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Is Psychological Distress a Risk Factor for the Incidence of Diabetes Among American Indians? The Strong Heart Study

University of South Dakota

Jack Goldberg

University of Washington

Clemma Jacobsen

University of Washington

Thomas K. Welty

Aberdeen Area Tribal Chairmen’s Health Board

This study was conducted to determine if psychological distress increases the risk of type2 diabetes in American Indians. A prospective cohort study of 919 individuals free of diabetes from 13 Native communities was conducted to determine who developed diabetes. Psychological distress was assessed at baseline (1993-1995) by the Mental Component Summary (MCS) of the Short Form-36. The risk of diabetes was estimated at follow-up (1997-1999) according to quartiles of the MCS score. There was no evidence of a trend between psychological distress and the development of diabetes (ptrend = .73). The risk of diabetes in individuals in the highest quartile (17.5%) was nearly identical to that in the lowest quartile (16.5%) (odds ratio = 1.1, 95% confidence interval 0.7-1.7). The absence of association persisted even after adjustment for known risk factors for diabetes. Thus the study concludes that psychological distress is not related to the incidence of diabetes in American Indians.

Key Words: type 2 diabetes • psychological distress • American Indians • Native Americans

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