Psychosocial screening and management of young people aged 18-25 years with diabetes
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Background: Routine psychosocial screening and management of people with diabetesis recommended.Aims: To proﬁle demographic, medical and psychosocial characteristics of young peo-ple with diabetes, and to develop a screening tool and care pathway for routine use.Methods: Indices of diabetes control and recorded diabetes complications were compli-mented by psychosocial screening tools assessing psychological, diabetes speciﬁc andperceived stress (Kessler 10, Problem Area in Diabetes, Perceived Stress Scale), well-being (World Health Organization Well Being Index-5), disordered eating (Eating Dis-order Risk Inventory-3 Risk Composite), compensatory behaviour questionnaire, socialsupport (Multidimensional Scale of Perceived Social Support), resilience (ConnorDavidson Resilience Scale – 2 item) and ﬁnancial concerns. Service provision and dem-ographic data were also collected. Diabetes and mental health clinicians then identiﬁeda subset of measures to use for routine screening along with care pathways.Results: Psychosocial screening was well accepted. Participants (151) had suboptimalglycaemic control (glycated haemoglobin 8.0 interquartile range 1.8%/64 interquartilerange 22 mmol/mol). Severe diabetes-related distress (Problem Area in Diabetes ≥40)was found in 19.4% and 26.0% reported difﬁculties managing healthcare costs. A men-tal health disorder was likely in 9.7%, whilst 23.4% had high Kessler 10 scores. LowWorld Health Organization Well Being Index-5 scores (≤13) were seen in 29.0%. Riskfor an eating disorder (Eating Disorder Risk Inventory-3 Risk Composite) was 12.7%,whereas approximately 36.0% had disturbed eating behaviours.Conclusion: Psychosocial screening of young adults with diabetes identiﬁed complexneeds. A brief psychosocial screening tool and associated care pathways were developedfor routine use in a young adult tertiary referral diabetes clinic. The tool assesses con-structs, such as diabetes distress, depression, anxiety, well-being, hypoglycaemia-una-wareness, fear of hypoglycaemia, social support, weight, shape and eating concerns andﬁnancial concerns. This will provide a longitudinal data source for further research toinform clinical practice.
Internal Medicine Journal
Public Health and Health Services not elsewhere classified