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Examination of the Illness Representations among Children with T1DM in Relation to Mental Health Factors


 Background: This study aimed to investigate the association of the mental health and diabetes-specific variables with the illness representations in children with type 1 diabetes mellitus (T1DM).Methods: A total of 115 children with T1DM were recruited through the outpatient clinic in Debrecen, Hungary. Our measures were The Pictorial Representation of Illness and Self Measure Drawing Test (PRISM-D), Child Depression Inventory (CDI), Cantril Self-Anchoring Striving Scale, and Self-Rated Health (SRH). Glycosylated haemoglobin (HbAlc) values were obtained from medical reports. Results: We found significant mild correlations amongst the mental health factors. Those children who can be characterized with clinical depressive symptoms drew significantly fewer (r = - 0.253; p < 0.05) circles with significantly less area (r = - 0.253; p < 0.05) at the PRISM-D test. Furthermore, those children who did not draw any important relationships possessed significantly more depressive symptoms than those who drew at least one important person. Those children who were diagnosed at a younger age, reported significantly better health condition (r = 0.215; p= 0.024), and displayed smaller distance (r = -0.261; p= 0.006) between the Self-circle and the Illness-circle. Conclusions: The PRISM-D test provides a more complex picture of the subjective effect of the disease, and thus appears a promising additional tool to analyse the emotional and cognitive representations and the psychological burden of T1DM. Beside the medical treatment of the T1DM-children, the earliest screening and psychological interventions for mental health problems are of high priority.