ArticleClinical epidemiology2021
Psychological Distress and All-Cause, Cardiovascular Disease, Cancer Mortality Among Adults with and without Diabetes.
Article in Clinical epidemiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- The relationship between stigma and psychological distress among people with diabetes: a meta-analysis.BMC psychology · 2023Pooled it
- Symptom experience subtypes and their association with social isolation in older adults with diabetes and coronary heart disease: a latent profile analysis study.Frontiers in medicine · 2026Article
- Trajectory prediction model of diabetes distress in adults with type 2 diabetes mellitus: a 12-month prospective longitudinal study.Frontiers in psychology · 2026Article
- Article
- Network Analysis of Depressive Symptoms, Social Support, and Diabetes Distress Among Patients with Type 2 Diabetes: A Cross-Sectional Study.Patient preference and adherence · 2025Article
- Observational
- Cardiovascular mortality risk in patients with ovarian cancer: a population-based study.Journal of ovarian research · 2024Article
- Associations between depression and cancer risk among patients with diabetes mellitus: A population-based cohort study.Cancer medicine · 2023Article
- The Impact of Social Determinants of Health on Eye Care Utilization in a National Sample of People with Diabetes.Ophthalmology · 2023Article
- The multiple roles of life stress in metabolic disorders.Nature reviews. Endocrinology · 2023Review
- Cardiovascular Mortality Risk in Patients with Bladder Cancer: A Population-Based Study.Journal of cardiovascular development and disease · 2022Article
Corrections and comments
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Authors and funding
10 authors at 8 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimTo examine the association of psychological distress with all-cause, cardiovascular disease (CVD) and cancer mortality in US adults, and verified whether the associations differed between participants with and without diabetes.
methodsA total of 485,864 adults (446,288 without diabetes and 39,576 with diabetes) who participated in the National Health Interview Survey from 1997 to 2013 were linked to the National Death Index through December 31, 2015. Psychological distress was measured by the Kessler 6 distress scale (K6). Multivariable Cox proportional hazards regression models were performed to estimate hazard ratios (HR) and 95% confidence intervals (95% CI) for the association between psychological distress and mortality.
resultsWe ascertained 11,746 deaths (mean follow-up, 7. 7 years) among people with diabetes and 51,636 deaths (9.9 years) among those without diabetes. Psychological distress was associated with higher all-cause, CVD, and cancer mortality. Compared to non-diabetic adults without psychological distress, HRs (95% CI) were 1.07 (1.04 to 1.09) for mild, 1.26 (1.22 to 1.30) for moderate and 1.46 (1.38 to 1.55) for severe psychological distress. Compared to the same reference group, in diabetic participants the HRs were 1.39 (1.33 to 1.44) for no psychological distress, 1.59 (1.53 to 1.66) for mild, 1.90 (1.80 to 2.00) for moderate and 1.98 (1.82 to 2.17) for severe psychological distress. Similar associations were also observed for CVD and cancer mortality but with non-statistically significant interaction.
conclusionPsychological distress was associated with higher mortality, particularly in participants with diabetes. Strategies to ameliorate psychological distress may be important to reduce mortality in this population.
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