Efficacy of Formal Screening for Depression in Pediatric Type 1 Diabetes Clinic

by Winer, Jeffrey Craig

This study was undertaken to examine the efficacy of screening for depression in a pediatric diabetes clinic and how the yield of such screening compares with established screening protocols aimed at identifying early microvascular complications and associated autoimmune diseases. Two-hundred-fifteen children and adolescents 8-18 years old in the Yale Pediatric Diabetes Center were screened for depression using the Children¡¯s Depression Inventory (CDI), with information including gender, age, duration of diabetes, HbA1C, and results of other screening protocols compiled. A total of 8.4% of our cohort had CDI scores ¡Ý13 indicative of clinically-significant depressive symptoms, with a range of 0-34. Depression scores were not associated with gender, age, or HbA1C. However, duration of diabetes showed a trend toward statistical significance (adjusted p=.068). Screening for depression using the CDI with a cutoff of ¡Ý13 had similar positive testing rates as screening for microalbuminuria, hypercholesterolemia, thyroid dysfunction, and celiac sprue; in contrast, none of the clinic patients had evidence of retinopathy at their last ophthalmologic examination. These findings indicate that screening for depression in a pediatric diabetes clinic identifies a substantial number of youngsters with high levels of depressive symptoms and has a yield that is equal to or greater than other standard screening tests and examinations. Thus, screening appears to be warranted.