European Journal of Pediatrics

, Volume 173, Issue 2, pp 203–212

Depression and adherence to treatment in diabetic children and adolescents: a systematic review and meta-analysis of observational studies

  • Chuenjid Kongkaew
  • Katechan Jampachaisri
  • Chollapat A. Chaturongkul
  • C. Norman Scholfield
Original Article

DOI: 10.1007/s00431-013-2128-y

Cite this article as:
Kongkaew, C., Jampachaisri, K., Chaturongkul, C.A. et al. Eur J Pediatr (2014) 173: 203. doi:10.1007/s00431-013-2128-y

Abstract

Depression compromises diabetes treatment in juveniles, and this study aimed to identify influential targets most likely to improve adherence to treatment and glycemic control. Prospective observational studies investigating associations between depression and treatment adherence in juveniles with type 1 diabetes were extracted from MEDLINE, EMBASE, CINAHL, PsycINFO and Cochrane Central. Nineteen studies comprising 2,935 juveniles met our criteria. Median effect sizes between depression and treatment adherence were 0.22 (interquartile range (IQR), 0.16–0.35) by patient and 0.13 (IQR, 0.12–0.24) caregiver report. Corresponding values for depression/glycemic control were 0.16 (IQR, 0.09–0.23) and 0.08 (IQR, 0.04–0.14), respectively. Effect sizes varied with study design, publication year and assessment tools: CES-D yielded a higher effect size than other assessment tools for depression, where associations for depression and either adherence or glycemic control was investigated. Several behaviours influenced adherence and glycemic control. Conclusion: This study showed moderate associations between depression and poor treatment adherence. Targeting behaviour and social environments, however, may ultimately provide more cost-effective health gains than targeting depressive symptoms.

Keywords

Diabetes type 1 Non-adherence Depression Children Adolescents 

Abbreviations

T1DM

Type 1 diabetes mellitus

T2DM

Type 2 diabetes mellitus

EMBASE

Excerpta Medica Database

CINAHL

Cumulative Index to Nursing and Allied Health Literature

HbA1c

Haemoglobin A1c

CDI

Children's Depression Inventory

CES-D

Centre for Epidemiological Studies Scale for Depression

BASC

Behaviour Assessment System for Children

CDI-S

Children's Depression Inventory-Short Form

SCI

Self-Care Inventory

BGMF

Blood glucose monitoring frequency

DSMP

Diabetes Self-Management Profile

DMS

Diabetes Self-Management Scale

SCQ

Self-Care Questionnaire

IQR

Interquartile range

CI

Confidence interval

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Chuenjid Kongkaew
    • 1
  • Katechan Jampachaisri
    • 2
  • Chollapat A. Chaturongkul
    • 3
  • C. Norman Scholfield
    • 1
  1. 1.Faculty of Pharmaceutical SciencesNaresuan UniversityPhitsanulokThailand
  2. 2.Faculty of SciencesNaresuan UniversityPhitsanulokThailand
  3. 3.Child Development & Neuropsychiatric UnitBangkok Medical CenterBangkokThailand

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