Figure 4. Psychological Stress Scores and Diagnosis of Presymptomatic Type 1 Diabetes in a Study of the Yield of a Public Health Screening of Children for Islet Autoantibodies in Bavaria, Germany.

Violin plots of Patient Health Questionnaire 9 (PHQ-9) depression scores of mothers and fathers of children with presymptomatic type 1 diabetes. Scores were assessed at the metabolic staging visit and at 6 and 12 months after diagnosis. Scores for children in the control cohort and children with symptomatic type 1 diabetes enrolled in the DiMelli study¹⁴ are also shown. Scores range from 0 to 27 and were interpreted as no to minimal depression if less than or equal to 4 and as severe depression if greater than 20. The violin plots display the density of PHQ-9 scores. The box plots display the median and interquartile range and extend to the upper and lower adjacent values.