Mental health outcomes in adolescents and emerging adults with diabetes
Notice bibliographique
Résumé
Background: The prevalence of type 1 diabetes (T1D) is increasing, thereby leading to an increasing number of adolescents with T1D transferring from paediatric to adult care. During this crucial transition period, the adolescent with T1D faces emotional, occupational, social, and financial changes which may increase his/her risk of mental health disorders. First, we aimed to study the risk of mental health outcomes in adolescents and emerging adults with diabetes in comparison to that of their peers without diabetes. Second, we aimed to explore if delays in establishing adult diabetes care following transition from paediatric care among adolescents and emerging adults with diabetes confer an increased risk of mental health outcomes. Methods: We conducted a retrospective cohort study of adolescents and emerging adults with and without diabetes living in Québec, Canada using data between April 1, 1997, and March 31, 2015, from the Québec Integrated Chronic Disease Surveillance System (QICDSS) maintained at the Institut National de Santé Publique du Québec (INSPQ). To address the first aim, all individuals with diabetes ages 1 to 15 years between April 1, 1997, and December 31, 2013, were identified and formed the exposed group. All individuals in the same age range (1-15 years) who did not have diabetes during the study period (1997-2015) were identified and formed the unexposed group. Exposed and unexposed individuals were enrolled at age 15 years and were followed up until age 25 years, March 31, 2015, death, or migration from the province, whichever came first. Multivariate Cox proportional hazard models were used to compare time to mental health outcomes among individuals with diabetes compared to those without.To address the second aim, individuals with diabetes, 15 to 25 years old, who had an adult visit for diabetes following their last paediatric diabetes-related visit were retained. Those who had a gap in establishing adult care greater than 180 days formed the exposed group and those who did not have such a gap formed the unexposed group. Exposed and unexposed individuals were followed from the transition date (180th day following the last paediatric visit for diabetes) until age 25 years, March 31, 2015, death, or migration from the province, whichever came first. Multivariate Cox proportional hazard models were used to compare time to mental health outcomes among individuals with versus without a gap in establishing adult care. Results: For the first aim, we identified 3,544 individuals with diabetes diagnosed between ages 1 to 15 years and 1,388,397 individuals without diabetes. After adjusting for material deprivation, social deprivation, sex, rural residency and year of birth, adolescents and emerging adults with diabetes were 33% more likely to experience a severe mood disorder (adjusted hazard ratio (HR) 1.33, 95% confidence interval (CI) 1.19-1.50), 325% more likely to be hospitalized for a suicide attempt (HR 3.25, 95% CI 1.79-5.88), 82% more likely to visit a psychiatrist at least once (HR 1.82, 95% CI 1.67-1.98) and 29% more likely to have any psychiatric disorder (HR 1.29, 95% CI 1.21-1.37), compared to their peers without diabetes. For the second aim, we identified 741/1,772 (41.8%) adolescents with diabetes who had a gap in establishing adult care and 1,031/1,772 (58.2%) adolescents who did not have such a gap. In multivariate Cox regression models, a gap in establishing adult diabetes care was not associated with any of the mental health outcomes. Conclusions: We found an increased risk of mental health outcomes in adolescents and emerging adults with diabetes compared to their peers without diabetes. This increase risk may arise from the developmental challenges faced by the emerging adult with a chronic disease, rather than the continuity of care received during the transfer to adult care.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».