{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T17:18:33Z","timestamp":1788369513496,"version":"build-2803163510"},"reference-count":22,"publisher":"Bioscientifica","issue":"8","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":32,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine i) the prevalence of depressive symptoms and diabetes-related distress and ii) the association between their combined presence and metabolic outcomes in Latin American children with type 1 diabetes mellitus (T1DM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study included children with T1DM of &amp;gt; 1 year duration from 10 diabetes centers in Argentina and Chile. Age, sex, socioeconomic status (SES), and HbA1c were evaluated. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D; range: 0\u201360; depression: \u226516), and diabetes distress was assessed using the Problem Areas in Diabetes (PAID; range: 0\u201380; distress: \u226540). Spearman correlation, phi coefficient, and multivariable logistic regression were used for statistical analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 244 children (50% female), the median age was 13.4 years (IQR: 11.3\u201315.0) and the median HbA1c was 8.3% (IQR: 7.2\u20139.5). Depressive symptoms were present in 52% of participants, and diabetes distress was present in 26.6%. The agreement between CES-D and PAID categorical thresholds was fair (phi = 0.39). The Both-1 group (n = 55; 22.5%) (high CES-D and PAID) showed an inverse Spearman correlation with SES (r = \u22120.32, P &amp;lt; 0.01) and a positive correlation with HbA1c (r = 0.30, P &amp;lt; 0.01). In multivariable logistic regression, higher HbA1c levels (OR: 1.34; 95% CI: 1.1\u20131.6) and lower SES (OR: 0.36; 95% CI: 0.2\u20130.6) were independently associated with the Both-1 group (high CES-D and PAID), adjusted for age, sex, and BMI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In Latin American children with T1DM, the combined presence of depressive symptoms and diabetes-related distress was associated with poorer metabolic control and lower SES.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1530\/ec-26-0512","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T11:58:56Z","timestamp":1786708736000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-10","source":"Crossref","is-referenced-by-count":0,"title":["Depression and distress in pediatric type 1 diabetes: a Latin American multicenter study"],"prefix":"10.1530","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9533-9343","authenticated-orcid":true,"given":"Valeria","family":"Hirschler","sequence":"first","affiliation":[{"name":"Diabetes Argentine Society, Epidemiology 1 , ,","place":["Buenos Aires, Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio D","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"CEMIC, Pharmacology 2 , ,","place":["Buenos Aires, Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Benitez","sequence":"additional","affiliation":[{"name":"Hospital Pediatrico Juan Pablo Segundo 3 , ,","place":["Corrientes, Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Escalante Marassi","sequence":"additional","affiliation":[{"name":"Hospital Pediatrico Fernando Barreyro 4 , , ,","place":["Posadas, Misiones, Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Figueroa Sobrero","sequence":"additional","affiliation":[{"name":"Hospital San Roque 5 , , ,","place":["Parana, Entre Rios, Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernesto","family":"Bogado","sequence":"additional","affiliation":[{"name":"Hospital San Roque 5 , , ,","place":["Parana, Entre Rios, Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Roussos","sequence":"additional","affiliation":[{"name":"Hospital de ni\u00f1os Ricardo Gutierrez 6 , ,","place":["Buenos Aires, Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Gaete","sequence":"additional","affiliation":[{"name":"Hospital de ni\u00f1os Ricardo Gutierrez 6 , ,","place":["Buenos Aires, Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angeles","family":"Arrigo","sequence":"additional","affiliation":[{"name":"Hospital Prof. Ramon Exeni 7 , ,","place":["Buenos Aires, Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florencia","family":"Grabois","sequence":"additional","affiliation":[{"name":"Hospital Provincial Neuqu\u00e9n Dr Castro Rendon 8 , ,","place":["Neuqu\u00e9n, Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugenia","family":"Andres","sequence":"additional","affiliation":[{"name":"Hospital de Ni\u00f1os Pedro de Elizalde 9 , ,","place":["Buenos Aires, Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Laura","family":"Arzamendia","sequence":"additional","affiliation":[{"name":"Hospital de Ni\u00f1os Pedro de Elizalde 9 , ,","place":["Buenos