Psychological distress and short-term disability in people with diabetes: results from the Canadian Community Health Survey.

OBJECTIVES Psychological distress may have different effects on short-term disability depending on individual disease severity, which can affect daily life activities. The objective of this study was to evaluate the interaction between psychological distress and activity limitations in daily life, in relation to self-reported disability days in a community sample of people with diabetes. METHODS The responses of 3082 adults with self-reported diabetes to the Canadian Community Health Survey Cycle 3.1 were analyzed. RESULTS Prevalence of disability days was higher in diabetic subjects with coexisting psychological distress and activity limitations (67%) than in individuals with either activity limitations in daily life (38%) or psychological distress (30%) alone. With no psychological distress and no activity limitations as reference and after adjusting for relevant covariates, the odds ratio of disability was 2.63 [95% confidence interval (95% CI)=1.60-4.33] for psychological distress, 5.57 (95% CI=3.86-8.05) for activity limitations, and 19.4 (95% CI=11.7-31.9) for activity limitations and comorbid psychological distress. CONCLUSIONS The results suggest that there is a joint effect of psychological distress and activity limitations on short-term disability. Detecting and managing psychological distress might be particularly beneficial for persons with diabetes.