Brittle diabetes: psychopathological aspects

Area of Science:

• Psychiatry
• Endocrinology
• Clinical Psychology

Background:

• Type I diabetes can present as
• brittle,
• characterized by severe glycemic instability and frequent hospitalizations.
• Psychosocial issues are often implicated as underlying causes of brittle diabetes.
• This study investigates the psychopathological profile of brittle diabetes.

Purpose of the Study:

• To conduct a systematic psychopathological assessment of brittle diabetes.
• To evaluate general psychopathology and personality traits using DSM-IV-TR criteria.
• To differentiate psychological profiles between brittle and stable type I diabetics.

Main Methods:

• A case-control study involving 21 brittle type I diabetics and 21 matched stable diabetics.
• Assessment of general psychopathology using the Symptom Checklist-90-R (SCL-90-R).
• Evaluation of personality traits and disorders using the Millon Clinical Multiaxial Inventory-III (MCMI-III) based on DSM-IV-TR.

Main Results:

• Brittle diabetics scored higher on the SCL-90-R
• Phobic Anxiety
• subscale compared to stable diabetics.
• No significant differences were found in other SCL-90-R symptom dimensions or global distress indices.
• Brittle diabetics showed lower compulsive personality traits but higher scores across paranoid, schizoid, schizotypal, antisocial, borderline, narcissistic, avoidant, dependent, depressive, and passive-aggressive personality traits.

Conclusions:

• Brittle diabetics do not differ from stable diabetics in global psychopathological distress or most Axis I DSM-IV-TR diagnoses, except for phobic anxiety.
• Brittle diabetes is associated with less functional and more maladaptive personality features.
• Individuals with brittle diabetes frequently experience a wider range and intensity of pathological personality traits across all DSM-IV-TR clusters.