SLR - March 2020 - Nicholas L. Varakin
Reference: Robinson ME, Simard M, Larocque I, Shah J, Nakhla M, Rahme E. Risk of Psychiatric Disorders and Suicide Attempts in Emerging Adults With Diabetes. Diabetes Care 2020; 43:484–486.Scientific Literature Review
Reviewed By: Nicholas L. Varakin, DPM
Residency Program: Temple University Hospital – Philadelphia, PA
Podiatric Relevance: All diabetics should see a podiatrist at least once a year for evaluation and care. It is easy to be lower extremity problem focused on exam, but as important as it is to take care of the feet, it is equally important to recognize red flags of other systemic issues; including mental health. Psychiatric disorders and mental health issues may represent an overlooked portion of a patient’s overall well-being, especially with newly diagnosed and younger populations. While these issues may be out of our scope of practice, it is critical that we be able to recognize that a problem may exist and refer them to the appropriate specialist.
Methods: This is a retrospective cohort study out of Quebec which included 3,544 individuals with Diabetes and 1,388,397 without Diabetes. The study was performed using linked health administrative databases. They looked at patients between the ages of 1-15 who were diagnosed with Diabetes and those who were not. Then they looked at the risk of psychiatric disorders in these individuals when they were between the age of 15-25. The study looks at adolescents and emerging adults specifically. The outcomes examined were mood disorders, hospitalization for a suicide attempt, death by suicide, and visits to a psychiatrist. Those with a diagnosis of ADHD were excluded.
Results: Individuals with Diabetes were more likely to have mood disorders diagnosed in the ED or Hospital (adjusted hazard ratio of 1.33), attempt suicide (3.25), visit a psychiatrist (1.82), or have any psychiatric disorders (1.29). There was no difference in mood disorder diagnosis in the outpatient setting.
Conclusions: This study focused on adolescents and emerging adults who have been diagnosed with diabetes. The results demonstrate that this age cohort with diabetes may be at increased risk of having mental health problems. Interestingly, there was no difference in mood disorder diagnosis in the outpatient setting. This could represent the fact that mental health may be overlooked unless the patient is in a more acute scenario and that as healthcare providers, we could be more diligent in identifying those at risk in our outpatient clinics and making the appropriate referrals to improve the patient’s overall well-being.