Aires, Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Pablo","family":"Rojas Godoy","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico San Borja-Arriaran\/IDIMI 10 , ,","place":["Santiago de Chile, Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ethel","family":"Codner","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico San Borja-Arriaran\/IDIMI 10 , ,","place":["Santiago de Chile, Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciana","family":"Araujo","sequence":"additional","affiliation":[{"name":"Hospital Pediatrico Avelino Castelan 11 , , ,","place":["Resistencia, Chaco, Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis F","family":"Palacios Porta","sequence":"additional","affiliation":[{"name":"Hospital Nacional A.Posadas 12 , ,","place":["Buenos Aires, Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Molinari","sequence":"additional","affiliation":[{"name":"University of Buenos Aires, School of Pharmacy and Biochemistry, Mathematics 13 , ,","place":["Buenos Aires, Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel R","family":"Witte","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Aarhus, Aarhus University Hospital 14 , ,","place":["Aarhus, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"2026090213044276400_bib1","doi-asserted-by":"crossref","first-page":"1272","DOI":"10.1111\/dme.12860","article-title":"Cyclical relationship between depressive symptoms and diabetes distress in people with type 2 diabetes mellitus: results from the montreal evaluation of diabetes treatment cohort study","volume":"32","author":"Burns","year":"2015","journal-title":"Diabet Med"},{"key":"2026090213044276400_bib2","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/j.jpsychores.2014.06.015","article-title":"Relationships of diabetes-specific emotional distress, depression, anxiety, and overall well-being with HbA1c in adult persons with type 1 diabetes","volume":"77","author":"Strandberg","year":"2014","journal-title":"J Psychosom Res"},{"key":"2026090213044276400_bib3","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.diabres.2019.01.026","article-title":"PAID-11: a brief measure of diabetes distress validated in adults with type 1 diabetes","volume":"149","author":"Stanulewicz","year":"2019","journal-title":"Diabetes Res Clin Pract"},{"key":"2026090213044276400_bib4","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.2337\/dc09-2175","article-title":"The relationship between diabetes distress and clinical depression with glycemic control among patients with type 2 diabetes","volume":"33","author":"Fisher","year":"2010","journal-title":"Diabetes Care"},{"key":"2026090213044276400_bib5","doi-asserted-by":"crossref","first-page":"143","DOI":"10.2337\/diaspect.27.2.143","article-title":"Targeting diabetes distress: the missing piece of the successful type 1 diabetes management puzzle","volume":"27","author":"Pallayova","year":"2014","journal-title":"Diabetes Spectr"},{"key":"2026090213044276400_bib6","doi-asserted-by":"crossref","first-page":"542","DOI":"10.2337\/dc06-1614","article-title":"Clinical depression versus distress among patients with type 2 diabetes: not just a question of semantics","volume":"30","author":"Fisher","year":"2007","journal-title":"Diabetes Care"},{"key":"2026090213044276400_bib7","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1111\/j.1464-5491.2006.01881.x","article-title":"A randomized trial of adding insulin glargine vs avoidance of insulin in people with type 2 diabetes on either no oral glucose-lowering agents or submaximal doses of metformin and\/or sulphonylureas. The Canadian INSIGHT (implementing new strategies with insulin glargine for hyperglycaemia treatment) study","volume":"23","author":"Gerstein","year":"2006","journal-title":"Diabet Med"},{"key":"2026090213044276400_bib8","doi-asserted-by":"crossref","DOI":"10.1136\/bmjdrc-2023-003607","article-title":"Parental diabetes distress is a stronger predictor of child HbA1c than diabetes device use in school-age children with type 1 diabetes","volume":"11","author":"Patton","year":"2023","journal-title":"BMJ Open Diabetes Res Care"},{"key":"2026090213044276400_bib9","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1176\/ajp.143.8.1024","article-title":"Assessment of depression in childhood and adolescence: an evaluation of the center for epidemiological studies depression scale for children (CES-DC)","volume":"143","author":"Faulstich","year":"1986","journal-title":"Am J Psychiatry"},{"key":"2026090213044276400_bib10","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1177\/014662167700100306","article-title":"The CES-D Scale: A self-report depression scale for research in the general population","volume":"1","author":"Radloff","year":"1977","journal-title":"Appl Psychol