Behavioural and Emotional Problems in Malaysian Children and Adolescents with Type 1 Diabetes Mellitus: A Cross-sectional Study in a Single Centre

Abstract

Introduction. Type 1 diabetes mellitus (T1DM) is an autoimmune disorder that requires a lifelong treatment regimen which may affect psychosocial development. Objective. To identify behavioural and emotional problems in children and adolescents with T1DM. Methodology. A cross-sectional study using the Child Behaviour Check List (CBCL) was conducted among all T1DM patients receiving treatment at the Paediatric Endocrine Unit, Hospital Tunku Azizah Kuala Lumpur, Malaysia. Results. Forty T1DM patients were included. The mean age of the participants was 12.4 years (SD=2.69), with 52.5% males, and 75% Malay. The average duration of illness was 4.8 years, 9 were pre-pubertal, while mean HbA1c was 9.4%. Thirty-five percent of the respondents had parent-reported internalizing problems and 17.5% had parent-reported externalizing problems. Those >12 years old had more internalizing problems (p=0.004) compared to those ≤12 years old. The differences were in the anxious/depressed syndrome subscale (p=0.001) and withdrawn/depressed syndrome subscale (p=0.015). There were no statistically significant differences in the 3 main global scores by gender, glycaemic control, duration of illness and pubertal status by univariate analysis. Conclusion. T1DM patients >12 years old were at higher risk of developing psychosocial difficulties. This highlighted the benefit of screening of behavioural and emotional issues in children and adolescents with T1DM.

Keywords

• Type 1 Diabetes Mellitus, psychosocial, Child Behaviour Check List, CBCL