This is an ongoing, longitudinal study of 8-to-13 year-old children with insulin-dependent diabetes mellitus (IDDM) who have been followed since the IDDM was diagnosed. The project continuation will assure: (a) a minimum of 5-year follow-up on all Ss, (b) follow-up of up to 10-years on early recruits (thus, some Ss will be studied up to late adolescence/early adulthood), and (c) time to analyze fully our extensive data base. The study's objectives include the following: (a) establish the incidence of depression as an initial response to/later sequela of IDDM, (b) test the hypothesis that an initial depressive reaction is akin to """"""""mourning"""""""" and a good prognosticator of later adjustment, (c) examine over time the interface of psychosocial and medical variables, (d) delineate the characteristics of coping, (e) delineate predictors of poor """"""""metabolic control"""""""", (f) test the hypothesis that adolescents have """"""""unique"""""""" problems, increased psychiatric illness and worsening of metabolic control, (g) examine precursers of adolescent adjustment and medical status, and (h) delineate the psychologic/functional impact of the onset of diabetic complications. The project entails a repeated assessment design with 95 newly diagnosed juvenile diabetics and their parents. Ss and their parents are evaluated via a broad-based, standardized test battery to assure reliable and valid data, and replications. Diverse variables are assessed; e.g., clinical/psychiatric symptoms, attitude toward IDDM, social and educational functioning, familial parameters. Both clinician- and self-rated scales are used. Medical and all salient outcome variables are assessed independently. The study will provide guidelines to medical staff as to the longitudinal characteristics and process of coping with IDDM among children, adolescents, and their parents, and young adults. Identification of risk rates and correlates of psychiatric illness, including depression, may facilitate early intervention. Delineation of the interface of psychosocial and medical variables may clarify unresolved issues in the field and provide data for clinical management, psychosocial intervention, and patient education.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project (R01)
Project #
2R01DK025568-08
Application #
3227486
Study Section
Behavioral Medicine Study Section (BEM)
Project Start
1979-04-01
Project End
1989-11-30
Budget Start
1986-12-01
Budget End
1987-11-30
Support Year
8
Fiscal Year
1987
Total Cost
Indirect Cost
Name
University of Pittsburgh
Department
Type
Schools of Medicine
DUNS #
053785812
City
Pittsburgh
State
PA
Country
United States
Zip Code
15213
Kovacs, M; Obrosky, D S; Goldston, D et al. (1997) Major depressive disorder in youths with IDDM. A controlled prospective study of course and outcome. Diabetes Care 20:45-51
Kovacs, M; Goldston, D; Obrosky, D S et al. (1997) Psychiatric disorders in youths with IDDM: rates and risk factors. Diabetes Care 20:36-44
Kovacs, M; Mukerji, P; Iyengar, S et al. (1996) Psychiatric disorder and metabolic control among youths with IDDM. A longitudinal study. Diabetes Care 19:318-23
Pollock, M; Kovacs, M; Charron-Prochownik, D (1995) Eating disorders and maladaptive dietary/insulin management among youths with childhood-onset insulin-dependent diabetes mellitus. J Am Acad Child Adolesc Psychiatry 34:291-6
Charron-Prochownik, D; Kovacs, M; Obrosky, D S et al. (1995) Illness characteristics and psychosocial and demographic correlates of illness severity at onset of insulin-dependent diabetes mellitus among school-age children. J Pediatr Nurs 10:354-9
Kovacs, M; Mukerji, P; Drash, A et al. (1995) Biomedical and psychiatric risk factors for retinopathy among children with IDDM. Diabetes Care 18:1592-9
Kovacs, M; Ho, V; Pollock, M H (1995) Criterion and predictive validity of the diagnosis of adjustment disorder: a prospective study of youths with new-onset insulin-dependent diabetes mellitus. Am J Psychiatry 152:523-8
Kovacs, M; Charron-Prochownik, D; Obrosky, D S (1995) A longitudinal study of biomedical and psychosocial predictors of multiple hospitalizations among young people with insulin-dependent diabetes mellitus. Diabet Med 12:142-8
Goldston, D B; Kovacs, M; Ho, V Y et al. (1994) Suicidal ideation and suicide attempts among youth with insulin-dependent diabetes mellitus. J Am Acad Child Adolesc Psychiatry 33:240-6