Special Considerations in the Systematic Psychosocial Screening of Youth with Type 1 Diabetes

The American Diabetes Association recommends psychosocial screening for individuals with type 1 diabetes (T1D). The purpose of this study is to present (a) several high priority decisions that program developers may encounter when building a new psychosocial screening program and (b) both the screening development process and results of one mental health screening program within a multidisciplinary pediatric diabetes clinic, with particular emphasis on parent-youth screening agreement and changes to elevation status over time.

Youth with T1D ages 12-17 and parents of youth with T1D ages 8-17 were administered mental health screeners as a part of outpatient diabetes visits over a 1-year period. Youth depression and anxiety were screened using self- and parent proxy-report versions of the Patient-Reported Outcomes Measurement Information System (PROMIS).

Youth (n = 154) and parents (n = 211) completed mental health screening measures, such that 228 youth were screened. Intraclass correlation coefficients (ICCs) between youth- and parent proxy-report agreement were good for the measures of depression (ICC = .787) and anxiety (ICC = .781), with parent proxy-reports significantly higher than youth self-reports of anxiety (p < .01). Of the 93 youth with follow-up screening data and no youth- or parent proxy-reported elevation on the initial screener, 16.1% had at least one elevated screener within 1 year.

Findings indicate that questions of who to screen and how often to screen may deserve increased scrutiny, as this screening program's data suggest that there may be benefit to obtaining both youth- and parent report more often than annually.