Somatic items in the assessment of depressive symptoms in pediatric patients with diabetes

Depression inventories contain somatic items which may be related to disease rather than to depression in individuals with chronic illness. Adolescents with type 1 diabetes (n = 151) and medically well controls (n = 68) completed the Center for Epidemiological Studies-Depression Scale (CES-D) which includes somatic and cognitive/affective symptoms. Diabetes patients reported higher levels of all depressive symptoms than controls; the discrepancy was equivalent for somatic and cognitive/affective symptoms. For diabetes patients, somatic and cognitive/affective symptoms did not correlate with indices of disease control except for number of diabetes-related hospitalizations, where the correlations were equivalent. In participants with diabetes and in controls, somatic and cognitive/affective symptoms were strongly correlated with each other. These findings were not moderated by level of depressive symptoms. Our study suggests that the somatic items on the CES-D do not confound the measurement of depressive symptoms in young people with type 1 diabetes.