressive symptom), Quality of Life Scale for Children and Adolescents(QLS, evaluating overall satisfaction of QoL, parent-child relationship and peer relationship), Pubertal Development Scale (PDS, evaluating development status). All data were input into SPSS 13.0 software for statistical analysis. Statistic methods included descriptive statistics, t test, analysis of variance, Chi-square analysis, Pearson correlation analysis, multiple linear stepwise regression analysis, multi-factor non-condition logistic analysis.Results:1.The Cronbach'Alpha coefficient of Depression Self-Rating Scale of Children was 0.80, split-half reliability was 0.79, retest reliability was 0.68; the Cronbach'Alpha coefficient of Quality of Life Scale for Children and Adolescents in the overall satisfaction subscale was 0.80, split-half reliability was 0.73, retest reliability was 0.71.2.The mean DSRS score of this group was 9.51±5.19. Among 136 subjects with T1DM,24 suffered from depressive symptom, the prevalence rate of depressive symptom in this group was 17.6%.3. The multi-factor non-condition logistic regression analysis showed that age(OR=2.831), current education status(OR=9.822), parents'current marital status (OR=0.061), yearly household income(OR=0.415), hospitalization in the past 6 months(OR=8.797),peer relationship (OR=0.133), parent-child relationship(OR=0.182), FBS(OR=0.061) and sample source(OR=8.366) were factors which independently predicted depressive symptom in patients(8-19 years old) living with T1DM.Higher household income, better peer relationship and parent-child relationship, better metabolic status and samples from Diabetes Center of Central South University were protective factors, drop-out, parents' current marital status is separeated/divorced/widowed, hospitalization in the past 6 months and elder age were risk factors.4. Multiple linear stepwise regression analysis showed:parent-child relationship(β=0.313),DSRS score(β=-0.226),peer relationship(β=0.212), current education status(β=-0.167) and if one-child family(β=2.466) were included to the regression equation(F=31.411, P=0.000) in which overall satisfaction of QoL was dependent variables. The 5 factors could explain 57.1% of the variation for overall satisfaction of QoLConclusion:1.The proportion of subjects with depressive symptom among children and adolescents living with T1DM in Hunan Province was high.2.The influential factors of depressive symptom among children and adolescents with T1DM included age, current education status, parents' current marital status,yearly household income, hospitalization in the past 6 months, peer relationship and parent-child relationship, FBS and sample source. 3. The influential factors of the overall satisfaction of QoL among children and adolescents with TIDM included parent-child relationship, depressive symptom, peer relationship, current education status and if one-child family.4. There was a significant negative association between depressive symptom and overall satisfaction of QoL5. Subjects with depressive symptom had poorer overall satisfaction of QoL, parent-child relationship, and peer relationship.