Meas"},{"key":"2026090213044276400_bib11","doi-asserted-by":"crossref","first-page":"754","DOI":"10.2337\/diacare.18.6.754","article-title":"Assessment of diabetes-related distress","volume":"18","author":"Polonsky","year":"1995","journal-title":"Diabetes Care"},{"key":"2026090213044276400_bib12","doi-asserted-by":"crossref","first-page":"523","DOI":"10.3390\/jcm14020523","article-title":"Spanish validation of the problem area in diabetes-pediatric version survey and its weak association with metabolic control parameters in pediatric diabetes: a cross-sectional multicenter study","volume":"14","author":"Civitani","year":"2025","journal-title":"J Clin Med"},{"key":"2026090213044276400_bib13","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1093\/jpepsy\/jsp063","article-title":"Anxiety symptoms in adolescents with type 1 diabetes: association with blood glucose monitoring and glycemic control","volume":"35","author":"Herzer","year":"2010","journal-title":"J Pediatr Psychol"},{"key":"2026090213044276400_bib14","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1037\/hea0000219","article-title":"Depressive symptoms, daily stress, and adherence in late adolescents with type 1 diabetes","volume":"34","author":"Baucom","year":"2015","journal-title":"Health Psychol"},{"key":"2026090213044276400_bib15","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1111\/dme.12861","article-title":"Longitudinal relationship of diabetes-related distress and depressive symptoms: analysing incidence and persistence","volume":"32","author":"Ehrmann","year":"2015","journal-title":"Diabet Med"},{"key":"2026090213044276400_bib16","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1111\/j.1464-5491.2011.03401.x","article-title":"Screening tools used for measuring depression among people with type 1 and type 2 diabetes: a systematic review","volume":"29","author":"Roy","year":"2012","journal-title":"Diabet Med"},{"key":"2026090213044276400_bib17","doi-asserted-by":"crossref","first-page":"S7","DOI":"10.2337\/dc18-S001","article-title":"Improving Care and Promoting Health in Populations: Standards of Medical Care in Diabetes-2018","volume":"41","author":"American Diabetes Association","year":"2018","journal-title":"Diabetes Care"},{"key":"2026090213044276400_bib18","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1111\/j.1464-5491.2009.02896.x","article-title":"Does diabetes-related distress explain the presence of depressive symptoms and\/or poor self-care in individuals with type 1 diabetes?","volume":"27","author":"Lloyd","year":"2010","journal-title":"Diabet Med"},{"key":"2026090213044276400_bib19","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1037\/hea0000645","article-title":"Depressive symptoms and diabetes management from late adolescence to emerging adulthood","volume":"37","author":"Baucom","year":"2018","journal-title":"Health Psychol"},{"key":"2026090213044276400_bib20","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s11892-020-01301-3","article-title":"How do the challenges of emerging adulthood inform our understanding of diabetes distress? An integrative review","volume":"20","author":"Wentzell","year":"2020","journal-title":"Curr Diab Rep"},{"key":"2026090213044276400_bib21","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0181218","article-title":"Reduction of diabetes-related distress predicts improved depressive symptoms: a secondary analysis of the DIAMOS study","volume":"12","author":"Reimer","year":"2017","journal-title":"PLoS One"},{"key":"2026090213044276400_bib22","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1016\/j.jdiacomp.2016.04.023","article-title":"Diabetes distress from the patient\u2019s perspective: qualitative themes and treatment regimen differences among adults with type 2 diabetes","volume":"30","author":"Tanenbaum","year":"2016","journal-title":"J Diabetes Complications"}],"container-title":["Endocrine Connections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.bioscientifica.com\/ec\/article-pdf\/doi\/10.1530\/EC-26-0512\/524871\/ec-26-0512.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/journals.bioscientifica.com\/ec\/article-pdf\/doi\/10.1530\/EC-26-0512\/524871\/ec-26-0512.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T17:04:49Z","timestamp":1788368689000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.bioscientifica.com\/ec\/article\/15\/8\/e260512\/78000\/Depression-and-distress-in-pediatric-type-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,1]]},"references-count":22,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8,1]]}},"URL":"https:\/\/doi.org\/10.1530\/ec-26-0512","relation":{},"ISSN":["2049-3614"],"issn-type":[{"value":"2049-3614","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,1]]},"article-number":"e260512"}}