OBJECTIVE To estimate the association and familial coaggregation of childhood-onset type 1 diabetes with depression, anxiety, and stress-related disorders. RESEARCH DESIGN AND METHODS This was a population-based cohort study with use of data from Swedish nationwide registers. A total of ∼3.5 million individuals born in Sweden 1973–2007 were linked to their biological parents, full siblings and half-siblings, and cousins. Cox models were used to estimate the association and familial coaggregation of type 1 diabetes with depression, anxiety, and stress-related disorders. RESULTS Individuals diagnosed with childhood-onset type 1 diabetes (n = 20,005) were found to be at greater risks of all outcomes: any psychiatric diagnosis (adjusted hazard ratio [aHR] 1.66 [95% CI 1.59–1.72]) or specific diagnoses of depression (1.85 [1.76–1.94]), anxiety (1.41[1.33–1.50]), and stress-related disorders (1.75 [1.62–1.89]), as well as use of antidepressants or anxiolytics (1.30 [1.26–1.34]), compared with individuals without type 1 diabetes. Overall, relatives of individuals with type 1 diabetes were at elevated risks of developing these outcomes, with the highest risks seen in parents (aHRs 1.18–1.25), followed by full siblings (aHRs 1.05–1.20), and the magnitudes of risk estimates appear proportional to familial relatedness. CONCLUSIONS These results support existing evidence that children and adolescents with type 1 diabetes are at greater risks of developing depression, anxiety, and stress-related disorders and indicate that shared familial factors might contribute to these elevated risks. Our findings highlight the need for psychological consulting for children and their families in diabetes care. Quantitative and molecular genetic studies are warranted to further understand the etiology of these psychiatric disorders in type 1 diabetes.

中文翻译：

---

儿童期 1 型糖尿病与抑郁、焦虑和压力相关疾病的关联和家族聚集：基于人群的队列研究

目的 评估儿童期发病 1 型糖尿病与抑郁、焦虑和压力相关疾病的关联和家族聚集性。研究设计和方法 这是一项基于人群的队列研究，使用来自瑞典全国登记处的数据。1973-2007 年在瑞典出生的总共有 350 万人与他们的亲生父母、同胞兄弟姐妹和同父异母兄弟姐妹以及堂兄弟有联系。Cox 模型用于估计 1 型糖尿病与抑郁、焦虑和压力相关疾病的关联和家族聚集性。结果发现被诊断患有儿童期发病的 1 型糖尿病（n = 20,005）的个体在所有结局方面的风险更大：任何精神病诊断（调整后的风险比 [aHR] 1.66 [95% CI 1.59–1.72]）或抑郁症（1.85 [1.76–1.94]），焦虑症（1.41[1. 33–1.50]）和压力相关疾病（1.75 [1.62–1.89]），以及使用抗抑郁药或抗焦虑药（1.30 [1.26–1.34]），与没有 1 型糖尿病的个体相比。总体而言，1 型糖尿病患者的亲属发生这些结果的风险较高，父母的风险最高（aHRs 1.18-1.25），其次是同胞兄弟姐妹（aHRs 1.05-1.20），风险估计的大小出现了与家庭关系成正比。结论 这些结果支持现有证据，即患有 1 型糖尿病的儿童和青少年患抑郁症、焦虑症和压力相关疾病的风险更大，并表明共同的家庭因素可能导致这些风险升高。我们的研究结果强调了在糖尿病护理中为儿童及其家人提供心理咨询的必要性。