Personality changes and social adjustment during the first three years of diabetes in children

Two groups of 64 diabetic and 30 carefully selected and matched non-diabetic control children 4-17 years old were studied with regard to psychological and social adaptation. Four sets of psycho-social methods were used: (a) psychiatric assessment of the mental state, (b) evaluation of the social situation, (c) measurement of the intellectual capacity, and (d) a Rorschach test. A base-line study was done within 5 months after the onset of diabetes and a follow-up 3 years later with the same methods. The mental state was assessed with regard to 18 variables, and the Rorschach test utilized 12 variables. There were no significance differences as to mental state between diabetics and non-diabetics neither at base-line nor at follow-up. Within each group, however, the diabetics showed an increase with regard to symptoms of aggression while the non-diabetics showed a decrease in such symptoms. Diabetics with high or low glucosuria levels did not differ in this respect. When summarizing mental deviations from average in the two groups the diabetics showed more deviations both at base-line and at follow-up, and a tendency towards higher degrees of mental activity, emotional ability and social contact. In the Rorschach test the diabetics showed a higher level of anxiety concerning their own health than the non-diabetics, but there was a decrease in this variable over the 3-year period. However, in an attempt to summarize the degree of mental disturbance, as estimated in the Rorschach test, no significant differences were found between diabetics and non-diabetics. Nor were any significant differences found between the groups with regard to social problems or intellectual capacity. It is concluded that the few abnormal patterns of raction that were observed may well be explained by the traumatic experience of the onset of a serious chronic disorder such as diabetes, and that a relatively strict care given to diabetic children does not seem to disturb their own or their parents' coping ability or psycho-social adjustment. The strictness might even have a supportive effect.