Cognitive and Somatic Symptoms of Depression Are Uniquely Related to HbA1c and Suicide Attempt History

Screening for depression and suicide risk is an essential part of care for adolescents and young adults (AYA) with type 1 diabetes (T1D), as increased depression symptoms and suicide attempt history are independently associated with elevated Hba1c. As symptoms of depression and prolonged hyperglycemia may coexist, further insight may be gained from an understanding of how somatic versus cognitive symptoms may uniquely relate to clinical outcomes in AYA with T1D. This study examined the independent relationships between HbA1c and suicide attempt history with cognitive and somatic symptoms on the Patient Health Questionnaire-9 Adolescent Version (PHQ-9) for AYA with T1D. The PHQ-9 was electronically administered (n = 2,491) at routine outpatient medical visits, and PHQ-9 scores, relevant background variables (age, sex, race, ethnicity, diabetes duration), and HbA1c values were obtained via chart review. AYA with T1D were 15.7 years old and had diabetes for 6.2 years, on average. After adjusting for covariates, somatic (B = .08, p <0.001), but not cognitive symptoms (B = .02, p = 0.3), predicted HbA1c levels. Follow up analyses showed this relationship varied by sex, with somatic symptoms and HbA1c related in females (B = .10, p = .002) but not males (B = .05, p = .14), and by race, with somatic symptoms and HbA1c related in those who identify as African American (B = .13, p = .009) but not White (B = .03, p = .32). Logistic regression analyses controlling for relevant background variables showed cognitive symptoms (B = .46, p < 0.001), but not somatic symptoms (B = .06, p = 0.39), were related to suicide attempt history. Findings demonstrate the value of independently monitoring cognitive and somatic symptoms of depression for AYA with T1D. Somatic symptoms are more strongly related to glycemic control, particularly for AYA with T1D who are female and identify as African American, respectively, whereas cognitive symptoms are significantly related to suicide attempt history. Disclosure J. M. Gettings: None. E. J. Pantesco: None. N. Andorko: None. S. M. Willi: Advisory Panel; Boehringer Ingelheim International GmbH, Medtronic.