ESPE Yearbook of Paediatric Endocrinology

Pediatr Diabetes. 2025 Jun 2;2025:6662248. doi: 10.1155/pedi/6662248

Brief summary: This prospective study assessed suicide risk screening in pediatric patients with diabetes by administering the Patient Health Questionnaire-(9 PHQ-9) and Ask Suicide-Screening Questions (ASQ) surveys during routine visits at a tertiary pediatric diabetes center.

The aim of this study was to determine the prevalence of suicide risk among adolescents with type 1 (T1D) and type 2 diabetes (T2D) and to evaluate the diagnostic accuracy of 2 screening tools: the PHQ-9), which includes 8 items on depressive symptoms and 1 item on suicide risk, and the ASQ, a brief 4-item yes/no questionnaire.

309 adolescents were included, 237 with T1D (mean age 14.8 years) and 72 with T2D, (mean age 16.1 years). Among those with T2D, 23.6% had a diagnosis of ADHD, 27.8% had depression, 33.3% were under the care of a regular behavioral health provider, 41.2% were prescribed psychotropic medications, and 48.6% had a family history of mental health disorders. Overall, 50% of adolescents with T2D reported depressive symptoms.

Compared to adolescents with T1D, those with T2D had nearly twice the rate of documented mental health diagnoses (45.8% vs. 25.3%) and PHQ-9–screened depression (50% vs. 27.8%), as well as more than double the rate of suicide risk identified by the ASQ (19.4% vs. 8.4%). Suicide risk was approximately twofold higher in adolescents with T2D than in those with T1D, based on both PHQ-9 Item 9 (12.5% vs. 5.9%) and the ASQ (19.4% vs. 8.4%).

Key Message: Adolescents with T2D exhibit high rates of depression and suicidal ideation. Relying solely on PHQ-9 Item 9 is insufficient for detecting suicide risk; using a dedicated screening tool like the ASQ is recommended for accurate identification of at-risk youth.