Date of Award

Spring 5-15-2020

Document Type

Independent Study

Degree Name

Master of Science (MS)

Department

Nursing

Program Affiliation

Psychiatric-Mental Health Nurse Practitioner (PMHN)

First Advisor

Desiree Gagner-Tjellesen, MS, PMHCNS-BC

Abstract

Adverse mental health outcomes comprise the leading complication of type 1 diabetes(TID)in children and adolescents(Cameron & Northam, 2012). Comorbid mental health conditions lead to decreased adherence, worsening glycemic control, increased family conflict, poor self-image, and decreased quality of life(QOL). Evidence shows20-50% of youth with TID sought mental healthcare over a five year period yet less than 4% received any form of care during that time(Cameron & Northam, 2012; Jaser, 2010). This literature review was based on review of a case involvinga10 year old male “Benji” whose mother brought him to clinic requesting a second opinion after seeking mental healthcare for “Benji” for five years without benefit. Historical diagnoses included oppositional defiant disorder(ODD), attention deficit hyperactivity disorder (ADHD), and reactive attachment disorder(RAD); medical history was significant for diagnosisofTIDatage4. Per report, previous providers avoided or limited medications secondary to concerns regarding TID. After careful evaluation and review of collateral information, Benji received diagnoses of social anxiety disorder, ADHD and post traumatic stress disorder(PTSD). It was also determined that Benji’s disruptive behavior occurred secondary to unrecognized hypoglycemic events at school. This literature review addresses four objectives. First, document the prevalence of psychosocial dysfunction in youth with TID. Second, review current recommendations for the mental healthcare of this population. Third, present results from studies of screening, prevention, and intervention measures. Fourth, establish the need for integrated mental healthcare in routine TID care centers. Findings indicated that research on comorbid mental health in youth with TID remains scarce. Despite recommendations for routine screening and intervention, children and adolescents continue to encounter barriers to care, experience negative diabetes outcomes, psychosocial dysfunction, and decreased QOL. Research is needed to establish efficacy of integrated, routine mental health and diabetes specific care for youth with TID.

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