title: Association between diagnosed diabetes and serious psychological distress among U.S. adults: the Behavioral Risk Factor Surveillance System, 2007.
abstract: OBJECTIVE
  To estimate the prevalence of serious psychological distress (SPD) according to diabetes status and to assess the association of diabetes-related risks and conditions with SPD among U.S. adults.
  
  
  METHODS
  We analyzed data from the Behavioral Risk Factor Surveillance System, 2007. SPD was determined by a score of > or = 13 on the Kessler-6 scale. We used log-binomial regression analysis to estimate prevalence ratios (PRs) and 95 % confidence intervals (CIs).
  
  
  RESULTS
  We estimated the prevalence of SPD to be 7.6 % and 3.6 % among U.S. adults with and without diagnosed diabetes (unadjusted PR: 2.09; 95 % CI: 1.87, 2.34). The association of diagnosed diabetes with SPD was attenuated after adjustments for potential confounding effects of cardiovascular risk factors and cardiovascular comorbid conditions (adjusted PR, 1.12; 95 % CI: 0.99, 1.27). Significant correlates of SPD among persons with diagnosed diabetes were young age, low education levels, low household income, obesity, current smoking, no leisure-time physical activity, presence of one or more micro- or macro-vascular complications, and disability.
  
  
  CONCLUSIONS
  The crude prevalence of SPD among adults with diagnosed diabetes was twice as high as that among those without diabetes. The increased prevalence of SPD may be accounted for by the excessive rates of cardiovascular risks and comorbid conditions among people with diagnosed diabetes.
authors.affiliation: Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway N.E., Atlanta, GA 30341, USA. cli@cdc.gov
authors.forename: Chaoyang
authors.initials: C
authors.lastname: Li
authors.forename: Earl S
authors.initials: ES
authors.lastname: Ford
authors.forename: Guixiang
authors.initials: G
authors.lastname: Zhao
authors.forename: Tara W
authors.initials: TW
authors.lastname: Strine
authors.forename: Satvinder
authors.initials: S
authors.lastname: Dhingra
authors.forename: Lawrence
authors.initials: L
authors.lastname: Barker
authors.forename: Joyce T
authors.initials: JT
authors.lastname: Berry
authors.forename: Ali H
authors.initials: AH
authors.lastname: Mokdad
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D040343:Behavioral Risk Factor Surveillance System; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology; D014481:United States / Q000453:epidemiology; D055815:Young Adult