One in five patients with a mean age of 19 scored in the depressive range on the Center for Epidemiologic Studies Depression (CES-D) scale. In turn, depressive symptoms were associated with poorer adherence to treatment (F=3.56, P<0.05, R2 = 0.11). In both adolescents and adults with diabetes, patients who report symptoms of depression are known to have greater difficulty coping with their disease. "Emerging adults with type 1 diabetes struggle with consistent self-care, and greater understanding of factors influencing disease management in this age group is of significant importance as they assume independent responsibility for disease management." Monaghan M, et al "Depressive symptoms and self-care behaviors in emerging adults with type 1 diabetes" PES 2013; Abstract 1522.303.