WASHINGTON – Total social competence and externalizing behavior may play a role in how well children and adolescents control their diabetes, according the results of a study involving 78 patients.
“Lower total psychosocial competence is a strong predictor of poor metabolic control in diabetic youth,” Dr. Ivana Balic, a general psychiatry resident, and Dr. Burleson W. Daviss, a child psychiatrist, both of the University of Texas Health Sciences Center at San Antonio, wrote in a poster. Externalizing psychopathology was a lesser predictor.
The researchers recruited 78 children and adolescents (mean age 12 years) from a clinic or a diabetes camp for this study, presented at the annual meeting of the American Psychiatric Association. Using the Child Behavior Checklist, they assessed total social competence and externalizing symptoms. Along with sociodemographics, the researchers assessed these factors as predictors of poor metabolic control 3 months later. Poor metabolic control was defined as an HbA1c level of 10 mg/dL or greater. In all, 56% of the youth had poor metabolic control. On univariate analysis, age and living with a single parent were significant predictors of poor metabolic control, along with lower total social competence, family conflict, dietary noncompliance, and externalizing symptoms. Interestingly, internalizing symptoms did not significantly predict poor metabolic control.
All of the significant predictors from univariate analysis were incorporated into the backward stepwise logistic regression. The final predictive model included age, living with a single parent, lower total social competence, dietary noncompliance, and family conflict. This model correctly classified 74% of the youth with poor metabolic control.
Total competence, as tested by the Child Behavioral Checklist, describes children's capability in school activities, social activities, and other areas of competence. “Children who do a good job at the things that total competence is measuring also are more likely to do a better job at handling their diabetes,” said Dr. Balic in an interview. Children who have trouble in these areas might have more trouble managing diabetes.
Age and living with a single parent also were significant predictors of poor metabolic control. DR. DAVISS