Relationship of serious psychological distress to quality of life in adults with diabetes.
OBJECTIVE
To examine the association between serious psychological distress (SPD) and the Physical and Mental Health components of Quality of Life (QOL) while controlling for depression in a national sample of adults with diabetes.


METHODS
SPD was assessed in 1,659 adults with diabetes who participated in the 2007 Medical Care Expenditure Survey (MEPS). SPD was measured by the 6-item Kessler scale. Depression was assessed with the PHQ-2 screen. Quality of life was measured with the physical (PCS) and mental (MCS) components of the SF-12. We used multiple linear regression to assess the relationship between SPD and quality of life while controlling for relevant covariates and depression screen results to assess the independent effect of SPD on QOL above and beyond the effect of depression.


RESULTS
Among US adults with diabetes, 9% had SPD and 15.4% screened positive for depression. Among those with SPD, 85.8% had depression and among those with depression, 50.5% had SPD. In the adjusted model for socio-demographic factors and comorbidities, SPD was significantly associated with lower PCS scores (-5.51 95% CI -7.55; -3.45) and MCS scores (-18.99 95% CI -20.81; -17.18). In the adjusted model that also controlled for depression, SPD was still significantly associated with lower PCS scores (-3.03 95% CI -5.63; -0.43) and MCS scores (-9.46 95% CI -11.67; -7.24).


CONCLUSIONS
Among U. S. adults, SPD is associated with significantly diminished QOL above and beyond the effects of depression. Targeted interventions to mitigate the adverse effects of SPD are needed, independent of programs to address depression.
Ralph H. Johnson VA Medical Center, SC Medical University of South Carolina, Charleston, SC.
Clara E
CE
Dismuke
Medical University of South Carolina, Charleston, SC.
Melba A
MA
Hernandez-Tejada
Ralph H. Johnson VA Medical Center, SC Medical University of South Carolina, Charleston.
Leonard E
LE
Egede
D000328:Adult; D000368:Aged; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003710:Demography; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006306:Health Surveys; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D014481:United States / Q000453:epidemiology
SF-12; diabetes; quality of life; serious psychological distress